High Risk Pregnancy Flashcards
Preterm Labor
What is preterm labor
Labor between 20 to 36 6/7 days of weeks
Preterm Labor
What are signs and symptoms of preterm labor
- > 6 uterine contaction in an hr
- cramping
- pressure
- backache
- pink tinged discharge
Preterm Labor
What are risk factors of preterm labor
- prior hx of incompetent cervix/preterm delivery
- extreme age
- infections
- multiple preganancy
- abdominal trauma
*>3 elective abortion - stress
- poor lifestyle choices
Preterm Labor
Daignosis of Pretern labor
- cervical length
- fetal fibroncetin
- cervical exam
- external fetal monitor
Preterm Labor
What are managements of preterm labor
- IV hydration
- bedrest
- tocolysis: magnesium sulfat, terbulaine, nifedipine
- improve neonatal outcomes: magnesium sulfate, betamethasone
Preterm Labor
What is PROM (preterm rupture of membrane)
rupture of amniotic sac prior to 37 wks
Preterm Labor
What are signs and symptoms of PROM
leaking fluid of vagina
oligohydramnios=low amniotic fluid
Preterm Labor
What is the management for PROM
bedrest
assess uterine activity and cord prolapse
administer agents
Hypertensive Disorder
What are types of hypertensive disorders
gestational hypertension
preeclampsia
Hypertensive Disorder
What are characterisitcs of gestational hypertension
- after 20wks
- increased bo
- treated: labetolo, nifedipine, nethldopa
Hypertensive Disorder
What are characteristics of preeclampsia
- after 20 wks
- mutliple organ systems involved
Hypertensive Disorder
What are preeclampsia risk factors
- pre-gestational htn or diabetes
- obesity
- extreme age
- 1st pregnancy
- multiple gestation
- hx of preeclampsia
Hypertensive Disorder
Risk factor for the mother in preeclampsia
HELLP syndrome
Renal failure
placental abruption
pulmonary edema
eclampsia
stoke
death
Hypertensive Disorder
Risk factor for the baby in preeclampsia
premature
intrauterine growth restriction
oligohydramnios
death placental abruption
Hypertensive Disorder
What is the assessment of women with preeclampsia
- bp measurment accuracy
- munual for unexpected findings
- urine: protein/platelt/liver enzyme
- headache/blurred vision
- edema
- deep tendon reflex
Hypertensive Disorder
what are some prevention of preeclampsia
control of htn and obsesity
low dose aspirin
Hypertensive Disorder
What are nursing interventions of preeclampsia
- monitor s/s
- decrease environmental stimuli
- fetal monitoring
- labs monitor: platlet, AST, ALT, LDH creatine
- magneisum sulfate
Hypertensive Disorder
What is the role of Magnesium Sulfate
- decrease risk of exlampsia (seizure)
- normal 1.5 to 2.5
- therapeutic 4 to 7
- can lead to repsiratory depression, edema, renal failure, coma
antidote calcium gluconate
Diabetes
What are two types of diabetes in pregnancy
Pre-gestational & gestational
Diabetes
What are Pregestational Diabetes
- Type 1 & 2
- care prior to pregnancy
- A1C>7 reduced birth defect
- insulin adjustement
Diabetes
What are Gestational Diabetes
- Preganancy-related
- 1hr oral glucose tolerance test (24 to 26 wks)
Diabetes
What is the oral glucose tolerance test
24 to 26 wks
positive in hr = need 3 hr test
treatment :diet, insulin, glucose monitor, surveillance of fetal health
Diabetes
What risk does diabetes pose to the fetal
- marosomia
- birth injuries
- preterm birth
- pregestational
Diabetes
What risk do diabetes pose on mom
- preterm labor
- increased risk for preeclampsia
- increased risk for UTI
- pregeastational
Diabetes
What is the management of Gestational Diabetes
- adherence key
- Diet: carbs throughout day
- Insulin: combo short/long acting
- fingerstick bg
Hemorrhagic disorder
What are the Hemorrhagic disorder types
Placenta Previa
Placental Abruption
Hemorrhagic disorder
What is Placenta Previa
- partially or completely covering the cervix
- impplants to low
Hemorrhagic disorder
Characteristics of Placenta Previa
- routine US
- painless/bright red bleeding in large amounts
- C-section only safe mode
- painless bright red
- large amounts
Hemorrhagic disorder
What is care for placenta previa
- NO VAGINAL EXAMS
- maintain IV acess
- vitals every 4hrs
- magnesium sulfate, betamethasone
Hemorrhagic disorder
What is the Placenta Abruption
- placenta seperate from uterine wall before delivery baby
Hemorrhagic disorder
What are characteristics of Placental abruption
- abdominal trauma
- dark red
- smaller amount
- moderate-severe pain
- ultrasound unreliable
Hemorrhagic disorder
What are classifications of the placental abruption
Grade 1
Grade 2
Grade 3
Hemorrhagic disorder
What is Placenta abruption: Grade 1
- mild seperation
- Vital signs, FHR stable
Hemorrhagic disorder
What is PLacenta abruption: Grade 2
- Partial seperation
- Elevated maternal heart rate
- BP stable
- low fibronogen levels
Hemorrhagic disorder
What is Placenta abruption: Grade 3
- fetal death common
- hypertonic contraction
- maternal shoc
- death
Hemorrhagic disorder
What is the management f placental abruption
- Large bore IV
- baseline health history, clotting factor
- c-section
Hemorrhagic disorder
What are similarities between both Hemorrhagic disorder
- cause vaginal bleeding
- cause massive hemorrhage
- cause death of mother/fetus
Hemorrhagic disorder
What is Rh Factor Incompatibility
pregnancy complication that occurs when a pregnant woman has Rh-negative blood and her fetus has Rh-positive blood
Infectious disease
What is TORCH infection
T=toxoplasmosis
O=other infections
R=rubella
C= cytomegalovirus
H=herpes simplex virus
Infectious disease
What is Toxoplasmosis
- intellectual disability
- found in cat ltter, raw meath, goat milk
- protozoal infection
Infectious disease
What is Rubella in preganancy
- symptoms: mild, rash, aches, swollen glads
- deaf, blind, intellectal disability, heart defect in baby
- newborn needs isolation
- MMR is live needs to be given after or before pregnancy
Infectious disease
What is the cytomegalovirus
- development delay, hearing loss, visual impairment, dental problems
- prevention handwash, avoid saliva contact
Infectious disease
What is the Herpes Simplex Virus
- S/S: painful lesons, congenital infection: fever, juandice, seziure, poor feeding
- Fetal risk: miscarriage, low birth weight, preterm
Infectious disease
What is Hyperemesis Gradidarum
- excessive vomiting
- interference with nutrition
- imbalance of fluid/electrolyte
Infectious disease
What is Hyperemesis Gravidarum’s Management
- replace fluids
- NPO
- Measure I&O
- emotional support
