HYPEREMESIS GRAVIDARUM AND ECTOPIC PREGNANCY

Question 1

excessive nausea and
vomiting during
pregnancy

Answer 1

hyperemesis gravidarum

Question 2

causes of hyperemesis g.

Answer 2

• high hcg
• hyperthyroidism
• hypofunction of anterior pituitary and adrenal cortex
• abnormal corpus luteum
• h. pylori infection
• psychologic factors

Question 3

true or false - high estrogen and progesterone = ptyalism = hyperemesis gravidarum

Answer 3

true

Question 4

true or false - in hyperemesis g. the gastric motility is hightened

Answer 4

false - lower gastric motility

Question 5

___ > F&E imbalance > hypovolemia, hypotension, tachycardian, high hct and bun, low uo > ___

Answer 5

dehydration; metabolic acidosis

Question 6

metabolic acidosis efects:

Answer 6

• disruption of cardiac function
• fetal death
• muscle wasting
• vitamin deficiencies

Question 7

electrolytes that are low during hyperemesis g.

Answer 7

Na, K, Cl

Question 8

true or false - there is weakening of peripheral nerves during hyperemesis g.

Answer 8

true

Question 9

nursing diagnosis for hyperemesis g.

Answer 9

imbalanced nutrition, risk for deficient fluid volume, fear, ineffective coping

Question 10

calories per day for client with hyperemesis g.

Answer 10

2500 calories

Question 11

true or false - in feeding a client with hyperemesis g, serve large portions of food presented
attractively

Answer 11

false - small portions

Question 12

true or false - put basin out of sight

Answer 12

true

Question 13

how to control vomiting

Answer 13

• antiemetics (metoclopramide)
• NPO

Question 14

how to correct DHN

Answer 14

• IV - ringer’s solution
• measure I and O, and amount of vomitus

Question 15

how to restore electrolyte balance

Answer 15

add potassium chloride to IV infusion

Question 16

what is given to maintain adequate nutrition in clients with hyperemesis g.

Answer 16

• thiamine - B1
• pyridoxine - B6

Question 17

diet plan for hyperemesis g.

Answer 17

clear liquid > dry toast, cracker every 2-3 hours > soft diet > normal diet

Question 18

• implantation of fertilized ovum in a site other
  than the endometrial lining of the uterus
• may occur on the surface of the ovary or in the
  cervix

Answer 18

ectopic pregnancy

Question 19

most common site of ectopic p.

Answer 19

fallopian tube - distal 3rd

Question 20

ectopic implantation:

• ___% occur in the ampulla
• ___% occur in the isthmus
• ___% occur in the fimbriae

Answer 20

• 80
• 12
• 8

Question 21

true or false - ectopic p. is second most frequent cause of bleeding in early pregnancy

Answer 21

true

Question 22

causative factors of ectopic p.

Answer 22

• tubal damage – PID
• previous tubal surgery
• congenital anomalies of the tube
• Endometriosis
• previous ectopic pregnancy
• presence of an IUD
• exposure to diethylstilbestrol (DES)

Question 23

true or false - ectopic p. occurs more frequently in women who smoke, with IUD, or
following in vitro fertilization

Answer 23

true

Question 24

clinical manifestations of ectopic pregnancy

Answer 24

• missed period
• abd pain
• vaginal spotting

Question 25

assessment for ectopic pregnancy

Answer 25

sharp stabbing pain in one of the lower quadrants + scant vaginal spotting

Question 26

if internal bleeding progresses to acute hemorrhage, what may happen?

Answer 26

- lightheadedness - rapid pulse - shock

Question 27

A ___ will demonstrate the ruptured tube and blood collecting in the peritoneum

Answer 27

transvaginal sonogram

Question 28

Either a falling ___ or ___ level suggests that the pregnancy has ended

Answer 28

Hcg / serum progesterone

Question 29

A ___ or ___ can be used to visualize the fallopian tube

Answer 29

laparoscopy or culdoscopy

Question 30

if the ectopic pregnancy is not terminated:

Answer 30

- rigid abd - cullen's sign - extensive or dull vaginal or abd pain - shoulder pain - mass is palpable in douglas' cul-de-sac

Question 31

* If the woman is receiving treatment using methotrexate, the nurse advises the woman to avoid ___.

Answer 31

sun exposure

Question 32

Stress the need to return for follow-up ___ testing

Answer 32

B-Hcg

Question 33

If an ectopic pregnancy can be diagnosed by a sonogram before the tube has ruptured, it can be treated medically by the oral administration of ___followed by ____.

Answer 33

methotrexate, leucovorin

Question 34

A ___ is performed after the chemotherapy to assess whether the tube is fully patent

Answer 34

hysterosalpingogram or sonogram

Question 35

what is given for sloughing of the tubal implantation site

Answer 35

mifepristone

Question 36

true or false - As with miscarriage, women with Rh-negative blood should receive Rh (D) immune globulin (RhIG) after an ectopic pregnancy for isoimmunization protection in future childbearing.

Answer 36

true

Question 37

The therapy for a ruptured ectopic pregnancy is ___ to ligate the bleeding vessels and to remove or repair the damaged fallopian tube.

Answer 37

laparoscopy