HYPEREMESIS GRAVIDARUM AND ECTOPIC PREGNANCY Flashcards
excessive nausea and
vomiting during
pregnancy
hyperemesis gravidarum
causes of hyperemesis g.
- high hcg
- hyperthyroidism
- hypofunction of anterior pituitary and adrenal cortex
- abnormal corpus luteum
- h. pylori infection
- psychologic factors
true or false - high estrogen and progesterone = ptyalism = hyperemesis gravidarum
true
true or false - in hyperemesis g. the gastric motility is hightened
false - lower gastric motility
___ > F&E imbalance > hypovolemia, hypotension, tachycardian, high hct and bun, low uo > ___
dehydration; metabolic acidosis
metabolic acidosis efects:
- disruption of cardiac function
- fetal death
- muscle wasting
- vitamin deficiencies
electrolytes that are low during hyperemesis g.
Na, K, Cl
true or false - there is weakening of peripheral nerves during hyperemesis g.
true
nursing diagnosis for hyperemesis g.
imbalanced nutrition, risk for deficient fluid volume, fear, ineffective coping
calories per day for client with hyperemesis g.
2500 calories
true or false - in feeding a client with hyperemesis g, serve large portions of food presented
attractively
false - small portions
true or false - put basin out of sight
true
how to control vomiting
- antiemetics (metoclopramide)
- NPO
how to correct DHN
- IV - ringer’s solution
- measure I and O, and amount of vomitus
how to restore electrolyte balance
add potassium chloride to IV infusion
what is given to maintain adequate nutrition in clients with hyperemesis g.
- thiamine - B1
- pyridoxine - B6
diet plan for hyperemesis g.
clear liquid > dry toast, cracker every 2-3 hours > soft diet > normal diet
- 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
ectopic pregnancy
most common site of ectopic p.
fallopian tube - distal 3rd
ectopic implantation:
- ___% occur in the ampulla
- ___% occur in the isthmus
- ___% occur in the fimbriae
- 80
- 12
- 8
true or false - ectopic p. is second most frequent cause of bleeding in early pregnancy
true
causative factors of ectopic p.
- tubal damage – PID
- previous tubal surgery
- congenital anomalies of the tube
- Endometriosis
- previous ectopic pregnancy
- presence of an IUD
- exposure to diethylstilbestrol (DES)
true or false - ectopic p. occurs more frequently in women who smoke, with IUD, or
following in vitro fertilization
true
clinical manifestations of ectopic pregnancy
- missed period
- abd pain
- vaginal spotting
assessment for ectopic pregnancy
sharp stabbing pain in one of the lower quadrants + scant vaginal spotting
if internal bleeding progresses to acute hemorrhage, what may happen?
- lightheadedness
- rapid pulse
- shock
A ___ will demonstrate the
ruptured tube and blood collecting in the
peritoneum
transvaginal sonogram
Either a falling ___ or ___ level suggests that the pregnancy has ended
Hcg / serum progesterone
A ___ or ___ can be used to visualize the fallopian tube
laparoscopy or culdoscopy
if the ectopic pregnancy is not terminated:
- rigid abd
- cullen’s sign
- extensive or dull vaginal or abd pain
- shoulder pain
- mass is palpable in douglas’ cul-de-sac
- If the woman is receiving treatment using methotrexate, the nurse advises the woman to avoid ___.
sun exposure
Stress the need to return for follow-up ___ testing
B-Hcg
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 ____.
methotrexate, leucovorin
A ___ is performed after the chemotherapy to assess whether the tube is fully patent
hysterosalpingogram or sonogram
what is given for sloughing of the tubal implantation site
mifepristone
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.
true
The therapy for a ruptured ectopic pregnancy is ___ to ligate the bleeding vessels and to remove or repair the damaged fallopian
tube.
laparoscopy
