Maternal Hemorrhagic Causes & Disorders/1st Trimester: Spontaneous abortion

Question 0

Primary cause of bleeding
First trimester (2)

Answer 0

1) Spontaneous abortion

2) Ectopic pregnancy

Question 1

Vaginal Bleeding during pregnancy…normal ?

Answer 1

is always ABNORMAL and must be investigated to determine cause.

Question 2

Primary cause of bleeding
First trimester (2)
Spontaneous Abortion
Labs (4)

Answer 2

1) Hgb and Hct if considerable blood loss
2) Clotting factors monitored for DIC
3) WBC if infection is suspected
4) Serum (hCG) levels to confirm pregnancy

Question 3

Diagnostic and Therapeutic Procedures (5)

Answer 3

1) Ultrasound determine viable, partial or complete
2) Exam cervix
3) D & C
4) D & E after 16 weeks
5) Prostaglandins and oxytocin (Pitocin)

(ATI 67)

Question 4

Primary cause of bleeding
First trimester: (2)
Spontaneous abortion
1) wks
Cramps, Bleeding, Tissue Passed, Cervical Opening
2) Threatened
3)  Inevitable 
4)  Incomplete
5)  Complete
6)  Missed
7)  Septic
8)  Recurrent 
(ATI 66)

Answer 4

1)

Question 5

Primary cause of bleeding
First trimester (2)
Spontaneous Abortion
Is vaginal exam indicated?

Answer 5

NO

Question 6

Primary cause of bleeding
First trimester (2)
Spontaneous Abortion
Nursing Actions

Answer 6

1) Bleeding color and amount
2) Perform pregnancy test
3) Bed rest, risk of fall due to sedation
4) Assist with an ultrasound
5) AVOID VAGINAL EXAM
6) Adm blood products and meds
7) Determine how much tissue has passed, save for exam
8) Assist with termination of pregnancy

Question 7

Primary cause of bleeding
First trimester (2)
Assessment: Subjective and Objective Data

Answer 7

1) Backache and abd tenderness
2) Ruptured membranes and dilation of the cervix
3) Fever
4) s/s of hemorrhage eg, hypotension and tachycardia

Question 8

Hypovolemic Shock aka

Answer 8

Hemorrhagic shock

Question 9

Hypovolemic Shock aka Hemorrhagic Shock

1) What is it?
2) What are the s/s?

Answer 9

1) Life threating, 20% of of body’s blood or fluid supply is loss
2) Tachycardia, hypotension, weak pulse, diaphoretic, low or no urine output

Question 10

Primary cause of bleeding
First trimester (2)
Risk Factors

Answer 10

(ATI 66)

Question 11

Total Body Blood Volume

Answer 11

Average 5 liters

Question 12

Primary cause of bleeding
First trimester (2)
Spontaneous Abortion
Health Promotion and Disease Prevention
Discharge Instructions

Answer 12

1) Notify HCP: Heavy, bright red vaginal bleeding
2) Fever
3) Expect discharge, normal for 1-2 wks
4) Take antibotics
5) Refrain from tub baths, sexual intercourse for 2 weeks
6) Avoid becoming pregnant for 2 month