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Maternity complications Flashcards

1
Q

what are the 2 main signs of miscarriage

A

spotting AND cramping (2 together)

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2
Q

what is the treatment for miscarrage (2)

A

measure hCG lvls (worry when they drop)

bedrest and pelvic rest (no sex)

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3
Q

if miscarrage is imminent whtat do we do? (3)

A

IV
blood
dilation and cuttage

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4
Q

What is hydatidiform mole also called

A

molar pregnancy

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5
Q

what is hydatidiform mole

A

benign neoplasaslm; can turn malignant

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6
Q

is there a fetus involved in hydatidiform mole

A

no

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7
Q

how does molar pregnany start

A

uterus enlarges too fast

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8
Q

what are the two signs of molar pregnancy

A

absent fetal heart sounds

bleeding

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9
Q

how is molar pregnancy confirmed

A

U/S

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10
Q

should someone with molar pregnancy attempt to get pregnant again in the follow up time? how is follow up time determined

A

no
hCG measured weekly until normal
rechecked every 2-4 weeks; then every 1-2 months for 6 montsh to a year

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11
Q

what will be done to ensure no metastisis in a molar pregnancy

A

CXR

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12
Q

how is ectopic pregnancy determined

A

U/S

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13
Q

if a client has one ectopic pregnancy are they at risk for another

A

yes

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14
Q

what is the main goal of treatment for ectopic pregnancy

A

save the tube

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15
Q

what is given to a mom with an ectopic pregnancy? what does it do

A

methotrexate –> stops growth of embryo to save tube

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16
Q

what is done if methotrexate does not work in ectopic pregnancy

A

laparoscopic incsion will be made into the tube and the embryo will be removed
- potentially whole tube is removed

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17
Q

when is a laparotomy done in ectopic prengnacy

A

if the tube has ruptured or the ectopic pregnancy is advnaced

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18
Q

what are you worried about if the fallopian tube ruptures in an ectopic pregnancy

A

hemorrhage - need blood transfusion

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19
Q

what is the most common pregnancy complication associated with bleeding in later months of pregnancy

A

placenta previa

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20
Q

what is placenta previa

A

placenta has implanted wrong

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21
Q

what is done to confirm placental location

A

U/S

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22
Q

how does placenta previa occur

A

placenta begins to prematrurely separate when the cervix begins to dilate and efface –> baby doesnt get O2

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23
Q

what is low lying placenta

A

placenta is on side of uterus

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24
Q

what is partial previa

A

halfway covering the cervix

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25
what is complete previa
placenta compltely covering cervix
26
what is the problem with placenta previa
placenta is coming out first
27
does placneta previa require hospitilization? why?
yes, to prevent blood loss and fetal hypoxia if pt. goes into labor
28
what is the delivery method of choice for placenta previa
c-section
29
what should not be done on pregger ladies with placenta previa
no vaginal exams --? can puncture placenta
30
what are 4 fetal complications for placenta previa
preterm delivery intrauterin growth retardation fetal distress anemia
31
what are two maternal complications for placenta previa
hemorrhage | potential DIC risk (blood clot formation)
32
what is abruptio placenta
when the placenta seperates prematurely and bleeds | can be partial or complete
33
when does abruptio placenta occur
during the last part of pregnancy
34
what is done to confirm abrupto placenta
U/S
35
how is severity of abruptio placenta measured
scale of 1-3; 3 is the worst
36
wht can cause abruptio placenta
previous c section rapid deompression of utures (membranes rupture) associated with cocaine, PIH and smoking
37
what are 3 signs and symptoms of abruptio placenta
rigid board like abdomen with or w/o vag. bleed abdominal pain and increased uterine tone difficult to palpate fetus
38
what are the two priorites for abuptio placenta
manage fetal status | manage maternal shock
39
what is incompetent cervix
heavy baby on cervix causes it to dilate prematurely
40
when does incompetent cervix occur
4th month of pregnancy
41
what health hx will a pt. with incompetent cervix usually report
hxx of painless second trimester miscarrages
42
what is the treatment for incompetent cervix
purse string suture to reinforced cervix | may have c section to preserve the suture
43
can a woman with incompetent cervix deliver vaginally
yes, doctors can clip the suture
44
what is the percentage of carrying a baby to term after purse string sutures are done on an incompetent cervix
80-90%
45
what is hyperemis gravidarum
excessive vomiting that starts out like regular morning sickness but can lead to dehydration starvation and death
46
what is hyperemeis gravidarum related to
high levles of estrogen and hCG
47
what happens to the HCT in hyperemesis gravidarum
increases
48
what happens to UO in hyperemesis greavidarum
decrases
49
what happens withpotassium in hyperemesis gravidarum
decreases (lots of potassium in stomach)
50
what will be seen int he urine of people with hyperememsis gravidarum
ketones -> body breaking down fat
51
how long should a patient with hyperemeiss gravidium be npo
48 hours
52
how much IVFs should be given to someone with hyperememisis gravidarum for the first 24 hours
3L
53
what is preeclampsia
increased BP, proteinurai, edema after 20th weeks
54
what is sudden weight gain and face and swollen hands a sign of
preeclampsia
55
are preeclampsia patients prone to clonus or seizures
yes
56
what temp should foods be for patients with hyperemeis gravidarum
icy cold or steaming hot
57
when you see a pregnant client thag gains 2 or more pounds in a week what are you worried about
pregnancy induced htn
58
what is considered mild preeclampsia
BP 30/15 off their baseline, documented 6 hours apart
59
what is the treatment for mild preeclampsia
bed rest as much as possible
60
what needs to be increased in pateints with preeclampsia diet
protein --> they have glomerular damage with proteinuria
61
what is severe preeclampsia defined as
160/110 documented 6 hours apart
62
what are we worried about with severe preeeclampsia? how do we prevent this
sedate to delay seizures
63
whta drug is used for severe preeclampsia
magnesium sulfate; sedative, anticonvulsant, vasodilate
64
what are the actions of magneisum sulfate
anticonvulsant sedative vasoidlator
65
what needs to be done when magnesium sulftae is given
client check every 1-2 hours for toxicity
66
will magnesium sulfate is used what will happen with labor
it will stop, need to use oxytocin
67
what is used for preterm labor
magnesium sulfate
68
what is the only cure for preeclampsia
delivery
69
how long is a postpartum client at risk for seizures if they have preeclampsia
48 hours
70
why are steroids used for preeclampsia patients
stimulate surfactant prduction in teh alveolar spaces and causes less tension when infant breaths
71
how long is betamethasone used for preeclampsia babies during pregnancy
24-34 weeks to reduce infant mortality
72
what is the turning poing from preeclampsia to eclampsia
having a seizure
73
what is premature labor defined as
20-37 weeks
74
what is the treatment for preterm labor
tocolytics magnesium sulfate betamethaosn
75
what is the side effect of terbutaline
pulse hyerpactivity
76
how is betamehtasone given to mom and what is its purpose in preterm labor
given IM to mom | stimulates maturation of the babsy lungs in preterm birth
77
what are two non pharmacological ways preterm albor can be stopped by
hydrating and treating vaignal and UTIs
78
what is the definition of a prolapsed cord?
when the umbilical cord falls down through the cervix
79
what is imporant to check when membranes ruptuer? what are you worried about
fetal heart tones , worried about prolapsed cord
80
what does it mean if the cord cesases to pulsate
fetal death
81
can shoulder dysocia lead to erbs or bells palsy
yes
82
whos at risk for should dysocia
giant babies gestational diabest previous hx of should dystocia post date delviery --> large fetus
83
what is a mcroberts maneuver
hyperflexing maternal legs to fix shoulder sytocia
84
what is mazzanti techniqes
applying suprapubic pressure when shoulder dystocia occurs, must be done by primary health care physician
85
what is the leading cause of neonatal morbidity
group b strep
86
how is group b strep passed to baby
from birhth canal of infected mom
87
when is the only time a baby is at risk for contracting group b strep form mo
after membranes have ruptuerd
88
what is the treatment for group b strep in moms
prophylactic penicillin

NCLEX (10 decks)

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