Maternity complications

Question 1

what are the 2 main signs of miscarriage

Answer 1

spotting AND cramping (2 together)

Question 2

what is the treatment for miscarrage (2)

Answer 2

measure hCG lvls (worry when they drop)

bedrest and pelvic rest (no sex)

Question 3

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

Answer 3

IV
blood
dilation and cuttage

Question 4

What is hydatidiform mole also called

Answer 4

molar pregnancy

Question 5

what is hydatidiform mole

Answer 5

benign neoplasaslm; can turn malignant

Question 6

is there a fetus involved in hydatidiform mole

Answer 6

no

Question 7

how does molar pregnany start

Answer 7

uterus enlarges too fast

Question 8

what are the two signs of molar pregnancy

Answer 8

absent fetal heart sounds

bleeding

Question 9

how is molar pregnancy confirmed

Answer 9

U/S

Question 10

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

Answer 10

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

Question 11

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

Answer 11

CXR

Question 12

how is ectopic pregnancy determined

Answer 12

U/S

Question 13

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

Answer 13

yes

Question 14

what is the main goal of treatment for ectopic pregnancy

Answer 14

save the tube

Question 15

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

Answer 15

methotrexate –> stops growth of embryo to save tube

Question 16

what is done if methotrexate does not work in ectopic pregnancy

Answer 16

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

Question 17

when is a laparotomy done in ectopic prengnacy

Answer 17

if the tube has ruptured or the ectopic pregnancy is advnaced

Question 18

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

Answer 18

hemorrhage - need blood transfusion

Question 19

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

Answer 19

placenta previa

Question 20

what is placenta previa

Answer 20

placenta has implanted wrong

Question 21

what is done to confirm placental location

Answer 21

U/S

Question 22

how does placenta previa occur

Answer 22

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

Question 23

what is low lying placenta

Answer 23

placenta is on side of uterus

Question 24

what is partial previa

Answer 24

halfway covering the cervix

Question 25

what is complete previa

Answer 25

placenta compltely covering cervix

Question 26

what is the problem with placenta previa

Answer 26

placenta is coming out first

Question 27

does placneta previa require hospitilization? why?

Answer 27

yes, to prevent blood loss and fetal hypoxia if pt. goes into labor

Question 28

what is the delivery method of choice for placenta previa

Answer 28

c-section

Question 29

what should not be done on pregger ladies with placenta previa

Answer 29

no vaginal exams --? can puncture placenta

Question 30

what are 4 fetal complications for placenta previa

Answer 30

preterm delivery intrauterin growth retardation fetal distress anemia

Question 31

what are two maternal complications for placenta previa

Answer 31

hemorrhage | potential DIC risk (blood clot formation)

Question 32

what is abruptio placenta

Answer 32

when the placenta seperates prematurely and bleeds | can be partial or complete

Question 33

when does abruptio placenta occur

Answer 33

during the last part of pregnancy

Question 34

what is done to confirm abrupto placenta

Answer 34

U/S

Question 35

how is severity of abruptio placenta measured

Answer 35

scale of 1-3; 3 is the worst

Question 36

wht can cause abruptio placenta

Answer 36

previous c section rapid deompression of utures (membranes rupture) associated with cocaine, PIH and smoking

Question 37

what are 3 signs and symptoms of abruptio placenta

Answer 37

rigid board like abdomen with or w/o vag. bleed abdominal pain and increased uterine tone difficult to palpate fetus

Question 38

what are the two priorites for abuptio placenta

Answer 38

manage fetal status | manage maternal shock

Question 39

what is incompetent cervix

Answer 39

heavy baby on cervix causes it to dilate prematurely

Question 40

when does incompetent cervix occur

Answer 40

4th month of pregnancy

Question 41

what health hx will a pt. with incompetent cervix usually report

Answer 41

hxx of painless second trimester miscarrages

Question 42

what is the treatment for incompetent cervix

Answer 42

purse string suture to reinforced cervix | may have c section to preserve the suture

Question 43

can a woman with incompetent cervix deliver vaginally

Answer 43

yes, doctors can clip the suture

Question 44

what is the percentage of carrying a baby to term after purse string sutures are done on an incompetent cervix

Answer 44

80-90%

Question 45

what is hyperemis gravidarum

Answer 45

excessive vomiting that starts out like regular morning sickness but can lead to dehydration starvation and death

Question 46

what is hyperemeis gravidarum related to

Answer 46

high levles of estrogen and hCG

Question 47

what happens to the HCT in hyperemesis gravidarum

Answer 47

increases

Question 48

what happens to UO in hyperemesis greavidarum

Answer 48

decrases

Question 49

what happens withpotassium in hyperemesis gravidarum

Answer 49

decreases (lots of potassium in stomach)

Question 50

what will be seen int he urine of people with hyperememsis gravidarum

Answer 50

ketones -> body breaking down fat

Question 51

how long should a patient with hyperemeiss gravidium be npo

Answer 51

48 hours

Question 52

how much IVFs should be given to someone with hyperememisis gravidarum for the first 24 hours

Answer 52

3L

Question 53

what is preeclampsia

Answer 53

increased BP, proteinurai, edema after 20th weeks

Question 54

what is sudden weight gain and face and swollen hands a sign of

Answer 54

preeclampsia

Question 55

are preeclampsia patients prone to clonus or seizures

Answer 55

yes

Question 56

what temp should foods be for patients with hyperemeis gravidarum

Answer 56

icy cold or steaming hot

Question 57

when you see a pregnant client thag gains 2 or more pounds in a week what are you worried about

Answer 57

pregnancy induced htn

Question 58

what is considered mild preeclampsia

Answer 58

BP 30/15 off their baseline, documented 6 hours apart

Question 59

what is the treatment for mild preeclampsia

Answer 59

bed rest as much as possible

Question 60

what needs to be increased in pateints with preeclampsia diet

Answer 60

protein --> they have glomerular damage with proteinuria

Question 61

what is severe preeclampsia defined as

Answer 61

160/110 documented 6 hours apart

Question 62

what are we worried about with severe preeeclampsia? how do we prevent this

Answer 62

sedate to delay seizures

Question 63

whta drug is used for severe preeclampsia

Answer 63

magnesium sulfate; sedative, anticonvulsant, vasodilate

Question 64

what are the actions of magneisum sulfate

Answer 64

anticonvulsant sedative vasoidlator

Question 65

what needs to be done when magnesium sulftae is given

Answer 65

client check every 1-2 hours for toxicity

Question 66

will magnesium sulfate is used what will happen with labor

Answer 66

it will stop, need to use oxytocin

Question 67

what is used for preterm labor

Answer 67

magnesium sulfate

Question 68

what is the only cure for preeclampsia

Answer 68

delivery

Question 69

how long is a postpartum client at risk for seizures if they have preeclampsia

Answer 69

48 hours

Question 70

why are steroids used for preeclampsia patients

Answer 70

stimulate surfactant prduction in teh alveolar spaces and causes less tension when infant breaths

Question 71

how long is betamethasone used for preeclampsia babies during pregnancy

Answer 71

24-34 weeks to reduce infant mortality

Question 72

what is the turning poing from preeclampsia to eclampsia

Answer 72

having a seizure

Question 73

what is premature labor defined as

Answer 73

20-37 weeks

Question 74

what is the treatment for preterm labor

Answer 74

tocolytics magnesium sulfate betamethaosn

Question 75

what is the side effect of terbutaline

Answer 75

pulse hyerpactivity

Question 76

how is betamehtasone given to mom and what is its purpose in preterm labor

Answer 76

given IM to mom | stimulates maturation of the babsy lungs in preterm birth

Question 77

what are two non pharmacological ways preterm albor can be stopped by

Answer 77

hydrating and treating vaignal and UTIs

Question 78

what is the definition of a prolapsed cord?

Answer 78

when the umbilical cord falls down through the cervix

Question 79

what is imporant to check when membranes ruptuer? what are you worried about

Answer 79

fetal heart tones , worried about prolapsed cord

Question 80

what does it mean if the cord cesases to pulsate

Answer 80

fetal death

Question 81

can shoulder dysocia lead to erbs or bells palsy

Answer 81

yes

Question 82

whos at risk for should dysocia

Answer 82

giant babies gestational diabest previous hx of should dystocia post date delviery --> large fetus

Question 83

what is a mcroberts maneuver

Answer 83

hyperflexing maternal legs to fix shoulder sytocia

Question 84

what is mazzanti techniqes

Answer 84

applying suprapubic pressure when shoulder dystocia occurs, must be done by primary health care physician

Question 85

what is the leading cause of neonatal morbidity

Answer 85

group b strep

Question 86

how is group b strep passed to baby

Answer 86

from birhth canal of infected mom

Question 87

when is the only time a baby is at risk for contracting group b strep form mo

Answer 87

after membranes have ruptuerd

Question 88

what is the treatment for group b strep in moms

Answer 88

prophylactic penicillin