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NCLEX > Maternity complications > Flashcards

Maternity complications Flashcards

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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
Q

what is complete previa

A

placenta compltely covering cervix

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26
Q

what is the problem with placenta previa

A

placenta is coming out first

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27
Q

does placneta previa require hospitilization? why?

A

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

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28
Q

what is the delivery method of choice for placenta previa

A

c-section

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29
Q

what should not be done on pregger ladies with placenta previa

A

no vaginal exams –? can puncture placenta

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30
Q

what are 4 fetal complications for placenta previa

A

preterm delivery
intrauterin growth retardation
fetal distress
anemia

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31
Q

what are two maternal complications for placenta previa

A

hemorrhage

potential DIC risk (blood clot formation)

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32
Q

what is abruptio placenta

A

when the placenta seperates prematurely and bleeds

can be partial or complete

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33
Q

when does abruptio placenta occur

A

during the last part of pregnancy

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34
Q

what is done to confirm abrupto placenta

A

U/S

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35
Q

how is severity of abruptio placenta measured

A

scale of 1-3; 3 is the worst

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36
Q

wht can cause abruptio placenta

A

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

37
Q

what are 3 signs and symptoms of abruptio placenta

A

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

38
Q

what are the two priorites for abuptio placenta

A

manage fetal status

manage maternal shock

39
Q

what is incompetent cervix

A

heavy baby on cervix causes it to dilate prematurely

40
Q

when does incompetent cervix occur

A

4th month of pregnancy

41
Q

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

A

hxx of painless second trimester miscarrages

42
Q

what is the treatment for incompetent cervix

A

purse string suture to reinforced cervix

may have c section to preserve the suture

43
Q

can a woman with incompetent cervix deliver vaginally

A

yes, doctors can clip the suture

44
Q

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

A

80-90%

45
Q

what is hyperemis gravidarum

A

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

46
Q

what is hyperemeis gravidarum related to

A

high levles of estrogen and hCG

47
Q

what happens to the HCT in hyperemesis gravidarum

A

increases

48
Q

what happens to UO in hyperemesis greavidarum

A

decrases

49
Q

what happens withpotassium in hyperemesis gravidarum

A

decreases (lots of potassium in stomach)

50
Q

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

A

ketones -> body breaking down fat

51
Q

how long should a patient with hyperemeiss gravidium be npo

A

48 hours

52
Q

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

A

3L

53
Q

what is preeclampsia

A

increased BP, proteinurai, edema after 20th weeks

54
Q

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

A

preeclampsia

55
Q

are preeclampsia patients prone to clonus or seizures

A

yes

56
Q

what temp should foods be for patients with hyperemeis gravidarum

A

icy cold or steaming hot

57
Q

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

A

pregnancy induced htn

58
Q

what is considered mild preeclampsia

A

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

59
Q

what is the treatment for mild preeclampsia

A

bed rest as much as possible

60
Q

what needs to be increased in pateints with preeclampsia diet

A

protein –> they have glomerular damage with proteinuria

61
Q

what is severe preeclampsia defined as

A

160/110 documented 6 hours apart

62
Q

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

A

sedate to delay seizures

63
Q

whta drug is used for severe preeclampsia

A

magnesium sulfate; sedative, anticonvulsant, vasodilate

64
Q

what are the actions of magneisum sulfate

A

anticonvulsant
sedative
vasoidlator

65
Q

what needs to be done when magnesium sulftae is given

A

client check every 1-2 hours for toxicity

66
Q

will magnesium sulfate is used what will happen with labor

A

it will stop, need to use oxytocin

67
Q

what is used for preterm labor

A

magnesium sulfate

68
Q

what is the only cure for preeclampsia

A

delivery

69
Q

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

A

48 hours

70
Q

why are steroids used for preeclampsia patients

A

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

71
Q

how long is betamethasone used for preeclampsia babies during pregnancy

A

24-34 weeks to reduce infant mortality

72
Q

what is the turning poing from preeclampsia to eclampsia

A

having a seizure

73
Q

what is premature labor defined as

A

20-37 weeks

74
Q

what is the treatment for preterm labor

A

tocolytics
magnesium sulfate
betamethaosn

75
Q

what is the side effect of terbutaline

A

pulse hyerpactivity

76
Q

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

A

given IM to mom

stimulates maturation of the babsy lungs in preterm birth

77
Q

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

A

hydrating and treating vaignal and UTIs

78
Q

what is the definition of a prolapsed cord?

A

when the umbilical cord falls down through the cervix

79
Q

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

A

fetal heart tones , worried about prolapsed cord

80
Q

what does it mean if the cord cesases to pulsate

A

fetal death

81
Q

can shoulder dysocia lead to erbs or bells palsy

A

yes

82
Q

whos at risk for should dysocia

A

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

83
Q

what is a mcroberts maneuver

A

hyperflexing maternal legs to fix shoulder sytocia

84
Q

what is mazzanti techniqes

A

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

85
Q

what is the leading cause of neonatal morbidity

A

group b strep

86
Q

how is group b strep passed to baby

A

from birhth canal of infected mom

87
Q

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

A

after membranes have ruptuerd

88
Q

what is the treatment for group b strep in moms

A

prophylactic penicillin

NCLEX (10 decks)

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