MODULE 5: PAT: GP: Danger Signs & Hyperemesis Gravidarum Flashcards
Danger signs of pregnancy
a. Vaginal bleeding
b .Persistent vomiting
c. Chills and fever
d. Sudden escape of fluid from vagina
e. Abdominal or chest pain
f. Absence of fetal heart sounds
g. Swelling of face and fingers
h. Flashes of lights
i. Blurring of vision
j. Severe headache and dizziness
Vaginal bleeding
a. Should be reported immediately
b. Degree of bleeding should be evaluated
c. May lead to hypovolemic shock due to blood loss
PERSISTENT VOMITING (Hyperemesis Gravidarum)
a. (Severe) Nausea and vomiting that continues after 12 weeks
of pregnancy is extended vomiting
b. It depletes the nutritional value to the fetus
Dehydration; Malnutrition
Dehydration can cause uterine contractions ->
preterm labor -> preterm delivery
It depletes the nutritional value to the fetus
Dehydration ; Malnutrition
Side Effects
a. Hypotension
b. Dizziness
c. Fainting
d. Electrolyte imbalance
Treatment
IV fluid management
Child and fever
a. May be due to intrauterine infection
b. Serious complication to both mother and fetus
c. Pregnant: At risk for UTI
d. chorioamnionitis
Pregnant: At risk for UTI
a. Encourage good personal hygiene
b. Should be identified and treated immediately
c. Possible: Preterm labor, preterm delivery, LBW, SGA, sepsis
Chorioamnionitis
a. Chorion and amnion – membranes that surrounds the
fetus and the amniotic fluid
b. Possible ma-acquire ng fetus; infection
Amniotic Fluid Leakage
a. Membranes are ruptured
b. Mother and fetus are threatened because uterine cavity is no
longer sealed against infection
c. Possible:
o Miscarriage
o Stillbirth
o Premature birth
o Nuchal cord – umbilical cord is squeezed to the fetus
o Cesarean delivery – due to fetal distress
o Pelvic inflammatory disease
(SUDDEN) ABDOMINAL / CHEST PAIN
a. May mean tubal pregnancy that have ruptured
b. Separation of placenta
c. Preterm labor
d. Chest pain – pulmonary embolus that follow thrombophlebitis
o DVT = (+) Homan Sign
e. Avoid massaging the lower leg because thrombus
might detach and travel to smaller vessels
Absence of fetal heart sound
a. IUFD/Stillbirth – after they have been initially auscultated on
the 4th and 5th month
b. IUFD = Intrauterine Fetal Demise
o Monitored after 20th week of pregnancy
o May change clotting system of the pregnant woman
o May lead to significant bleeding – stillbirth should be
delivered
c. Possible cause:
o Infection
o Chorioamnionitis
o Genetic disease
Hyperemesis Gravidarum
a. Pernicious/persistent vomiting
b. Excessive nausea and vomiting that persists beyond 12 weeks
gestation
o May extend up to 16 weeks AOG
c. Leads to complications like dehydration, weight loss,
starvation and fluid electrolyte imbalance
d. Cause: unknown
o Associated with thyroid functioning and H. Pylori
▪ Helicobacter Pylori – bacteria that causes ulcer
o High levels of human chorionic gonadotropin (hCG)
Assessment of Hyperemesis Gravidarum: Nausea and Vomiting
a. Not relieved by any remedies, even dry crackers
b. Experience dehydration
▪ Thirsty, increase PR, significant weight loss,
concentrated and scanty urine
▪ Normal urine output: 30 ml/hr.
Assessment of Hyperemesis Gravidarum: Ketonuria
(+) Ketones in urine – breaking down of stored fats and
protein for cell growth
Assessment of Hyperemesis Gravidarum: Elevated hematocrit concentration
a. Hematocrit HCT: 32 to 42%
b. Vomiting -> Hematoconcentration -> thromboembolism
Assessment of Hyperemesis Gravidarum: Electrolytes
a. hyponatremia
b. hypokalemia
c. hypochloremia
Assessment of Hyperemesis Gravidarum: Hypokalemic Alkalosis
loss of potassium -> loss of acid
Assessment of Hyperemesis Gravidarum: Ataxia and Confusion
a. signs of wernicke - Korsakoff syndrome
b. ataxia: poor muscle coordination
c. vitamin B1 (Thiamine) Deficiency
