pregnancy complications

Question 1

Placenta Previa

Answer 1

condition that affects the placenta and can occur during the last two trimesters of pregnancy
mild to severe bleeding
“afterbirth first”
placenta implants near or over the cervical os

Question 2

things that put you at risk for placenta previa

Answer 2

previous c-section(s), and the risk increases with the more c-sections you have

Question 3

placenta previa is associated with serious complications like:

Answer 3

hemorrhage, emergency c-section, abruption (separation) if the placenta

Question 4

what is causing cases of placenta previa to rise?

Answer 4

increased number of caesarean births, increasing maternal age, more infertility treatments

Question 5

how to detect placenta previa

Answer 5

ultrasound provides early detection

Question 6

pathophysiology of placenta previa

Answer 6

increased surface area for placenta to attach(?)
it is avoided sometimes even if the embryo is implanted low in the uterus bc of trophotropism –>seeking area of higher vascularity and nutrition

Question 7

management of placenta previa

Answer 7

if fetus and parent are stable->expectant management->wait and see–>can be at home and hospital
ultrasound can determine morbidity
depends on parity, amount of bleeding, is fetus develop enough to survive outside of uterus, risk of hemorrhage

Question 8

nursing assessment for placenta previa

Answer 8

thorough history–>possible risk factors and a physical examination

Question 9

risk factors for placenta previa

Answer 9

advanced maternal age (gestational pregnancy over 35 y/o)
cocaine use
previous c-section
multiparity
uterine injury
smoking
previous surgically induced abortion
infertility treatments
prior placenta previa
multiple gestations
short interval between pregnancies
hypertension or diabetes

Question 10

Bleeding associated with placenta previa

Answer 10

painless, bright red, vaginal occurring during 2nd/3rd trimester
first episode usually occurs around 27-32 weeks gestation
uterus cannot contract properly to stop the blood flow due to mal- implantation thus bleeding continues

Question 11

chronic hypertension

Answer 11

blood pressure exceeding 140/90 before pregnancy or 22 weeks gestational age

Question 12

gestational hypertension

Answer 12

begins around 22 weeks gestational age, >140/90, and usually resolves about after 12 weeks postpartum

Question 13

second stage of preeclampsia

Answer 13

hypertension, edema, proteinuria

Question 14

things for client to monitor themselves

Answer 14

weight gain (edema), protein in urine, blood presure

Question 15

signs to watch out for for preeclampsia

Answer 15

headache, visual disturbances, epigastric pain,

Question 16

solution to preeclampsia

Answer 16

giving birth bc preeclampsia depends on the trophoblastic tissue

Question 17

subjective assessment findings of preeclampsia when assessing client

Answer 17

unusual bleeding, visual changes, sever headaches, bruising, epigastric pain

Question 18

how to verify gestational hypertension

Answer 18

take BP twice 15 minutes apart, both must be >140/90

Question 19

proteinuria

Answer 19

> =300mg of protein in urine or using dipstick would be 1+ or greater

Question 20

common sites to test DTRs

Answer 20

biceps, triceps, patellar, achilles, plantar

Question 21

what is hyperflexia associated with

Answer 21

nervous system irritability related to preeclampsia

Question 22

magnesium toxicity signs

Answer 22

RR less than 12 breaths/min, absence of DTRs, decrease in urinary output

Question 23

clonus present:

Answer 23

jerky and rapid movement vs smooth movement from the muscle

Question 24

what is the onset of eclampsia

Answer 24

start of seizure activity

Question 25

hemolysis

Answer 25

destruction of red blood cells

Question 26

diagnostic testing for HELLP

Answer 26

elevated liver platelets: AST, ALT
elevated LDH
elevated BUN
elevated bilirubin level
low hematocrit

Question 27

MgSO4

Answer 27

prevention of seizures