Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 359: OB > Pregnancy w/ Complications > Flashcards

Pregnancy w/ Complications Flashcards

1
Q

def abortion

A

-fetus < 20 wks gest
or
-fetus weighing < 500 grams
- that is not viable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does SAB stand for

A

spontaneous abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when does SAB usually occur

A

within first 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

risk of SAB increases w/ _______ ________

A

paternal age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the most common cause of SAB’s

A

severe congenital anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

other causes of SAB’s

A

low progesterone levels
fibroids
scar tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

after a woman experiences her first SAB, when can she try getting pregnant again

A
  • wait a couple (3) months
  • get back on normal menstrual cycle
  • try getting pregnant again within a few months afterward
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

if a woman experiences more than 2 or 3 SAB’s, what is the protocol?

A
  • fertility testing
  • genetic testing
  • testing on the tissues of conception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the difference bx threatened abortion and inevitable/imminent abortion?

A
  • threatened abortion may have cramps, small amt of fluid/blood leakage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do HCP’s know if mom is losing the pregnancy?

A

HCG goes down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

if a woman experiences a missed abortion, they are ta high risk for

A
  • DIC with retained POC (products of conception)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

def recurrent SAB’s

A

3 or more consecutive SAB’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can cause recurrent SAB’s

A
  • genetic/ chromosomal abnormalities
  • anomalies of the female rep tract
  • insuff progesterone
  • immunologic factors - Rh factor, immunosuppression
  • cervical incompetence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do nurses asses for in the woman who experienced an SAB?

A

hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what do HCP’s ask woman to do after experiencing an SAB?

A

save all POC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

def ectopic pregnancy

A

implantation of fertilized ovum in a site other than the endometrial lining of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

possible causes of ectopic pregnancies

A
  • PID
  • STI’s/ STD’s
  • build up of scar tissue
  • IUD’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F- ectopic pregancy is always an emergency

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why us an ectopic pregnancy an emergency

A

high risk of rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

s/s of ectopic preg

A
  • sharp, one sided pain
  • syncope
  • referred shoulder pain
  • lower abdominal pain
  • scant dark/reddish brown vaginal spotting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how is ectopic preg dx’d

A
  • US
  • LMP
  • low hcg levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

medical mgmt of ectopic preg

A
  • methotrexate
  • Salpingostomy via lap
  • salpingostomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

under what conditions can methotrexate be used to terminate an ectopic pregancy

A
  • unruptured tube
  • embryo < 3.5 cm in size
  • stable maternal conditions
  • no fetal cardiac motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does methotrexate terminate an ectopic pregnancy

A
  • stops the growth of fetal cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

admin of methotrexate

A
  • given IM

- may be given up to 2 times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is considered a good outcome of termination of ectopic preg

A
  • removal of the embryo without removing the tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is considered a bad outcome of termination of ectopic pregnancy

A
  • if you have to remove the tube with the embryo

- loss of tube through rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Gestational Trophoblastic Disease is also known as________ __________

A

Molar Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is Molar preg caused by

A

abnormal trophoblastic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

def complete hydatidiform mole

A

no fetus present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

def partial hydatidiform mole

A

presence of fetal tissue/membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Molar pregnancy etiology

A
  • sperm and egg meet and travel down uterus
  • cells start growing and multiplying
  • uncontrolled multiplication of cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which molar pregnancy is considered viable?

A
  • none

- both complete and partial are non viable pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

women who have had a Molar pregnancy are at a high risk of developing

A

choriocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

dx of Molar pregnancy

A
  • vaginal bleeding: dk brown spotting to perfuse hemorrhaging
  • US
  • passing of hydropic vessels (grape-like clusters)
  • uterine enlargement greater than expected for gest age
  • absence of fetal heart sounds
  • ELEVATED HCG!!!!!
  • excessive N/V
  • elevated BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Molar pregnancies are more common among which women?

A
  • teens
  • women over 40
  • women who have taken Clomid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Medical tx of Molar pregnancy

A
  • D&C
  • possible hysterectomy if invasive
  • * Careful Follow Up*
  • serial HCG’s for the next year
  • chemo for choriocarcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

nursing care of woman who experienced a Molar Pregnancy

A
  • monitor VS and vaginal bleeding
  • assess abdominal pain
  • assess emotional state and coping ability
  • convey the importance of adhering to follow up care!!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

def placenta previa

A

placenta is improperly implanted in the lower uterine segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

classification of placenta previa

A

marginal
partial
total

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

marginal placenta previa

A

placenta just at the edge of the opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

partial placenta previa

A

placenta partially in the opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

total placenta previa

A

placenta completely covers entire cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the hallmark sign of placenta previa

A

painless bleeding after 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

s/s of placenta previa

A
  • sudden onset of painless bleeding after 20 weeks of gestation
  • scanty or profuse bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

placenta previa pts are at high risk for

A
  • bleeding

- infec

47
Q

how will placenta previa patients be birthed?

A

c sec

48
Q

def abruptio placenta

A

premature separation of a normally implanted placenta from the uterine wall

49
Q

maternal risk factors a/w abruptio placenta

A

bleeding
shock
hypovolemia
death

50
Q

fetal risk factors a/w abruptio placenta

A
  • hypoxia
  • neuro deficits- CP
  • pre term
51
Q

what can cause abruptio placenta

A

* cocaine abuse*
maternal HTN
abdominal trauma- fall, MVA

52
Q

T/F- women who have had an abruptio placenta are not at an incr risk for a recurrences for their next pregnancies

A

false- they are at an incr risk

53
Q

s/s of abruptio placenta

A 
vaginal bleeding
pain
uterine tenderness, irritability, high resting tone
port wine colored amniotic fluid
uterine contractions
decr fetal activity
fetal demise
54
Q

what is the focus of med mgmt for abruptio placenta

A
  • CV status of the mother

- status of the fetus

55
Q

nursing care for abruptio placenta

A
  • assess amt and nature of bleeding
  • assess and manage pain
  • monitor maternal VS
  • monitor status of fetus
  • assess uterine contractions
  • collect OB hx and length of gestation
  • obtaining lab data
  • assessing and providing psychosocial support
56
Q

early s/s of hypovolemic shock

A

low bp
tachycardia
decr urinary output

57
Q

late s/s of hypovolemic shock

A

bradycardia
renal failure
low bp
multisystem organ failure

58
Q

medical mgmt of hypovolemic shock

A

monitor fetus
promote tissue oxygenation
fluid replacement

59
Q

def placenta accreta

A

the chorionic villi attach directly to the myometrium of the uterus

60
Q

def placenta increta

A
  • the myometrium is invaded

- the placenta is growing into the wall of the uterus

61
Q

def placenta percreta

A
  • the myometrium is penetrated

- the placenta grows through the wall of the uterus and into the abdominal cavity

62
Q

primary complications of placenta accreta

A

maternal hemorrhage

failure of placenta to separate following birth

63
Q

how is placenta accreta diagnosed and what is the problem with diagnosis

A
  • dx by US

- can easily be missed if slight

64
Q

def Gest HTN

A
  • syst bp >140
  • diast bp >90
  • after 20 wks of preg with BO returning to normal within 6 wks post partum
65
Q

are all hypertensive mothers considered high risk

A

yes

66
Q

risk factors for developing GHTN

A

obese
less than 20 yrs
over than 40 yrs
diabetic mother

67
Q

def pre-eclampsia

A
  • syst bp >140/ diast bp >90 after 20 wks gestation

- accompanied by proteinuria (>0.3 g in 24 h urine)

68
Q

if a woman is dx’d w/ pre-eclampsia, what may be the protocol for her care

A

-mom may be admitted to antepartum for the remainder of her preg

69
Q

def eclampsia

A

the progression of pre-eclampsia to generalized seizures

70
Q

def chronic HTN

A
  • elevated BP before preg or development of HTN before 20 wks of gestation
71
Q

what lab levels should be monitored closely for women w/ HTN/ pre-eclampsia?

A

sodium

72
Q

pre-eclampsia pathophys

A
  • maternal vasospasm affecting every organ
  • incr PVR
  • decr perfusion to almost all organs
73
Q

prevention of GHTN

A
  • low dose ASA
  • calcium
  • magnesium
  • fish oil supplements
74
Q

in-pt mgmt for pre-eclampsia: bed rest

A 
quiet room
limit visitors/stressful visitors
keep light low
strict I/O's & daily weights
monitor lungs, inc spir, teds
monitor liver enzymes
fetal monitor once 2 h or twice per shift
75
Q

name 2 anticonv meds

A

mag sulfate

hydralazine (apresoline)

76
Q

action of mag sulfate

A

prevents and treats convulsions caused by pre-eclampsia

77
Q

loading dose of mag sulfate

A

4-6 grams in 100 cc IVPB

78
Q

what is the goal of mgmt for pts on mag sulfate?

A

keep pt on ther level

79
Q

what is the ther range for mag sulfate

A

serum level should be bx 4-7.5 meq’s

80
Q

major adverse rxns to mag sulfate

A 
***CNS Depressant***
decr DTR's
nausea/ vomitting
weakness
dizziness
slurred speech
81
Q

what is the antidote for mag sulfate?

A

calcium gluconate

82
Q

how long does mom need to be on mag sulfate after they deliver

A

24 hrs

83
Q

what must be closely monitored and how often

A
  • BP and VS

- Q Hr!!!!

84
Q

what is the med of choice for the tx of HTN during preg?

A

hydralazine

85
Q

other meds used to treat GHTN

A

phenytoin

diazepam

86
Q

s/s of HELLP

A

-sudden weight gain
-HTN
-edema in the upper extremilites more than in the lower extremities
- hemolysis—> anemia and jaundice
- elevated Liver enzymes
epigastric pain
NV
-Low platelets
thrombocytopenia
abnormal bleeding and clotting time
petechiae

87
Q

if mom is dx’d w/ HELLP, what are the delivery options

A

-mom may have to deliver baby early

88
Q

def hypertonic labor

A

-ineffective uterine contractions

89
Q

when does hypertonic labor occur

A

in the latent phase of labor

90
Q

hypertonic labor pathophys

A

contractions become more frequent

intensity increases—> incr pain and prolonged labor

91
Q

medical mgmt of hypertonic labor

A

bed rest
sedation
pitocin
amniotomy

92
Q

def precipitous labor

A

labor lasting more than 3 hrs

93
Q

what are the risks a/w precipitous labor

A

laceration from rapid descent

accelerated cervical dilation

94
Q

nursing dx r/t precipitous labor

A

risk for injury r/t rapid labor and birth

acute pain r/t rapid labor

95
Q

def prolonged pregnancy

A

a preg lasting more than 42 weeks

96
Q

maternal risks a/w prolonged pregnancy

A 
incr risk for induction
LGA infant
surgical delivery
use of forceps/vaccuum
psyhological stress
infec
97
Q

infant risks a/w prolonged pregnancy

A 
decr placental perfusion
oligohydramnios--> incr risk for:
   -cord compression
   - meconium aspiration
   - low apgar
98
Q

nursing dx r/t prolonged preg

A
  • fear r/t unknown outcome of baby

- ineffective individual coping r/t anxiety abt status of baby

99
Q

when there is a mo with a prolonged preg, how often is a biophys done?

A

q 24-48 hrs

100
Q

when is external version used

A

for breech or shoulder presentation

101
Q

when is external version performed

A
  • at 36 wks following:
  • US
  • NST
102
Q

why is US and NST done prior to external version

A

to eval fetal well being and confirm fetal/placental position

103
Q

when can an external version not be performed?

A

if the presenting part is engaged

104
Q

what med is admin before external version is performed and why

A

tocolytics
- relax the uterus

regional anesthesia

105
Q

name an example of a tocolytic

A

terbutaline

106
Q

when is an external version abruptly stopped

A
  • fetal decels

- fetal bradycardia

107
Q

nursing mgmt during an external version

A 
VS
NST
FHR monitoring
IVF
comfort
post procedure fetal and maternal monitoring
108
Q

def amniotomy

A

AROM

109
Q

when is an amniotomy done

A

@ 2 cm or >

110
Q

indications for amniotomy

A

shorten/augment labor
manipulate hormone release–> stim cxn
apply IUPC and/or fetal scalp electrode

111
Q

what are the risks a/w amniotomy

A

cord prolapse

112
Q

medical mgmt during amniotomy

A 
FHR
decr vaginal exams
temps q 2 h
comfort
hygeine
113
Q

ways to induce labor

A 
-AROM
pitocin
intercourse
nipple stim
mechanical dilation- foley
herbs
enemas
castor oil
evening primrose @ 36 wks to soften cervix
114
Q

nursing role during induction of labor

A 
VS
EFM
NST
FHR
Pain mgmt

NUR 359: OB (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions