Risk conditions related to pregnancy

Question 1

Signs and Symptoms of Maternal Cardiac Disease

Answer 1

1. Cough and respiratory congestion
2. Dyspnea and fatigue
3. Palpitations and Tachycardia
4. Peripheral edema
5. Chest Pain

Question 2

Interventions for Cardiac Disease

Answer 2

1. Monitor vital signs mom and baby
2. Limit physical activity
3. Monitor for signs of cardiac stress and decompensation

Question 3

Signs and Symptoms of Gestational Diabetes

Answer 3

1. Increased thirst and hunger
2. Frequent urination
3. Weight loss
4. Blurred vision
5. UTIs and yeast infection
6. Hypertension

Question 4

Treatment for Gestational Diabetes

Answer 4

1. Improve diet, insulin and exercise
2. monitor for hyper, hypo, proteinuria, glycosuria,
3. Monitor weight
4. Monitor calorie intake

Question 5

Disseminated Intravascular Coagulation

Answer 5

A condition in which clotting system is activated resulting in clot formation in the microcirculation.

Question 6

Risk Factor for DIC

Answer 6

• Dead fetus syndrome

- Severe preeclampsia

Question 7

Signs and symptoms of DIC

Answer 7

1. Uncontrolled bruising
2. Hematoma
3. Low platelets, hemoglobin, hematocrit, PT, aPPT etc.

Question 8

Treatment for DIC

Answer 8

1. Remove underlying cause
2. heparin
3. oxygen
4. transfusion
5. monitor urine output

Question 9

Abruptio placentae

Answer 9

Premature separation of the placenta from the uterine wall after the twentieth week of gestation and before the fetus is delivered. In abruptio placentae, acute abdominal pain is present.

Uterine tenderness accompanies placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen feels hard and boardlike on palpation as the blood penetrates the myometrium and causes uterine irritability.

Question 10

Placenta previa

Answer 10

Occurs when a baby’s placenta partially or totally covers the opening in the mother’s cervix — the lower end of the uterus that connects to the top of the vagina. Placenta previa can cause severe bleeding before or during delivery.

Question 11

Ectopic Pregnancy

Answer 11

Implantation of fertilized ovum outside the uterus

Question 12

Symptoms of ectopic pregnancy

Answer 12

1. missed period
2. abdo pain
3. dark brown bleeding/spotting
4. rupture (causing pain & shock)

Question 13

Interventions for ectopic pregnancy

Answer 13

1. Monitor vital signs
2. Monitor for rupture or shock
3. Administer methotrexate to inhibit cell division in embryo

Question 14

Endometritis

Answer 14

Infection of the lining of the uterus occurring postpartum caused by bacteria

Question 15

Signs and symptoms of endometritis

Answer 15

1. Chills & fever
2. increased pulse
3. decreased appetite
4. head/backache
5. prolonged afterpains
6. Tender large uterus
7. Foul odor to loch
8. Increased white cell count

Question 16

Interventions for endometritis

Answer 16

1. Antibiotics
2. Monitor vital signs
3. Fowler position to drain loch
4. Monitor fluid balance

Question 17

Fetal death in utero

Answer 17

Fetal death after 20 weeks gestation and before birth

Question 18

Hepatitis B

Answer 18

Viral infection that attacks the liver and can cause acute and chronic disease

Question 19

Hepatitis B causes what in newborns

Answer 19

1. Premature
2. Low birthweight
3. risk of neonatal death

Question 20

How is hep b transmitted?

Answer 20

Through blood, saliva, vaginal secretions, semen, and breast milk. Crosses the placental barrier.

Question 21

Interventions for newborns with Hep B positive moms

Answer 21

1. Limit vaginal screenings
2. Remove maternal blood quickly after birth
3. Suction fluids immediately
4. Administer Hep B vaccine soon after birth, then 1 month and 6 months.
5. Mother should not breastfeed

Question 22

Hematoma

Answer 22

Escape of blood into the maternal tissue after delivery (common after a forceps delivery). Can also be caused by damage to a blood vessel.

Question 23

Interventions for maternal hematoma

Answer 23

1. monitor obs
2. monitor for abnormal pain
3. apply ice to hematoma
4. give analgesia
5. monitor fluid balance
6. monitor for infection
7. administer antibiotics
8. prepare for incision and evacuation

Question 24

Retrovir

Answer 24

Drug administered at 14 weeks of gestation to prevent the transfer of HIV/AIDS from the mother to the baby. Baby receives this medication orally from birth to six weeks old.

Question 25

How does HIV affect a baby?

Answer 25

Infant is affected by maternal secretions through birth or breastfeeding.

Question 26

How is a mother diagnosed with HIV/AIDS during pregnancy?

Answer 26

1. ELISA test 2. Western blot 3. IFA Only options 2 & 3 confirm a diagnosis

Question 27

Interventions for patients with HIV/AIDS

Answer 27

1. avoid invasive procedures like amniocentesis 2. Avoid exposure to maternal fluids at birth (episiotomy, pitocin, internal scalp electrodes. 3. Clean and suction quickly after birth 4. Do not allow breast feeding

Question 28

Hydatidform Mole

Answer 28

When peripheral cells that attach the ovum to the uterine wall develop abnormally. The mole appears as a grape-like cluster and may be malignant or non-malignant.

Question 29

Molar pregnanacy

Answer 29

A molar pregnancy happens when tissue that normally becomes a fetus instead becomes an abnormal growth in your uterus. Even though it isn't an embryo, this growth triggers symptoms of pregnancy. A molar pregnancy should be treated right away. This will make sure that all of the tissue is removed. This tissue can cause serious problems in some women.

Question 30

Signs and symptoms of hydatidiform mole

Answer 30

1. Fetal heart rate not detectable 2. Vaginal bleeding 3. Hypertension 4. Proteinuria 5. Larger fundal height 6. Snowstorm pattern on ultrasounds

Question 31

Interventions for hyatidiform mole

Answer 31

1. Uterine evacuation 2. Tissue sent to lab for evaluation 3. Monitor patient for 1 year

Question 32

Hyperemesis gravidarium

Answer 32

Intractable nausea and vomiting during the first trimester which causes disturbances in nutrition, fluid and electrolyte balance.

Question 33

Signs and symptoms of hyperemesis

Answer 33

1. Nausea worst first thing in the morning 2. Persistent vomiting 3. Weight loss 4. Dehydration 5. Fluid & electrolyte imbalance

Question 34

Interventions for hyperemesis

Answer 34

1. IV meds, fluids, electrolytes and PN 2. Sit upright after meals 3. Drink liquids between meals

Question 35

Gestational hypertension

Answer 35

High blood pressure during pregnancy. Can be mild, severe or preeclampsia.

Question 36

Conditions that predispose gestational hypertension

Answer 36

1. diabetes 2. first pregnancy 3. 40 4. chronic hypertension 5. Rh incompatibility

Question 37

Complications of gestational hypertension

Answer 37

1. abruptio placentae 2. DIC 3. Thrombocytopenia 4. Platelet insufficiency 5. intrauterine growth restriction 6. intrauterine fetal death 7. HELLP

Question 38

Interventions for mild preeclampsia

Answer 38

1. lateral bed rest 2. monitor BP and weight 3. monitor neurological status 4. monitor deep tendon reflexes 5. Promote fluid intake 6. fluid balance 7. medication

Question 39

Interventions for mild hypertension/preeclampsia

Answer 39

1. monitor BP 2. monitor fetal activity and growth 3. encourage rest 4. medication 5. fluid balance

Question 40

Intervention for severe preeclampsia

Answer 40

1. bed rest 2. magnesium sulfate (to prevent seizures) 3. prepare to induce labor

Question 41

Eclampsia

Answer 41

Generalized seizures

Question 42

Interventions for eclampsia

Answer 42

1. Ensure open airway 2. Administer 02 3. monitor fetal heart rate 4. administer seizure medication

Question 43

Incompetent Cervix

Answer 43

Premature dilation of the cervix

Question 44

Symptoms of incompetent cervix

Answer 44

1. vaginal bleeding | 2. fetal membranes visible through cervix

Question 45

Interventions for incompetent cervix

Answer 45

1. Bed rest 2. Tocolysis (inhibits uterine contractions0 3. Cervical cerclage (band placed around the cervix to constrict it)

Question 46

Cervical cerclage

Answer 46

Band placed around the cervix to constrict it when incompetent cervix is diagnosed. Removed at 37 weeks.

Question 47

Rubella (german measles)

Answer 47

Infection of the rubella virus which affects the development of the fetus causing congenital defects of the heart, eyes, ears and brain.

Question 48

Toxoplasmosis

Answer 48

Parasitic infection caused by the mother ingesting infected undercooked food or being exposed to cat feces. Can be passed from mother to baby while pregnant.