Risk conditions related to pregnancy Flashcards
Signs and Symptoms of Maternal Cardiac Disease
- Cough and respiratory congestion
- Dyspnea and fatigue
- Palpitations and Tachycardia
- Peripheral edema
- Chest Pain
Interventions for Cardiac Disease
- Monitor vital signs mom and baby
- Limit physical activity
- Monitor for signs of cardiac stress and decompensation
Signs and Symptoms of Gestational Diabetes
- Increased thirst and hunger
- Frequent urination
- Weight loss
- Blurred vision
- UTIs and yeast infection
- Hypertension
Treatment for Gestational Diabetes
- Improve diet, insulin and exercise
- monitor for hyper, hypo, proteinuria, glycosuria,
- Monitor weight
- Monitor calorie intake
Disseminated Intravascular Coagulation
A condition in which clotting system is activated resulting in clot formation in the microcirculation.
Risk Factor for DIC
- Dead fetus syndrome
- Severe preeclampsia
Signs and symptoms of DIC
- Uncontrolled bruising
- Hematoma
- Low platelets, hemoglobin, hematocrit, PT, aPPT etc.
Treatment for DIC
- Remove underlying cause
- heparin
- oxygen
- transfusion
- monitor urine output
Abruptio placentae
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.
Placenta previa
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.
Ectopic Pregnancy
Implantation of fertilized ovum outside the uterus
Symptoms of ectopic pregnancy
- missed period
- abdo pain
- dark brown bleeding/spotting
- rupture (causing pain & shock)
Interventions for ectopic pregnancy
- Monitor vital signs
- Monitor for rupture or shock
- Administer methotrexate to inhibit cell division in embryo
Endometritis
Infection of the lining of the uterus occurring postpartum caused by bacteria
Signs and symptoms of endometritis
- Chills & fever
- increased pulse
- decreased appetite
- head/backache
- prolonged afterpains
- Tender large uterus
- Foul odor to loch
- Increased white cell count
Interventions for endometritis
- Antibiotics
- Monitor vital signs
- Fowler position to drain loch
- Monitor fluid balance
Fetal death in utero
Fetal death after 20 weeks gestation and before birth
Hepatitis B
Viral infection that attacks the liver and can cause acute and chronic disease
Hepatitis B causes what in newborns
- Premature
- Low birthweight
- risk of neonatal death
How is hep b transmitted?
Through blood, saliva, vaginal secretions, semen, and breast milk. Crosses the placental barrier.
Interventions for newborns with Hep B positive moms
- Limit vaginal screenings
- Remove maternal blood quickly after birth
- Suction fluids immediately
- Administer Hep B vaccine soon after birth, then 1 month and 6 months.
- Mother should not breastfeed
Hematoma
Escape of blood into the maternal tissue after delivery (common after a forceps delivery). Can also be caused by damage to a blood vessel.
Interventions for maternal hematoma
- monitor obs
- monitor for abnormal pain
- apply ice to hematoma
- give analgesia
- monitor fluid balance
- monitor for infection
- administer antibiotics
- prepare for incision and evacuation
Retrovir
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.
How does HIV affect a baby?
Infant is affected by maternal secretions through birth or breastfeeding.
How is a mother diagnosed with HIV/AIDS during pregnancy?
- ELISA test
- Western blot
- IFA
Only options 2 & 3 confirm a diagnosis
Interventions for patients with HIV/AIDS
- avoid invasive procedures like amniocentesis
- Avoid exposure to maternal fluids at birth (episiotomy, pitocin, internal scalp electrodes.
- Clean and suction quickly after birth
- Do not allow breast feeding
Hydatidform Mole
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.
Molar pregnanacy
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.
Signs and symptoms of hydatidiform mole
- Fetal heart rate not detectable
- Vaginal bleeding
- Hypertension
- Proteinuria
- Larger fundal height
- Snowstorm pattern on ultrasounds
Interventions for hyatidiform mole
- Uterine evacuation
- Tissue sent to lab for evaluation
- Monitor patient for 1 year
Hyperemesis gravidarium
Intractable nausea and vomiting during the first trimester which causes disturbances in nutrition, fluid and electrolyte balance.
Signs and symptoms of hyperemesis
- Nausea worst first thing in the morning
- Persistent vomiting
- Weight loss
- Dehydration
- Fluid & electrolyte imbalance
Interventions for hyperemesis
- IV meds, fluids, electrolytes and PN
- Sit upright after meals
- Drink liquids between meals
Gestational hypertension
High blood pressure during pregnancy. Can be mild, severe or preeclampsia.
Conditions that predispose gestational hypertension
- diabetes
- first pregnancy
- 40
- chronic hypertension
- Rh incompatibility
Complications of gestational hypertension
- abruptio placentae
- DIC
- Thrombocytopenia
- Platelet insufficiency
- intrauterine growth restriction
- intrauterine fetal death
- HELLP
Interventions for mild preeclampsia
- lateral bed rest
- monitor BP and weight
- monitor neurological status
- monitor deep tendon reflexes
- Promote fluid intake
- fluid balance
- medication
Interventions for mild hypertension/preeclampsia
- monitor BP
- monitor fetal activity and growth
- encourage rest
- medication
- fluid balance
Intervention for severe preeclampsia
- bed rest
- magnesium sulfate (to prevent seizures)
- prepare to induce labor
Eclampsia
Generalized seizures
Interventions for eclampsia
- Ensure open airway
- Administer 02
- monitor fetal heart rate
- administer seizure medication
Incompetent Cervix
Premature dilation of the cervix
Symptoms of incompetent cervix
- vaginal bleeding
2. fetal membranes visible through cervix
Interventions for incompetent cervix
- Bed rest
- Tocolysis (inhibits uterine contractions0
- Cervical cerclage (band placed around the cervix to constrict it)
Cervical cerclage
Band placed around the cervix to constrict it when incompetent cervix is diagnosed. Removed at 37 weeks.
Rubella (german measles)
Infection of the rubella virus which affects the development of the fetus causing congenital defects of the heart, eyes, ears and brain.
Toxoplasmosis
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.
