WEEK 3-ATI Flashcards
pph
corpus luteum
A structure that develops in an ovary where ovulation took place that secretes estrogen and progesterone until the placenta takes over.
how long is the cervix
slightly over 2 cm
internal cervical os
opening of the cervix at the uterus
external cervical os
Also known as endocervical canal, it is the passage that connects the vagina to the uterus.
what state is pregnancy in
prothrombotic state:
A blood condition that increases the risk of clots to form in blood vessels.
why does a prothrombotic state occur
pregnant clients have an increase in some coagulation factors, reduced fibrinolysis, and increased platelet reactivity.
fibrinolysis
A process that prevents clots from forming or breaks down clots that formed.
spontaneous abortion
Spontaneous pregnancy loss that occurs prior to 20 weeks gestation.
what are the 6 types of spontaneous abortions
threatened
inevitable
incomplete
complete
septic
missed
threatened abortion
The products of conception are threatened with expulsion through uterine cramping and bleeding. The embryo continues to be viable, and the cervix remains closed.
inevitable abortion
The products of conception have not passed through the client’s dilated cervix; abortion is unavoidable.
incomplete abortion
A partial passing of the products of conception from the cervical os.
some contents remain in the uterus
complete abortion
all products of conception have been completely expelled
septic abortion
Occurs when products of conception are retained and become infected.
missed abortion
Passage of some products of conception. The cervix is closed, but there is no fetal cardiac activity.
can spontaneous abortions happen prior to a client knowing they were pregnant?
yes
A nurse is caring for a client who has had a spontaneous abortion. Which of the following is a possible cause of spontaneous abortions?
chromosomal instability
cause of spontaneous abortions
varies and is not always known
what causes about 50% of spontaneous abortions
fetal chromosomal anomalies
spontaneous abortion and age relation
chance of having one DECREASES as the gestational age INCREASES
modifiable risk factors for a spontaneous abortion
hypertension
large amounts of caffeine
alcohol use
malnutrition
physical trauma
level of alcohol shown to cause spontaneous abortions
250 mL
although no level is considered safe of course
risk factors
for spontaneous abortion that cannot be modified are thrombophilia and antiphospholipid syndrome (APS)
thrombophilia
Blood disorder that causes blood clots.
antiphospholipid syndrome (APS)
A condition in which the immune system creates antibodies that attack tissues in the body.
rates with spontaneous abortions rise?
with maternal age
clinical presentation of spontaneous abortions
uterine cramping or light vaginal bleeding
not always
can also mean ectopic preg
vaginal bleeding may or may not be with passage of tissue too
septic spontaneous abortion clinical presentation
fever
purulent
foul-smelling vaginal discharge
tachycardia
most common medication for spontaneous abortion
misoprostol
800 mcg vaginally once PRN 3 hr up to 7 days after first dose
molar pregnancy
Unexpected chromosomes can cause a molar pregnancy, also known as a hydatidiform mole. Molar pregnancy is a premalignant condition and occurs after improper fertilization
most common type of molar pregnancy
gestational trophoblastic disease
gestational trophoblastic disease
Lesions or tumors, which include placental site nodule, exaggerated placental site, and molar pregnancy, that demonstrate unexpected growth of trophoblast of the placenta; usually non neoplastic, but can become cancerous; highly curable if treated early.
molar pregnancies are benign but can develop into a malignancy called?
gestational trophoblastic neoplasia (GTN)
gestational trophoblastic neoplasia (GTN)
A malignancy that includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. All GTN have the ability to metastasize and may be fatal without treatment.
how are molar pregnancies classified
complete
partial
invasive
complete molar pregnancy
the sperm fertilizes an egg, but there is no genetic material in the egg, so no embryo (fetal tissue) is formed.
most commonly has all paternal chromosomes because the sperm fertilizes an empty egg that lacks maternal chromosomes
partial molar pregnancy
embryo in which two sperm fertilize one egg
more dad genes than mom (BAD)
excessive amount of placental or trophoblastic growth and extra set of chromosomes
invasive molar pregnancy
tumor that grows where the placenta attaches to the uterus
enlarged and attach through the myometrium and possibly into vascular spaces
myometrium
middle layer of uterine wall
M for middle
A nurse is caring for a client who has a molar pregnancy that contains no genetic material and no fetal tissue. Which of the following types of molar pregnancies does the client have?
complete molar pregnancy
complete mole vs partial mole
complete: 46 xx (all dad)
partial: 69xx (all dad)
A nurse is caring for a client who has an invasive mole. Which of the following areas do invasive moles grow into?
myometrium
vascular sites
extrauterine spaces
An invasive mole has enlarged
hydropic villi that were retained in the uterus after a partial or complete molar pregnanc
hydropic villi
Small projections that connect the placenta to the uterus.
risk factors for a molar pregnancy
extremes of maternal ages (under 15 and over 35)
history of spontaneous abortion or infertility
history of molar preg
vaginal bleeding in molar pregnancies
prune juice
complications of molar pregnancy
hyperemesis gravidarum, vaginal bleeding, and pelvic discomfort.
missed period, positive pregnancy test
what can be seen also in a molar pregnancy
preeclampsia