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40 Cards in this Set
- Front
- Back
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Behavior associted with substance abuse
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-late pre natal care
-failure to keep appts -nconsisant follow through with recomended care -poor grooming, inadequate weight gain -needle punctures,thrombosed veins, cellulitis -defensive or hostile reactions -anger or apathy during pregnanacy |
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s/s recent cocaine use
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- sweating, HBP ,irr resp
-dilated pupils -sudden onset severly painful contractions -fetal tachy,excessive fetal activity -anger, caustic, abusive reactions and paranoia |
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recent cocaine use
interventions |
-saftey, seizure percautions
-set limits, monitor patient |
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Cues indicate violence against women
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-nonverbal: facial grimaccing, slow and unsteady gait, vomitting, abdominal tenderness, absense of facila response
- injuries -vague somatic complaints (anxiety, depression, panic) -discrepncy between history and injuries |
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Most common cause of SAB
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severe congenital abnormalitis that are incompatile with life
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first sign of threatened abortion
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vaginal bleeding
may be followed by uterine cramping, back ache or feelings of pelvic pressure |
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abortion is inevitble if
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membranes rupture and cervix dilates
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Incomplete abortion
def |
occurs when some bu not all products of conception are expelled from the uterus
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Incomplete abortion
s/s |
uterine bleeding
abd cramping |
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Complete abortion
def |
all POC are expelled from the uterus
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Missed abortion
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fetus dies during the first half of pregnancy but is retained in the uterus
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Missed abortion major complications
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-infection
-DIC |
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recurrant SAB
def |
three or more consecutive SABs
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Hypovolemic shock
s/s |
-tachycardia
-falling BP - pale skin and mm -confusion -restlessness -cool clammy skin |
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Risk factors for ectopic pregnancy
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- history of STDs
-h/o PID - prev ectopic pregnancy - failed tubal ligation -IUD -multiple induced abortion - maternal age over 35 |
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ectopic pregnancy
s/s |
- missed menstral period
-abd and pelvic pain -vaginal spotting |
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ectopic pregnancy
nursing considerations |
preventing/identifying
hypovolemic controlling pain providing psych support |
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Hydatiform mole
def |
form of gestational trophoblastic dsthat occurs when trophoblasts attache fertalized ovum to the uterine wall.abnormal growth of the placenta, not the uterus develops
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Hydatidiform mole
manifestations |
-vaginal bleeding
-uterus larger than expected for the duraion of the pregnancy -excessive nausea and vomitting -early development of preeclampsia and ecclampsia |
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Hydatidiform
managment |
- evacuation of the ole
-follow up to detect malignancies in the remaining trophoblastic tissue -avoid uterine contractions because it can force the trophoblastic tissue into the vascular system |
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Placenta previa
manifestations |
-sudden onset of painless uterine bleeding in the latter half of pregnancy
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Abrupto placentae
major complications |
-hemorrhage
-hpovolemic shock -clotting abnormalities fetus: anoxia, blood loss and pre term birth |
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Abrupto placentae
manifestations |
- vaginal bleeding
-abd or lower bac pain -uterine irritabilty with frequent low intensity contractions - high uterine resting tone identified by use of an intruterine pressure catheter - uterine tenderness that may be localized to the site of the abruption |
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Abrupto placentae
s/s of concealed hemorrhage |
- increase in fundal height
-hard, board like abdomen -high uterine baseline tone on electronic monitoring strip -persistant abd pain -systemic signs of early hemorrhage -persistantlate decelerations -vaginal bleeding that may be silent or absent |
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Late signs of hypovolemic shock
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-falling BP
-pallor of skin and mucous membranes, cold, clammy skin -urine output less than 30 mL per hour -restlessness agitation and decreased mentation |
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Preeclampsia
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SBP >140 orDBP > 90 that develops after 20 weeks of pregnancy and is accompanied by preotenuria
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Eclampsia
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preogression of preeclampsia to generalized seizures that cannot be atributed to other casues
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Chronic Hypertesion
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SBP > 140 or DBP 90 that was known to exist before pregnancy or develops before 20 weeks gestation. Also dxed if this cont into the postpartum period
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Nursing assesments for Preeclampsia and Mag toxicity
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- daily weight
-blood pressure - RR pulse ox - breath sounds - DTR - edema -UO -urine protein -LOC -HA, epigastric pain, visual problems -fetal HR lab data |
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HELLP prominent symptom
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-RUQ pain
-lower chest pain -epigastric pain |
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Maternal diabetes
comp to newborn |
-hypoglycemia
-hypocalcemia -hyperbilirubinemia -resp distress syndrome |
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gestational DM
def |
carbohydrate intolerance of variable severity that develops or is first recognized during pregnancy
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Gestational diabetes
diagnosed by OGTT |
-fasting greater than 95
-1 hour greater than 180 -2 hours greater than 155 -3 hours greater than 140 |
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Major effects of DM on pregnancy
increased maternal risks |
-PIH
-UTI -ketoacidosis -labor dystocia -birth injury to maternal tisues |
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Major effects of DM on pregnanacy
neonatal effects |
-congenital anomilies
-perinatl death -macrosomia -IUGR -pre term labor -birth injury -hypoglycemia -polycythemia -hyperbilirubinemeia hypocalcemia -resp distress syndrome |
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Maternal hypoglycemia
maternal s/s |
-shakiness
-sweating -pallor; cold; clammy skin -disorienation -HA -hunger -blurred vision |
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Maternal Hypergycemia
s/s |
-fatigue
-flushed, hot skin -dry mouth, excessive thirst -frequent urination -rapid, deep respirations, odor of cetone on breath -drowsiness/HA -depressed refelxes |
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Cardiac disease
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-sypnea
-syncope -hemoptysis -CP -heart murmur |
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Congestive heart failure
s/s |
cough
progressive DOE orthopnea pitting edema heart palpations progressive fatigue or syncope moist rales in lower lobes |
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Fe def anemia
s/s |
pallor
fatigue lethargy HA |
