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66 Cards in this Set
- Front
- Back
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CHAPTER NINE
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(Ignore this card)
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Is incompetent cervix painful?
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NO - painless dilation
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Are uterine ctxs responsible for incompetent cervix?
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No - dilation without contractions
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When does incompetent cervix occur
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around 20 weeks
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What medication is a risk factor for incompetent cervix?
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DES
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A short cervix is defined as
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Less than 20 mm in length
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A cerclage is removed at
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37 weeks gestation
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What effect does dehydration have on uterine contractions?
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stimulates uterine contractions
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Hyperemesis gravidarum is related to
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elevated hCG
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N/V is prolonged past when in hyperemesis gravidarum?
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12 weeks gestation
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What does hyperemesis gravidarum do to weight?
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results in 5% weight loss from prepregnancy levels
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Hyperemesis gravidarum may result in
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IUGR or preterm birth
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Hyperemesis gravidarum is more likely if maternal age is
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less than 20 y/o
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Is hyperemesis gravidarum related to gestational trophoblastic disease?
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Yes
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What happens to Na, K, and Cl during hyperemesis gravidarum?
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Decreased
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What happens to liver enzymes during hyperemesis gravidarum?
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increasaed
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During hyperemesis gravidarum, what does a thyroid test indicate?
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hyperthyroidism
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What IV solution is given to the patient with hyperemesis gravidarum?/
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Lactated Ringers
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Which vitamin is given to the patient with hyperemesis gravidarum?
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Vitamin B6 - pyridoxine
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Which antiemetics may be given to the patient with hyperemesis gravidarum?
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Promethazine (phenergan) and metoclopramide (Reglan)
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What is given to the patient with refractory hyperemesis gravidarum?
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Corticosteroids
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In severe cases or if N/V returns, what is done for the patient with hyperemesis gravidarum?
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tube feeding or TPN may be considered
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There is a risk for anemia if there were how many years between pregnancies?
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less than 2 years
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What physical assessment findings would be found in the patient with anemia?
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pallor, brittle nails, shortness of breath
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How is anemia treated prophylactically?
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60 mg of iron supplement
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What is used in the treatment of iron-deficiency anemia when PO supplements cannot be tolerated?
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iron dextran (imferon)
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Ideal blood glucose levels during pregnancy are
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70-110 mg/dL
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Are abortions related to GDM?
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Yes, spontaneous abortions are r/t poor glycemic control
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How are infections related to GDM?
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related to increased glucose in the urine and decreased resistance because of altered carbohydrate metabolism
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GDM is more common in what age group
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Those over 25 y/o
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S/S of hypoglycemia
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nervousness, HA, weakness, irritability, hunger, blurred vision, tinging of mouth or extremities
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S/S of hyperglycemia
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thirst, nausea, abd pain, frequency, flushed dry skin, fruity breath
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Describe a Glucola Screening Test / 1-hour GTT
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50 g oral glucose load followed by plasma glucose analysis 1 hour later performed at 24-28 weeks of gestation; 140 or greater indicates positive
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How much glucose is given with a three-hour GTT
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100 g
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Most PO hypoglycemic agents are contraindicated for GDM, but there is limited use of …
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glyburide (DiaBeta)
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GH
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gestational hypertension
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Describe GH
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begins after 20th week, B/P is 140/90 or greater OR an SBP increase of 30 or DBP increase of 15 from prepregnancy baseline; returns to baseline by 12 wks PP
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Describe mild preeclampsia
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GH with 1 or 2+ proteinuria and weight gain of more than 2 kg (4.4 lb) per week plus mild edema in upper extremities or face
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Describe severe preeclampsia
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B/P that is 160/100 or greater; proteinuria of 3 or 4+, elevated serum creatinine greater than 1.2 mg/dL, HA and blurred vision, hyperreflexia with ankle clonus, pulmonary or cardiac involvement, extensive peripheral edema, RUQ pain, thrombocytopenia
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Is eclampsia usually preceded by hyperreflexia and hemoconcentration?
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Yes
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In HELLP, 'low platelets' refers to how low?
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< 100,000
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GH (PIH) may result in what
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placental abruption, acute renal failure, hepatic rupture, preterm birth, and fetal and maternal death
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DM is a risk factor for PIH
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(Please ignore this side of the card)
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Rh incompatibility is a risk factor for PIH
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(Please ignore this side of the card)
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Molar pregnancy is a risk factor for PIH
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(Please ignore this side of the card)
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Name some S/S of PIH
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oliguria, scotoma, dyspnea, diminished breath sounds, jaundice, rapid weight gain of 2 kg(4.4 lb) per week in the second and third trimesters
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What happens to Hgb during PIH?
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decreases
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What happens to bilirubin during PIH?
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hyperbilirubinemia
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According to ATI, the client on MgSO4 should be on fluid restriction of what?
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100-125 mL/hour
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The client on MgSO4 should have a urine output of
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30 mL or greater per hour
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The client on MgSO4 should avoid what three foods?
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high in Na, high in caffeine, ETOH
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Describe Class I heart disease
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client exhibits no S/S with activity
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Describe Class II heart disease
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client has S/S with ordinary exertion
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Describe Class III heart disease
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client has S/S with minimal exertion
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Describe Class IV heart disease
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client has S/S with rest
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What does the healthcare provider determine the client's classification of heart disease/.
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At 3 and 7 months gestatoin
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The risk factors for heart disease includ3
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preterm labor, miscarriage, and IUGR
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List three physical assessment findings for the patient with heart disease?
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hemoptysis, IUGR, decreased amniotic fluid
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Holter monitoring is used…
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on the patient with heart disease
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Which vaccines should always be administered to clients with heart disease?
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influenxa and pneumococcus vaccines
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List five medications used for heart disease
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Propranolol (Inderal), gentamicin (Garamycin), Ampicillin (Polycillin), Heparin sodium, Digoxin (Lanoxin)
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Describe propranolol as a heart medicine
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(Inderal) - a beta-blocker that is used to treat tachyarrhythmias and to lower maternal B/P
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Describe Gentamicin as a heart medicine
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(Garamycin) - an aminoglycoside antibiotic that is used prophylactically to prevent endocarditis
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Describe Ampicillin as a heart medicine
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(Polycillin) an antibiotic that is used prophylacticallly to prevent endocarditis
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Describe heparin Na as a heart medicine
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an anticoagulant for PE, DVT, cyanotic heart defects, and rheumatic heart disease
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Describe Digoxin as a heart medicine
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(Lanoxin) - a cardiac glycoside that is used to increase CO during pregnancy, and may be prescribed if fetal tachycardia is present
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