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50 Cards in this Set
- Front
- Back
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what does early care do
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improved outcomes
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is every pregnancy the same
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no, each is different
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if something is normal, is it safe to say that it will remain that way?
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no, anything normal can become abnormal
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what kind of things do we need to look for/ask about in hi risk clients
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Health history (look for face and hand edema, ab pain, bleeding, increased BP, blurred vision, spots.)
Physical exams (VS, inspect,palpate of uterus and cervix,labs) |
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What is a spontaneous abortion?
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loss of pregnancy before the fetus is viable outside the uterus, misscarriage, birth that occours before the end of 20 weeks gestation.
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Spontaneous ab
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unexpected
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threatened
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partial separation of placenta
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Imminent
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inevitable
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Incomplete
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some prods of conception remain in the body
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Complete
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all prods of conception are expelled
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missed
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no viability, fetus is not expelled
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recurrent
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keep getting pregnant, keep losing baby, 3 or more
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What are some causes of abortion
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Abn developement, faulty implantation (unfavorable uerine environment), Infection/disease/drug use, trauma.
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What are some complications of abortion
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hemmorhage-bleeding, esp in 1st trimester. Sepsis-shock, renal failure
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How do we treat an abortion
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Depends on the type, but in general=stop the pain, freq VS, comfort (grief), teaching (comfort, safety, rest), RhoGam (usu with rh- moms, don't know babies blood type)
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What is another mane for a Hydatidiform mole?
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Gestational trophoblastic disease.
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What is a hydatidiform mole?
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degenerative process in the chorionic villi, gving rise to multiple cysts and rapid growth of the uterus, with hemmorhage.
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What are the s&s of a HM? How is it diagnosed?
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s&s of pregnancy, but not really pregnant, usu discovered in the first 18 weeks, and client may have a brownish froth in vag area. Dx through sonogram.
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How do we Tx a HM?
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D&C to remove the tumor, usu expelled in the 4th month. PIH or preeclamsia may appear in 1st trimester, so TX this as well.
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What teaching should be done? How often should a pap be done?
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Dont get preg for at least a year, and a pap q 3 mos.
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What is a client wth a HM at greater risk for?
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Uterine cancer, or choriocarcinoma.
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What is an ectopic pregnancy?
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implantation of all prods of conception somewhere besides the uterus, like the falloopian tubes.
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Doest it cause bleeding?
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yes, its the 2nd greatest cause of 1st trimester bleeding
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what are the S&S of EP
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severe pain, bleeding, dizzy/faint, Nause, vomiting, presents like appendicitis
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How is an EP Dx
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preg test, poss of fallopian tube rupturing, may bledd to death
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How do we Tx a EP?
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Methotrexate possibly, look at physical needs, teaching, RhoGam, Emotional needs.
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What is an incompetenet cervix?
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painless dilation of the cervical os, no contractions, everything empties, habital abortion.
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Tx of IC
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Cerclage/sew cervix shut, Activity restrictions (no sex), monitor mom/baby. Usu appears in 2nd trimester
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What is hyperemesis gravidarium?
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excessive vomiting during pregnancy that results in fluid and electrolyte imbalance and dehyration (nutritional imbalance) usu in 2nd trimester
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How do you Tx HG?
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rehydrate with IV fluids, antiemetics. NI-monitor I&O, small, frequent meals
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What is premature labor?
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labor prior to the 37th week. usu between 20-37 weeks.
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what is the desired outcome of premature labor
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healthy mom and baby
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what meds are given to help with PL?
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Mag sulfate, terbutaline, brethine.
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Hwat does mag sulfate do?
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Its a depressant, monitor the BP and deep tendon reflexes, monitor the I&O, and frequent VS.
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What is the theraputic level of Mag sulfate? What is the antidote to mag sulfate?
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4-8 is the ther level, and calcium gluconate is the antidote.
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How do we give terbutaline/brethine? Why do we give it?
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SQ or PO, its given for those individuals on bed rest at home. Take it q 4 hours, it may cause tachycardia and the jitters.
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Why do we give steriods to premature labor clients?
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Steroids such as betametasone and dexamethasone stress the baby and help with fetal lung devlopement. They inc surfactant and inturn help with O2 exchange.
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What is another drug used to prevent labor?
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Indomethasone, or indocin. Cant give to much, or may close the PDA.
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What is PIH?
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preg induced hypertension, toxemia, preeclampsia
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What is preeclampsia?
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hypertension, edema, and protienuria.
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What is mild/severe Pre?
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140/92, 2+protienuria, puffiness in hands and face.
170/110, 4+ protienuria, severe swelling. |
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What is the baseline rule for pre?
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30/15 above the baseline BP is pre status.
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When is preeclamsia most common? What are some S&S?
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Is most common in the 1st preg, however doesn't really show up until the 2/3rd trimester. It affects all systems, look for headaches, dyspnea, blurred vision, spots in eyes. Also montior for NV, hyper reflexia, and + clonus.
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What happens if yoy have all the signs of PIH and epigatric pain as well?
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possible HELLP syndome
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What can preeclampsia advance to?
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eclampsia
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What is eclampsia?
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It is severe preeclampsia with seizures, possibly caused by inc ICP or uteroplacental ischemia.
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Is there a cure for pre?
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yes, delivery of the baby (only one)
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What are S&S of Pre?
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Inc BP, protienuria, oliguria, headache, blurred vision/spots, abdomen hurts, NV, hyperreflexia.
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How is Dx of pre done?
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look for inc BP, Protienuria, edema, deep tendon reflexes, clonus.
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Should sezure precautions be take with pre/eclampsia, if so, what are they?
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yes, dark quiet room, mag sulfate (CNS depressant, monitor I&O's, keeps from seizing), Count fetal movements, assess for headache/consiousness/spots, daily weight, edema, deep tendon reflexes q4 hrs, bed rest, and an inc protien diet.
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