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80 Cards in this Set

  • Front
  • Back
What are the two broad categories that complicate pregnancy?
1. Related only to pregnancy
2. Can be seen anytime, but is worse with pregnancy.
What are the 5 most common pregnancy-related complications?
1. hemorrage during early preg.
2. hemorrage during late preg.
3. HEG
4. HTN disorders
5. Blood incompatibilities
What are the 3 most common causes of hemorrhage during the first half of the pregnancy?
1. Abortion (spontaneous)
2. Ectopic Preg.
3. Gestational trophoblastic disease.
A non-viable fetus is what?
Less than 20 weeks gestation, or less than 500 grams.
What is an abortion?
A spontaneous or an induced ending of pregnancy.
What 3 groups are most at risk for an abortion?
1. Less than 20
2. Older than 40
3. Increase dramatically over 40.
What is the most common cause of spontaneous abortion?
Congenital abnnormalities that are incompatible with life.
When does a spontaneous abortion usually occur?
Within the first 12 weeks.
What 7 infections can cause spontaneous abortions?
1. Syphilis
2. Listeriosis
3. Toxoplasmosis
4. Brucellosis
5. Rubella
6. Cytomegalic inclusion disease
7. Intraabdominal infections
What is listeriosis?
Usually gotten from unpasterized milk products.
What is toxoplastmosis?
Carried by cats. Mother's shouldn't handle or be around litter boxes.
What is Brucellosis?
Carried in milk. Most cows are tested once a year in this country.
What is Cytomegalic Inclusion Disease?
It's a herpes virus.
What are the 2 materal factors that may cause abortion?
1. Hypothyroidism
2. Reproductive organs abnormaliities.
What are the 6 sub-groups of spontaneous abortions?
1. Threatened
2. Inevitable
3. Incomplete
4. Complete
5. Missed
6. Recurrent
What is the first sign of a threatened abortion?
Vaginal Bleeding
What are the 4 s/s of a spontaneous abortion?
1. Vag bleeding
2. Uterine cramping
3. Persistent backache
4. Feeling of pelvic pressure
What 2 diagnostic tests is preformed when there is a possiblity of a threatened abortion?
1. Ultrasound to show gest. age and see if there is a heart rate.
2. hCG- to see if level is appropriate for gestational age.
What 2 things should a woman be told to watch for during a threatened abortion?
1. note the amount of bleeding by counting pads.
2. report any odor, which could mean infection.
What constitutes an inevitable abortion?
When the cervix dialates and membranes rupture
For what 2 reasons would a D & C be performed in an inevitable abortion?
1. Advanced pregancy, still less than 20 weeks
2. Excessive bleeding
Is the patient sedated for a D & C?
Yes.
What is an incomplete abortion?
Occurs when the contents of an abortion aren't completely expelled from the uterus.
Is there a way for an incomplete abortion to be actually complete?
Yes. The contents my be in the vagina and unable to be expelled because of size.
What 2 things happen to a women if all contents of an abortion are not expelled?
If stable, pt goes for D & C. IV fluid, and oxytocin are given after to decrease bleeding.
What are the 7 compensatory mechanisms seen during hypovolemic shock?
1. Fetal tachycardia
2. Maternal tachycardia
3. Thready pulse
4. Normal or slightly decreased BP
5. Increased resp rate
6. Low O2 sat
7. Cool, pale skin and mucous membranes.
What are the 8 later s/s of hypovolemic shock?
1. Falling BP
2. Falling O2
3. Pallor
4. Skin is cold and clammy
5. Urine output less than 30 mL/Hr.
6. Restlessness
7. Agitation
8. MSC
What 6 things should the nurse do to promote oxygenation of tissue for hypovelemic issues?
1. Lateral position on flat bed
2. Limit maternal movement
3. Reduce anxiety
4. Two large- bore IVs
5. Fluid to maintain output of 30 mL/Hr.
6. Get order for type and cross
What is hyperemesis gravidarum (HEG)?
Persistent, uncontrollable vomiting that begins in teh first weeks of preg and may continue throughout.
What are the 8 consquences of HEG?
1. Weight loss
2. Dehydration
3. Acidosis from starvation
4. Increased blood and urine ketones
5. Aldalosis for loss of HCL in gastric fluids
6. Hypokalemia
7. Vit. K defiency
8. Thiamine Deficiency
At what week gestation is a D & C no longer performed and why?
14 weeks d/t poss. hemorrhage.
What 3 things should a patient be taught after a complete abortion?
1. Rest
2. Watch for bleeding, fever, or pain
3. No intercourse until f/u
What is a missed abortion?
When the fetus dies within the first half of the pregnancy, but remains in the uterus
What defines recurrent abortions?
2 or 3 abortions depending on teh source.
Describe the accomplishments of the Tuskegee Airmen
1st black fighter squadron the 99th formed at Tuskegee AB Alabama. Never lost a bomber to enemy fire. Yet destroyed 409 enemy aircraft and won the last 4 aerial victories of the AAF in the Mediterranean Theater. They flew 15,553 sorties and 1578 missions by the end of the war.
What are the 3 major groups that cause DIC?
1. Infusion of tissue thromboplastin into circulation, as as with prolonged retention of a dead fetus or placenta
2. Endothelial damage, such as severe preeclampsia and HELLP syndrome
3. Effects of other diseases, such as maternal sepsis or amniotic fluid embolism.
What is the primary treatment of DIC?
Correct the cause
What 2 things make an ectompic pregnancy so bad?
1. Huge cause of maternal death
2. Reduces the ability to get pregnant d/t damage or destruction
What 3 things cause the damage to cause an ectopic pregnancy?
1. Pelvic infection, such as chlamydia or gonorrhoea.
2. Inflammation
3. Surgery, such as a failed tubal
When monitoring for s/s of tubal ruptures, what are the 4 things the nurse should be looking for?
1. Pain in the shoulders, neck, or pelvis
2. Dizziness or faintness
3. Increased vaginal bleeding
What are the 3 major groups that cause DIC?
1. Infusion of tissue thromboplastin into circulation, as as with prolonged retention of a dead fetus or placenta
2. Endothelial damage, such as severe preeclampsia and HELLP syndrome
3. Effects of other diseases, such as maternal sepsis or amniotic fluid embolism.
What is the primary treatment of DIC?
Correct the cause
What 2 things make an ectompic pregnancy so bad?
1. Huge cause of maternal death
2. Reduces the ability to get pregnant d/t damage or destruction
What 3 things cause the damage to cause an ectopic pregnancy?
1. Pelvic infection, such as chlamydia or gonorrhoea.
2. Inflammation
3. Surgery, such as a failed tubal
When monitoring for s/s of tubal ruptures, what are the 4 things the nurse should be looking for?
1. Pain in the shoulders, neck, or pelvis
2. Dizziness or faintness
3. Increased vaginal bleeding
Hast is Gestational Trophoblastic Disease (Hydatidiform Mole)?
When the trophoblast, which are the peripheral cells that attach to the uterus, develop adnormally
What does a moler pregnancy look like?
Grape clusters
What are the 6 s/s of a GTD pregnancy?
1. Higher than normal hCG
2. Ultrasound that shows either the clusters or absence of FHR or fetal sac
3. Larger than normal uterus for gestation
4. Vaginal bleeking that could be any color
5. HEG
6. Preeclampsia before 24 weeks
How is a moler prengnancy treated?
Removal of the trophoblasts and continueous f/u for a year so malignant changes could be caught early
What should be avoided until after the trophoblasts have been removed?
Oxytocin. It can be given after to help stop bleeding.
What are the 5 things that should be taught to a women after a procedure following a lost pregnancy as far as preventing infection?
1. Daily showers
2. Handwashing before and after pads
3. Wiping and cleaning front to back
4. Pad should be used instead of tampons
5. Intercourse should be avoided until f/u
What are the two reasons for hemorrhage in the last half of the pregnancy?
1. Placenta Previa
2. Abruptio placentae
What are the 3 types of Placenta Previa?
1. Marginal, or low-lying
2. Partial
3. Total
What is a marginal placenta previa?
Greater than 3 cm for the os of the cervix
What is a partial placenta previa?
Within 3 cm of the os of the cervix
What is a total placent previa
Where the placenta completely covers the os of the cervix.
What7 risks that increases the risk of placena previa?
1. C-section
2. Induced or spontaneous abortion
3. Previous Placenta previa
4. African or Asian
5. Smoking
6. Cocaine use
7. Male fetus
What are the 5 s/s of Abruptio Placentae?
1. Bleeding (vaginal or concealed)
2. Loccalized uterine tenderness
3. Low intensity contractions and poor relaxation between them
4. Aching or dull abdominal or low back pain
5. Hig resting uterine tone
3. A
3.
When the nurse is faced with a hemorrhagic situation what are the 8 assessment points that need to be addressed?
1. Amount and nature of bleeding
2. Pain
3. Maternal v/s
4. Condition of the fetus
5. Contractions
6. OB history
7. Gestational age
8. Labs
What is considered normal output?
1 mL/kg/hr
What are the 5 things that should be taught to a women after a procedure following a lost pregnancy as far as preventing infection?
1. Daily showers
2. Handwashing before and after pads
3. Wiping and cleaning front to back
4. Pad should be used instead of tampons
5. Intercourse should be avoided until f/u
What are the two reasons for hemorrhage in the last half of the pregnancy?
1. Placenta Previa
2. Abruptio placentae
What are the 3 types of Placenta Previa?
1. Marginal, or low-lying
2. Partial
3. Total
What is a marginal placenta previa?
Greater than 3 cm for the os of the cervix
What is a partial placenta previa?
Within 3 cm of the os of the cervix
What is a total placent previa
Where the placenta completely covers the os of the cervix.
What7 risks that increases the risk of placena previa?
1. C-section
2. Induced or spontaneous abortion
3. Previous Placenta previa
4. African or Asian
5. Smoking
6. Cocaine use
7. Male fetus
What are the 5 s/s of Abruptio Placentae?
1. Bleeding (vaginal or concealed)
2. Loccalized uterine tenderness
3. Low intensity contractions and poor relaxation between them
4. Aching or dull abdominal or low back pain
5. Hig resting uterine tone
3. A
3.
When the nurse is faced with a hemorrhagic situation what are the 8 assessment points that need to be addressed?
1. Amount and nature of bleeding
2. Pain
3. Maternal v/s
4. Condition of the fetus
5. Contractions
6. OB history
7. Gestational age
8. Labs
What is considered normal output?
1 mL/kg/hr
What is the BP of gestational HTN or PIH?
140/90. Develops after 20 weeks, but returns to normal after delivery and no proteinuria.
What is the BP of preeclampsia?
140/90. Develops after 20 weeks and there is postive proteinuria
What is the BP of eclampsia?
Same as preeclampsia, but progression to seizures
What is the BP of chronic HTN?
140/90 before pregnancy developed or develops before 20 weeks, or if BP doesn't return to normal after delivery
What are the 6 s/s of preeclampsia?
1. H/A
2. Drowsiness
3. Confusion
4. Blurred or Double Vision
5. Numbness and Tingling
6. "Upset Stomach"
When do most eclamptic seizures occur?
Within 24 hours postpartum.
What are 3 signs of impending seizures with preclampsia?
1. Hyperreflexia, Clonus
2. Cerebral irritablility, such as H/A and blurred vision
3. Epigastric pn, ruq pn, and n/v
What are 6 things to do to prevent seizures or make them safer?
1. Pad rails
2. Admit to quiest room possible
3. Keep lights low and noise down
4. Group nursing assessments
5. Move carefully and calmly around the room
6. Work with patients to restrict visitors
What's important to remember about HELLP syndrome?
Even though the pt may not have HTN, she may still be preeclamptic. Look for other symptoms.
What do you not do with the HELLP patient?
DO NOT PALPATE THE ABDOMEN!