26201880
Description
Flashcards by Laura Snow, updated more than 1 year ago
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Created by Laura Snow
over 3 years ago
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| Question | Answer |
| Preeclampsia defined? | Development of hypertension and proteinuria in a previously normotensive woman after 20 weeks |
| Diagnostic criteria for preeclampsia include? | Blood Pressure > 140/90 X 2 within 4 hours of each other Creatinine level greater than > 1.1mg/dL Platelet count less than < 100,000mm AST/ALT greater than > 12-16 g/dL Uric Acid greater than > 5.9 mg/dL |
| Risk factors for preeclampsia include? | Woman is younger than 19 or older than 40 years of age A first pregnancy with a new partner A history of severe preeclampsia Obesity Family history Multifetel gestation Chronic hypertension Type 1 diabetic |
| HELLP SYNDROME is a laboratory diagnosis for a variant of preeclampsia that involves hepatic dysfunction characterized by? | Hemolysis (destruction of red blood cells) AST greater than > 70 units/L Increased ALT Low platelet count less than < 100,000/mm 10% - 20% of women with preeclampsia develop |
| Most women with HELLP Syndrome will report what symptoms? | Malaise Influenza-like symptoms epigastric or upper right quadrant abdominal pain *Most symptoms occur at night and improve during the day* |
| What race does HELLP Syndrome occur more frequently in? | Caucasian women |
| The rate of preterm birth in women with HELLP Syndrome is approximately? | 70% with 15% of these occurring before 28 weeks of gestation. Most perinatal deaths occur before 28 weeks associated with placenta abruption or severe fetal growth restriction |
| The pathophysiologic changes of HELLP Syndrome occur as a result of? | Arteriolar vasospasm Endothelial cell dysfunction Impaired liver function (liver enzymes are elevated with hepatic tissue is damaged) |
| Risk factors for HELLP Syndrome? | Preeclampsia HTN |
| Outcomes for HELLP Syndrome associated w/ an increased risk for maternal death & adverse perinatal outcomes are? | Pulmonary edema Acute renal failure Disseminated intravascular coagulation (DIC) Placental abruption Liver hemorrhage Failure acute respiratory distress syndrome (ARDS) Sepsis stroke |
| Eclampsia defined? | Development of seizures or coma in women not attributable to other causes in a preeclamptic woman |
| Eclampsia signs and symptoms? | Persistent headache Blurred vision Severe epigastric or right upper quadrant pain Altered mental status Seizures/Convulsions |
| Immediate Care for Tonic-Clonic convulsions include? | Keep airway patent Turn head to one side Place pillow under head or shoulder if possible Do not leave patient/call for help Observe and record convulsion activity |
| Tonic contractions of all body muscles (seen as arms flexed, hands clenched, legs inverted) precedes the tonic-clonic convulsion, what takes place during this stage? | Muscles relax & contract Respiration's are halted & then begin again with long, deep, stertorous inhalations Hypotension follows Muscular twitching, disorientation, and amnesia persist for a while after the convulsion. The woman may vomit or be incontinent of urine/stool. |
| Nursing actions after tonic-clonic convulsions are? | Maternal stabilization Assess airway, breathing & pulse Suction secretions, insert oral airway Administer oxygen at 10L/min by nonrebreather face-mask. Insert IV |
| The drug of choice for treating eclamptic seizures and preventing them is? | magnesium sulfate |
| During the tonic-clonic convulsion the uterus becomes? | hypercontractile & hypertonic (As a result, the membranes may have ruptures or the cervix may have dilated rapid, and birth may be imminent) |
| The route of birth (induction of labor versus cesarean birth) depends on? | Maternal & fetal condition Fetal gestational age Presence of labor Cervical Bishop score |
| The four most common types of hypertensive disorders occurring in pregnancy are? | Gestational HTN Preeclampsia-Eclampsia Chronic HTN Preeclampsia superimposed on chronic HTN |
| Who is more likely to have a pregnancy complicated by chronic HTN than women of other races or ethnicities? | Non-Hispanic black women |
| Women who are hypertensive should be encouraged to make lifestyle changes before conception, such as? | smoking & alcohol cessation aerobic exercising losing weight if indicated well balanced diet |
| Women who are high risk for Hypertension are managed with antihypertensive medication & frequent assessment of maternal & fetal well-being. What is this medication called? | Methyldopa (aldomet) Safe for fetus |
| Hypertensive women after giving birth should be monitored closely for complications such as? | Pulmonary embolism HTN encephalopathy Renal failure |
| A pregnancy that ends as a result of natural causes before 20 weeks of gestation? | Miscarriage |
| Incidence & Etiology of miscarriage include? | Clinical recognized pregnancies 10-15% end in miscarriage 80% occur before 12 weeks 50% result from chromosomal abnormalities Varicella infection in the 1st trimester Endocrine imbalance (hypothyroidism, insulin dependent DM w/ high glucose levels |
| Late miscarriage, occurs between? | 12-20 weeks |
| Late miscarriage usually results from maternal causes such as? | maternal age & parity Premature dilation of cervix Inadequate nutrition Tobacco, alcohol and caffeine use Obesity Stressful life events |
| Different types of miscarriages are considered? | Threatened Inevitable Incomplete Complete Missed |
| What type of miscarriage will NOT lead to infection? | threatened |
| Clinical manifestations of miscarriages are? | Presence of uterine bleeding Uterine contractions Abdominal pain |
| Miscarriages between 6 & 12 weeks cause what? | Moderate discomfort Blood loss |
| A surgical procedure In which the cervix is dilated & suction curette is inserted to scrape the uterine walls and remove uterine contents is called? | dilation & curettage (D&C) |
| Ectopic pregnancy is defined as? | Fertilized ovum implanted outside uterine cavity |
| Incidence & Etiology of Ectopic pregnancy? | Ectopic pregnancy is the leading cause of infertility 95% occur in uterine (fallopian) tube |
| Clinical manifestations of Ectopic Pregnancy? | Abdominal Pain Delayed menses Abnormal vaginal bleeding that occurs approximately 6 to 8 weeks after the last normal period |
| Diagnosis for Ectopic pregnancy? | Quantitative hCG levels Transvaginal ultrasound |
| Medical management for Ectopic pregnancy? | Methotrexate Surgical |
| Normal non-pregnant hemoglobin, hematocrit levels are 12-16 g/dL. If the level has INCREASED, do you suspect preeclampsia or HELLP Syndrome? | Preeclamsia |
| Normal non-pregnant hemoglobin, hematocrit levels are 12-16 g/dL. If the level has DECREASED, do you suspect preeclampsia or HELLP Syndrome? | HELLP Syndrome |
| Normal creatinine levels are 0.5-1.1 mg/dL, If these levels are greater than 1.1 mg/dL, would you suspect preeclampsia or HELLP? | Lab values will INCREASE greater than 1.1 mg/dL for both, preeclampsia and HELLP |
| Normal lab values for Platelets are 150,000-400,000/mm3, for a pregnant woman showing signs of preeclampsia and HELPP syndrome, what will the platelet level be decreased to? | < less than 100,000/mm3 |
| Normal uric acid lab value is 2 - 6.6 mg/dL, if the patient has preeclampsia, what will the lab value be? | > greater than 5.9 mg/dL |
| Normal uric acid lab value is 2 - 6.6 mg/dL, if the patient has HELLP, what will the lab value be? | > greater than 10 mg/dL |
| What maternal and fetal assessment for lab evaluations for women with gestational hypertension and preeclampsia? | hematocrit platelet serum creatinine liver function (AST, ALT) PERFORMED WEEKLY |
| Sign and symptoms of gestational hypertension and preeclampsia with severe features? | severe headache blurred/double vision mental confusion right upper quadrant pain nausea/vomiting SOB decreased urine output |
| Gestational hypertension and preeclampsia with mild signs and symptoms? | ensure maternal safety and to deliver a healthy newborn as close to term as possible |
| Hyperemesis Garvidarum | Nausea and vomiting beginning 4 to 8 weeks of pregnancy with improvement at week 16. |
| What percentage does hyperemesis garvidarum affect pregnant women? | 70% within 4 to 8 weeks 10-20 % will experience symptoms at 20 - 22 weeks of gestation |
| Hyperemesis Garvidarum when severe will cause? | weight loss electrolyte imbalance nutritional deficiencies ketonuria |
| A factor related to the current pregnancy that makes a woman more likely to develop hyperemesis garvidarum? | carrying a female fetus |
| Clinical manifestations of hyperemesis garvidarum? | dry mucous membranes decreased B/P increased pulse rate poor skin turgor dehydration weight loss |
| Factors related to hyperemesis garvidarum? | pregnant with a female fetus younger maternal age nulliparity BMI less than 18.5 or greater than 25 low socioeconomical status multifetal gestation family history |
| Diet for hyperemesis garvidarum include? | avoid an empty stomach, eat every 2-3 hrs eat high protein snack at bedtime eat dry bland low fat foods follow the sweet and salty approach drink ginger ale drink liquids from a cup with a lid (NOT a straw) |
| spotting of blood with the cervix closed, mild uterine cramping? | threatened miscarriage |
| moderate to heavy amount of bleeding with an open cervix, tissue may be present with bleeding? | inevitable and incomplete miscarriage |
| cervix is closed after all products of conception were expelled, slight bleeding, mild uterine cramping | complete miscarriage |
| refers to a pregnancy in which the fetus has died but the products of conception remain in utero for days, weeks or even months | missed miscarriage |
| Three or more spontaneous pregnancy losses before 20 weeks of gestation? | Recurrent (habitual) miscarriage |
| What medication is given to prevent hemorrhage? | Oxytocin (Pitocin) |
| Discharge teaching for a woman after early miscarriage? | cleanse the perineum after each void or bowel movement avoid bath tubs for 2 wks avoid tampons call doctor if fever, or foul discharge occurs eat food high in protein and iron support groups time to grieve |
| Placenta Previa defined? | the placenta is implanted in the lower uterine such that it completely or partially covers the cervical os or is close enough to the cervix to cause bleeding when the cervix dilates |
| Placenta Previa manifestations? | painless bright vaginal bleeding after 20 wks of gestation decreased urine output |
| Most women with Placenta Previa give birth? | by cesarean |
| Management of Placenta Previa is determined by? | gestational age amount of bleeding fetal condition |
| Grade 1, mild separation Placental Abruption | minimal bleeding less than < 500 mL blood loss no pain normal fetal heart rate and pattern dark red stools |
| Grade 2, moderate separation Placental Abruption | absent to moderate bleeding 1000 - 1500mL blood loss dark red stools mild shock pain is present abnormal fetal heart rate and pattern |
| Grade 3, severe separation Placental Abruption | absent to moderate pain greater than > 1500 mL blood loss dark red stools shock common often sudden persistent uterine contractions abnormal fetal heart rate and pattern,fetal death can occur |
| Placenta Previa signs and symptoms? | moderate to severe bleeding and life threatening blood loss varies bright red blood abnormal lower uterine segment normal fetal heart rate and pattern |
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