Flashcards
Unit I Labor and Delivery Complications
Flashcards do conjunto (68)
- 1Preeclampsia defined?Development of hypertension and proteinuria in a previously normotensive woman after 20 weeks
- 2Diagnostic 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 - 3Risk 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 - 4HELLP 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 - 5Most 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* - 6What race does HELLP Syndrome occur more frequently in?Caucasian women
- 7The 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
- 8The 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) - 9Risk factors for HELLP Syndrome?Preeclampsia
HTN - 10Outcomes 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 - 11Eclampsia defined?Development of seizures or coma in women not attributable to other causes in a preeclamptic woman
- 12Eclampsia signs and symptoms?Persistent headache
Blurred vision
Severe epigastric or right upper quadrant pain
Altered mental status
Seizures/Convulsions - 13Immediate 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 - 14Tonic 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. - 15Nursing 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 - 16The drug of choice for treating eclamptic seizures and preventing them is?magnesium sulfate
- 17During 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) - 18The route of birth (induction of labor versus cesarean birth) depends on?Maternal & fetal condition
Fetal gestational age
Presence of labor
Cervical Bishop score - 19The four most common types of hypertensive disorders occurring in pregnancy are?Gestational HTN
Preeclampsia-Eclampsia
Chronic HTN
Preeclampsia superimposed on chronic HTN - 20Who is more likely to have a pregnancy complicated by chronic HTN than women of other races or ethnicities?Non-Hispanic black women
- 21Women 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 - 22Women 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 - 23Hypertensive women after giving birth should be monitored closely for complications such as?Pulmonary embolism
HTN encephalopathy
Renal failure - 24A pregnancy that ends as a result of natural causes before 20 weeks of gestation?Miscarriage
- 25Incidence & 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 - 26Late miscarriage, occurs between?12-20 weeks
- 27Late 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 - 28Different types of miscarriages are considered?Threatened
Inevitable
Incomplete
Complete
Missed - 29What type of miscarriage will NOT lead to infection?threatened
- 30Clinical manifestations of miscarriages are?Presence of uterine bleeding
Uterine contractions
Abdominal pain - 31Miscarriages between 6 & 12 weeks cause what?Moderate discomfort
Blood loss - 32A 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)
- 33Ectopic pregnancy is defined as?Fertilized ovum implanted outside uterine cavity
- 34Incidence & Etiology of Ectopic pregnancy?Ectopic pregnancy is the leading cause of infertility
95% occur in uterine (fallopian) tube - 35Clinical manifestations of Ectopic Pregnancy?Abdominal Pain
Delayed menses
Abnormal vaginal bleeding that occurs approximately 6 to 8 weeks after the last normal period - 36Diagnosis for Ectopic pregnancy?Quantitative hCG levels
Transvaginal ultrasound - 37Medical management for Ectopic pregnancy?Methotrexate
Surgical - 38Normal non-pregnant hemoglobin, hematocrit levels are 12-16 g/dL. If the level has INCREASED, do you suspect preeclampsia or HELLP Syndrome?Preeclamsia
- 39Normal non-pregnant hemoglobin, hematocrit levels are 12-16 g/dL. If the level has DECREASED, do you suspect preeclampsia or HELLP Syndrome?HELLP Syndrome
- 40Normal 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
- 41Normal 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
- 42Normal 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
- 43Normal 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
- 44What maternal and fetal assessment for lab evaluations for women with gestational hypertension and preeclampsia?hematocrit
platelet serum creatinine
liver function (AST, ALT)
PERFORMED WEEKLY - 45Sign 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 - 46Gestational hypertension and preeclampsia with mild signs and symptoms?ensure maternal safety and to deliver a healthy newborn as close to term as possible
- 47Hyperemesis GarvidarumNausea and vomiting beginning 4 to 8 weeks of pregnancy with improvement at week 16.
- 48What percentage does hyperemesis garvidarum affect pregnant women?70% within 4 to 8 weeks
10-20 % will experience symptoms at 20 - 22 weeks of gestation - 49Hyperemesis Garvidarum when severe will cause?weight loss
electrolyte imbalance
nutritional deficiencies
ketonuria - 50A factor related to the current pregnancy that makes a woman more likely to develop hyperemesis garvidarum?carrying a female fetus
- 51Clinical manifestations of hyperemesis garvidarum?dry mucous membranes
decreased B/P
increased pulse rate
poor skin turgor
dehydration
weight loss - 52Factors 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 - 53Diet 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) - 54spotting of blood with the cervix closed, mild uterine cramping?threatened miscarriage
- 55moderate to heavy amount of bleeding with an open cervix, tissue may be present with bleeding?inevitable and incomplete miscarriage
- 56cervix is closed after all products of conception were expelled, slight bleeding, mild uterine crampingcomplete miscarriage
- 57refers to a pregnancy in which the fetus has died but the products of conception remain in utero for days, weeks or even monthsmissed miscarriage
- 58Three or more spontaneous pregnancy losses before 20 weeks of gestation?Recurrent (habitual) miscarriage
- 59What medication is given to prevent hemorrhage?Oxytocin (Pitocin)
- 60Discharge 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 - 61Placenta 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
- 62Placenta Previa manifestations?painless bright vaginal bleeding after 20 wks of gestation
decreased urine output - 63Most women with Placenta Previa give birth?by cesarean
- 64Management of Placenta Previa is determined by?gestational age
amount of bleeding
fetal condition - 65Grade 1, mild separation Placental Abruptionminimal bleeding
less than < 500 mL blood loss
no pain
normal fetal heart rate and pattern
dark red stools - 66Grade 2, moderate separation Placental Abruptionabsent to moderate bleeding
1000 - 1500mL blood loss
dark red stools
mild shock
pain is present
abnormal fetal heart rate and pattern - 67Grade 3, severe separation Placental Abruptionabsent 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 - 68Placenta 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
Informações
- Descrição
- Preeclampsia Eclampsia Hypertension Miscarriage Ectopic pregnancy Hyperemesis gravidarum placental abruption placental previa
- Criado por
- Laura Snow
- Visualizações
- 36
- Avaliação