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Exam 2 NUR113
Grief & Loss: Perinatal Loss
| Question | Answer |
|---|---|
| What is Perinatal Loss? | death of fetus or infant anytime from conception to 28 days after birth |
| How can perinatal loss affect an individual? | It can be traumatic for the parents and other family members; causing intense grief |
| Define a misscarriage. | AKA spontaneous abortion occurs prior to 20 wks gestation |
| What is intrauterine fetal death (IUFD)? | Death of a fetus after 20 wks gestations AKA fetal demise or stillbirth |
| What causes loss of fetus in the womb? | -biological condition -accident involving umbilical cord (wrapped around neck or knot) -problem w/ placenta -environmental condition -abnormality for the fetus |
| What can cause a miscarriage? | not always known; blighted ovum, health conditions in mother, generally happens during 1st trimester (<20wks) |
| What can cause a stillborn birth? | - birth defects -chromosomal disorders -placental abruption -maternal infections -slow fetal growth -umbilical cord issues -Rh disease |
| What are risk factors for perinatal loss? | -Maternal Age over 40 -Health conditions (weak cervix, diabetes, thyroid disease) -Previous instance of perinatal loss -Use of drugs, ETOH, tobacco -Exposure to harmful chemicals -DIC may occur after fetal demise |
| How can perinatal loss be prevented? | Most cases can't be prevented; avoiding exposure to drug, tobacco, ETOH, harmful chemicals, and proper maternal care |
| What are the clinical manifestations of fetal demise/miscarriage? | - Spotting - Severe back pain - Cramping - Changes in fetal movement ** - Difficulty finding FHR |
| What interventions should be done for significant decrease in fetal movement? | clinician check FHR, if abnormal ultrasound is done; if the infant is found alive with complications, early delivery or c section is done |
| What is key information a nurse should know about grief in relation to Perinatal Loss? | - Beliefs may hinder grieving process - Disenfranchised grief: pregnancy may not have been known to others; may not be socially acceptable - Patients are at a higher risk for Postpartum Depression |
| What collaborative measures may be done to look into what happened? | -Testing on mother and fetus to determine cause (may be refused for religious reasons) -Referral to support groups or bereavement counseling to provide parents w/ additional supports |
| What cultural considerations may be take into account? | Parents may desire to speak w/ religious/spiritual leader - Jewish faith not allowed to mourn for a child who has been alive for less than 30 days - Islam believes that child is instantly admitted into heaven |
| Why is there pharmacological treatment following perinatal loss? | Depending on how the baby was lost, mom may need meds yo treat infections or complications |
| How is placental abruption treated? | IV Fluids and blood transfusion |
| What happens if a fetus is retained? | Mother will have to get a D&C to remove it |
| True or False: Moms are at low risk for DIC when they have a miscarriage or still brith. | False. They are at high risk |
| What is the treatment for postpartum depression? | Antidepressants and hormone therapy |
| What occurs during the assessment of a mother with suspected fetal demise? | - safety of mother and fetus - assess patient needs (resources/spiritual care) - Collaboration w/ social worker/grief counselor |
| Nursing Process: Planning | Goals Parents will ask questions about the loss Choose how to deliver the fetus Client's health will be monitored Support system will be available Parents will express grief over loss , avoid taking responsibility for fetal loss |
| Nursing Process: Implementation | -Educate on what to expect -Keep away from laboring women -Maintain supportive environment -Enable same nurse to stay with couple -Give couple time to process -Collect and save mementos/photos for parents - Treat baby like a live one |
| Nursing Process: Evaluation | Expected outcomes Ask questions about birthing process Make preferences for birthing process known Express grief over loss of baby Are given resources to help with grief Develop healthy coping mechanisms to work through grieving process |
Created by:
failingstudent88
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