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Exam III Definitions
Foundations of Maternal Newborn Nursing
| Question | Answer |
|---|---|
| Preeclampsia | Hypertensive disorder of pregnancy. Characterized by HTN & proteinuria |
| Eclampsia | HTN of pregnancy accompanied by seizures |
| The most common cause of spontaneous abortion | severe congenital abnormalities |
| Three Causes of Hemorrhage: during first half of pregnancy | Abortion, Ectopic pregnancy, Gestational trophoblastic disease |
| Inevitable Abortion | cannot be stopped when membranes rupture, cervix dilates |
| Threatened Abortion | 1st sign- vaginal bleeding |
| Vacuum curettage | to clean out uterus (if natural process is ineffective or incomplete) |
| D&C | for more advanced pregnancy or excessive bleeding (IV sedation or analgesic) |
| What is an Incomplete Abortion? | some, but not all products of conception are expelled from uterus |
| Incomplete Abortion | Initial treatment is cardiovascular stabilization |
| What is a complete abortion? | All products of conception are expelled from uterus |
| Manifestations of Complete Abortion | Uterine contractions and bleeding subside and cervix closes. |
| What is a Missed Abortion? | fetus dies during 1st half of pregnancy but is retained in uterus. |
| What is a serological test? | any of several laboratory procedures carried out on a sample of blood serum, the clear liquid that separates from the blood when it is allowed to clot. |
| What is the purpose of a serological test? | Detect serum antibodies or antibody-like substances that appear specifically in association with certain diseases. |
| When is a vaginal culture indicated? | it is used to check for overgrowth of yeast or other bacteria |
| How do you treat Pelvic Inflammatory Disease(PID)? | Acute PID is often treated with IV administration of broad-spectrum antibiotics. The IV antibiotics can be changed to oral treatment after 48 hours. |
| pregnancy-induced hypertension | Increased blood pressure; systolic increase of 30mmHg, diastolic increase of 15mmHg over the baseline pressure for the individual woman on two assessments at least 6-hr apart, Occurs mostly in the last trimester Proteinuria, Edema |
| Preeclampsia | systolic BP >= 140mmHg or diastolic BP >= 90mmHg that develops after 20wks gestation and is accompanied by proteinuria |
| Gestational hypertension | Systolic BP >=140mmHg or diastolic BP >=90mmHg that develops after 20 wks gestation but without significant proteinuria |
| Chronic Hypertension | Systolic BP >=140mmHg or diastolic BP >=90mmHg that was known to exist before pregnancy or develops before 20 wks gestation (also if HTN doesn't resolve during postpartum period) |
| preeclampsia should be suspected if the woman has a sudden increase in _____. | proteinuria from her baseline levels, a sudden increase in BP when it had been previously well controlled, development of thrombocytopenia or abnormal elevations of liver enzymes (AST or ALT). |
| In normal pregnancy vascular volume and cardiac output _____ significantly. | increase |
| Blood pressure ___ rise in normal pregnancy. | does't |
| Vasospasm ______ the diameter of the blood vessels which results in endothelial cell damage. | decreases |
| _________ also results in impeded blood flow and elevated BP. As a result, circulation to all body organs including kidneys, liver, brain and placenta is ______. | Vasoconstriction, decreased |
| Additional risks associated with preeclampsia and eclampsia | Pulmonary edema, circulatory or renal failure, intracranial hemorrhage |
| The only cure for eclampsia | The only cure is to deliver the baby |
| If mother has preeclampsia or eclampsia and the fetus is <34 wks, | steroids will be given to accelerate fetal lung maturity and an attempt to delay birth for 48hrs |
| Care is given with administering anti-hypertensive meds for the woman on magnesium sulfate to avoid _______. | hypotension |
| Most common med given to pregnant women to prevent seizures | Magnesium Sulfate |
| Disseminated Intravascular Coagulation(DIC) | “Life-threatening” defect in coagulation. Inappropriate coagulation in microcirculation Tiny clots form in tiny blood vessels, blocking blood flow to organs, causing ischemia |
| Three Causes of Hemorrhage: during first half of pregnancy | Abortion Ectopic pregnancy Gestational trophoblastic disease |
| Threatened abortion | 1st sign: vaginal bleeding May be accompanied by cramps, back pain |
| Inevitable Abortion | cannot be stopped when membranes rupture, cervix dilates (this is the difference between a threatened and inevitable abortion) |
| Manifestations of Inevitable Abortion | Ruptured membranes, Dilated cervix, Uterine Contractions, Active bleeding |
| Therapeutic Management of Inevitable Abortion | Vacuum curettage – to clean out uterus (if natural process is ineffective or incomplete) D&C – for more advanced pregnancy or excessive bleeding (IV sedation or analgesic) |
| Incomplete Abortion manifestations | Active uterine bleeding, Severe abdominal cramping |
| Complete abortion theraputic management | Rest, Watch for further bleeding, pain, or fever, Teaching—no sex until follow-up with doctor |
| Missed abortion can only be diagnosed by | Ultrasound examination confirms fetal death |
| Recurrent Abortions | three or more spontaneous abortions |
| Diseases that cause DIC fall into 3 categories | Infusion of thromboplastin into the circulation, which consumes or “uses up” clotting factors such as fibrinogen & platelets. Conditions characterized by endothelial damage. Non-Specific effects of diseases, Maternal sepsis, Amniotic fluid embolism |
| Priority treatment for DIC is to correct the cause. | correct the cause. |
| DIC may be diagnosed if you ____ | Observe for bleeding from unexpected sites |
| If coagulation are severely abnormal—epidural is _______. | contraindicated |
| Ectopic Pregnancy | implantation of fertilized ovum in an area outside uterine cavity. |
| Ectopic pregnancy aka “disaster of reproduction” | Significant cause of maternal death from hemorrhage Reduces chance of subsequent pregnancy because of damage to Fallopian tube |
| Clinical Manifestations or “Classic Signs” of ectopic pregnancy | Missed menstrual period Abdominal pain Vaginal “spotting” |
| Urine output below 30ml/hr may indicate _____. | renal failure |
| ____ _____may precede respiratory depression and indicate mag toxicity. | Absent reflexes |
| Methotrexate is used to | inhibit cell division (ectopic pregnancy) |
Created by:
amysfenton
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