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Exam III Definitions

Foundations of Maternal Newborn Nursing

QuestionAnswer
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