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Maternity Ch5 CCC105

Maternity Chapter 5 CCC PN 105

causes of high risk pregnancies maternal medical condition, environmental hazards, maternal behaviors, pregnancy itself
amniocentesis needle inserted into amniotic cavity to pull sample of amniotic fluid for fetal assessment; only physician gives results
nurse responsibilities for anmiocentesis prepare patient, explain test reason, clarify/interpret results with other providers
pregnancy danger signs sudden gush of fluid from vagina, vaginal bleeding, presistent vomiting, absominal pain, edema of face and hands, severe/persistent headache, blurred vision/dizziness
hyperemesis gravidarum excessive nausea and vomiting can impact fetal growth, lead to dehydration, reduce blood/oxygen/nutrients to fetus
hyperemesis gravidarum treatments correct dehydrations and electrolyte balance; antiemetic drugs may be prescribed; hospitalization
types of abortions spontaneous and induced
types of spontaneous abortions threatened, complete, recurrent
types of induced abortions therapeutic and elective
threatened abortion cramping anc backache with light spotting, cervix is closed, no tissue passed
threatened abortion treatment ultrasound to determine fetal life, bed rest, avoid coitus
complete abortion passage of all products of conception, cervix closes, bleeding stops
complete abortion treatment patient is monitored, emotional support is given, give Rhogam if necessary
recurrent abortion two or more consecutive spontaneous abortions, usually caused by incomptetent cervix or inadequate progesterone levels
recurrent abortion treatment, incompetent cervix cerclage (reinforcement with surgical suture) and monitoring for early signs of labor to prevent uterine rupture
therapeutic abortion intentional termination to preserve health of mother
elective abortion intentional termination for any reason besides health of mother
post-abortion teaching report increased bleeding, take temperature every 8 hours for 3 days
ectopic pregnancy 95% occurs in fallopian tube, tubal deformity or scarring may result; due to hormonal abnormalities, inflammation, infection, adhestions, congential defects, endometriosis
ectopic pregnancy fetal survival rate 0% chance
signs of ectopic pregnancy lower abdominal pain, light bleeding
signs of ruptured tube ectopic pregnancy sudden severe lower abdominal pain; vaignal bleeding, hypovalemic shock, shoulder pain
first priority of ectopic rutpure treatment control bleeding
hypovalemic shock shock due to sudden, severe blood loss
signs of hypovalemic shock fetal heart rate changes, tachycardia, tachypnea, shallow irregular respirations, hypotension, decreased urine output, pale skin/mucous membranes, cole/clammy skin, faintness, thirst
bleeding disorders of late pregnancy placenta previa, abruptio placentae
placenta previa abnormal implantaion of placenta in lower uterus instead of upper
signs of placenta previa bright red bleeding, painless bleeding
marginal placenta previa placenta reaches 2-3cm of cervical opening
partial placenta previa placenta partly covers cervical opening
total placenta previa placenta completely covers cervical opening
abruptio placentae premature separation of placenta that was normally implanted
signs of abruptio placentae dark red bleeding, enlarged uterus, painful bleeding; can be partial, total, or central
treatment of placenta previa attempt to maintain pregnancy until fetal lungs mature (34 wks); delivery of fetus if mother life jeopardized
treatment of abruptio placentae immediate cesarean delivery
risk factors for gestational hypertension first pregnancy, obesity, family history, over 40, under 19, multifetal pregnancy, chronic hypertension, chronic renal disease, diabetes
what is one factor that helps distinguish placenta previa from abruptio placentae pain level
preeclampsia gestational hypertension with proteinuria
eclampsia gestational hypertension with convulstions, progression of preeclampsia
cure for preeclampsia/eclampsia birth
problems r/t preeclampsia abruptio placentae, premature birth, still birth, eclampsia
treatment for gestational hypertension frequent prenatal visits, urinalysis, fetal assessments, possible medications
manifestations of gestational hypertension hypertension, edema, proteinuria
what BP is gestational hypertension increase of over 30/15 than normal
Rh incompatibility only with Rh- mother and Rh+ child
Rh incompatibilty treatments Rhogam at 28 weeks, baby blood tested immediately after birth, if incompatibility exists, mother is given Rhogam again within 72 hrs
erythroblastosis fetalis when maternal anti-Rh antibodies cross placenta and destroy fetal erythrocytes, occurs during 2nd pregnancy if first pregnancy was Rh incompatible
gestational diabetes mellitus (GDM) glucose intolerance with onset during pregnancy
cause of gestational diabetes (GDM) glucose metabolism affected because placental hormones increase cell resistance to insulin
risks of gestational diabetes (GDM) congenital abnormalities drom maternal hyperglycemia
gestational diabetes risk factors (GDM) maternal obesity, large infant, maternal age, previous stillbirth, history of GDM, family history of GCM
what is glucose of GDM fasting gludcose of 126, postmeal glucose over 200
treatment of GDM diet, monitor glucose blood levels, ketone monitoring, exercise, fetal assessment
fetal affects from GDM hypoglycemia, respiratory distress, macrosomia
affects of sickle cell disease on fetus preterm birth, growth restriction, fetal demise
TORCH infections Toxoplasmosis, Other, Rubella, Cytomegalovirus, Herpes
genital herpes infection during pregnancy if infection not active, mother can deliver vaginally; if outbreak, must be cesarean
2 types herpes 1 - cold sores, fever blisters; 2 - genital
HIV during pregnancy infanct can be infected through placenta, through maternal secretions at birth, through breast milk
pregnant women should not change cat litter box because of risk of toxoplasmosis
Group B Strep and pregnancy leading cause of perinatal infections that have a high neonatal mortality rate
Group B Strep test during pregnancy culture taken during 35-37 wks gestation
Group B Strep treatments during pregnancy penicillin given during labor, infant can die if not treated
Created by: cmp12345