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Bleeding & Pregnacy

Hemmoragic Complications, Descriptions Nursing Management

QuestionAnswer
When does spontaneous abortion occur? In 1st trimester, before 20 weeks.
What are EARLY (1st Trimester) causes of Spontaneous Abortion? Genetic/Chromosomal Abnormalities
What are LATE (2nd Trimester) causes of Spontaneous Abortion? Maternal Causes R/T Conditions or Drugs Premature (Insufficient) Dilation of Cervix Uterine or Cervical Defects (Fibroid) Chronic Conditions (DM, Hypothyroidism, Nephritis, HTN) Blood Disorders (Thrombophilias) Lupus Infections & Crack Cocaine
What is a THREATENED Abortion? A DEVELOPING spontaneous Abortion
What are S/S of THREATENED abortion? SLIGHT vaginal bleeding early in pregnancy NO dilation of cervix (closed) MILD uterine cramping No Conception Tissue Exposed
What DX test will be done for THREATENED abortion? Ultrasound to SEE IF SAC IS EMPTY Decreased hCG levels Decreased Progesterone Levels
How do you TX THREATENED abortion? Conservative support Bed Rest Nutritious Diet Hydration
What is an INEVITABLE abortion? When the passage of products of conception WILL occur.
What are the S/S of INEVITABLE abortion? MODERATE to HEAVYBleeding Cervical DILATION STRONG uterine cramping RUPTURE of MEMBRANES TISSUE is EXPELLED
What DX test will be done for INEVITABLE abortion? Ultrasound to SEE IF PREGNANCY IS LOST Decreased hCG levels
How do you TX INEVITABLE abortion? VACUUM CURETTAGE to retrieve tissue/Prevent Hemorrrhage and Infection Give prostaglandin analog (MISOPROSTOL)
What is an INCOMPLETE abortion? The EXPULSION of FETUS w/ RETENTION of PLACENTA
What are S/S of INCOMPLETE abortion? HEAVY Bleeding Cervical DILATION INTENSE uterine cramping TISSUE is EXPELLED
What DX test will be done for INCOMPLETE abortion? Ultra Sound to SEE THAT PLACENTA IS STILL IN UTERUS
How do you TX INCOMPLETE abortion? STABILIZE the CLIENT D&C to RETRIEVE PLACENTA Prostaglandin (MISOPROSTOL)
What is a COMPLETE abortion? ALL fetal tissue (BABY & PLACENTA) is EXPELLED
What are S/S of COMPLETE abortion? HX of VAGINAL BLEEDING & ABDOMINAL PAIN TISSUE is EXPELLED VERY LITTLE CURRENT BLEEDING VERY LITTLE CURRENT PAIN S/S of pregnancy DISAPPEAR
What DX test will be done for COMPLETE abortion? Ultrasound SHOWS EMPTY UTERUS
How do you TX COMPLETE abortion? NO TX, Only FOLLOW UP for Family Planning
What is a MISSED (Mother is Unaware) abortion? When the NONVIABLE embryo is in uterus for at least 6 weeks
What are S/S of MISSED abortion? IRREGULAR SPOTTING ABSENT uterine CONTRACTIONS MAY PROGRESS TO INEVITABLE abortion S/S of pregnancy DISAPPEAR Possible INFECTION
What DX tests will be done for MISSED abortion? Ultrasound AFTER DECREASE or NO INCREASE of Fundal Height
How do you TX MISSED abortion based on gestation? 1st Trimester -D&C 2nd Trimester- INDUCED LABOR & PGE2 to empty uterus w/o surgery
What is HABITUAL abortion? HX of 3 or more CONSECUTIVE spontaneous abortions. Pt. is not able to carry pregnancies to term.
What DX tests will be done for HABITUAL abortion? Assess Client HX.
How do you TX HABITUAL abortion? Determine Cause (Genetic/Reproductive Abnormalities, Insufficent Progesterone, Infection, Diseases) CERVICAL CERCLAGE in 2nd Trimester is cause is INCOMPLETE CERVIX
What will you ASSESS for all abortion? Uterine Bleeding for color amount and characteristics Count pads and saved clots Intensity, type and duration of pain/cramping Persistent Lower back pain LMP, V/S Previous pregnancy losses Pt Knowledge of situation Pt. Emotional state
Created by: samarianm