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Bleeding

In each trimester of pregnancy

QuestionAnswer
What complications are related to 1st trimester? Spontaneous abortions Ectopic pregnancy
What complications are related to 2nd trimester? Gestational trophoblastic disease (Molar Pregnancy)
What complications are related to 3rd trimester? Placenta previa Abruption Placenta
What are the S/S of Spontaneous abortions? Mild to severe cramping increased HR (early) decreased B/P (late) Spotting or hemorrhage
What are S/S of Ectopic pregnancy? Sharp one sided pain syncope referred shoulder pain increased HR (early) decreased B/P (late ) spotting to light vag bleeding
What are the s/s of GTD ( gestational trophoblastic disease) Molar pregnancy? Vaginal bleeding (old bleeding) looks like prune juice * Uterine enlargement Hydropic vesicles (grapelike clusters) HCg levels are elevated * Anemia Htn before 20 wks * Fetal heart tones are absent Hyperemesis - vomiting excessively *
What are s/s of Placenta Previa? Painless Bright red bleeding No ctx Abdomen soft and relaxed Fetal presenting part not engaged
What are s/s of Abruption Placenta? Dark venous bleeding concealed or apparent severe and steady abdominal pain Uterine tenderness Abdomen is firm to stony hard "boardlike" Ctx present
Risk factors of spontaneous abortion Maternal age Chromosomal abnormalities weakened cervix placental abnormalities chronic internal diseases endocrine imbalances maternal infections
Risk factors of Abruption Placenta Maternal age over 35 or under 20 uterine trama- accident, abuse cig smoking alcohol use cocaine abuse history of previous abruption Maternal hypertension
Risk factors of GTD (molar pregnancy) Choriocarcinoma Asians Vegans
Risk factors of Placenta Previa multiparity hypertension trauma maternal advanced age multiple gestations prior placenta previa smoker previous uterine incision
Risk factors of Ectopic pregnancy Inflammation of fallopian tube infection of the uterus- usually from gonorrhea or chlamydia
Treatments for spontaneous abortion emotional support D&C -Dilate and curettage suction and evacuation D&E- Dilate and evacuate
Treatments for Ectopic Pregnancy Medical or surgical surgery for ruptured tube removal or to repair tube Give Methotrexate
Treatment for Placenta Previa Bed rest 2nd and 3rd trimesters NO vaginal exams Give O2
Treatment of Abruption Placenta Bedrest O2 possible emergency c-section
Treatment of GTD (molar pregnancy) follow ups chest xray use birth control for 1 year Hcg level monitored and rechecked - need to get down
Top priority for spontaneous abortions prevention of hemorrhage or infection
Top priority for Placenta previa FHR monitoring fluid replacement Stop bleeding
Top priority for abruption placenta maintaining cardiovascular status for mom Prevention of infection
Top priority for GTD (molar pregnancy) hemorrhage and infection
Top priority for Ectopic pregnancy stop bleeding
Nursing interventions for spontaneous abortion Assess v/s, amount and appearance of any bleeding, level of comfort, and general physical health. Identify blood type support
Nursing interventions for Ectopic Pregnancy Assess appearance and amount of bleeding, monitor v/s for developing shock, assess emotional state and coping abilities, determine level of pain, and if surgery is necessary complete appropriate assessment
Nursing interventions for GTD (molar pregnancy) observe for symptoms of hydatidiform mole assess understanding emotional support monitor v/s and bleeding for hemorrhage determine presence of abdominal pain type and cross match blood for surgery administer oxytocin as ordered
Nursing interventions for Placenta previa assess blood loss, pain , and uterine contractility Evaluate FHR continuously observe mom and family ability to cope with unknown outcome
Nursing interventions for Abruption placenta monitor ctx and uterine resting tone measure abdominal girth
What is a partial mole? Part of placenta
What is complete mole? No baby just fluid
Placenta previa is categorized as being low lying ,Partial, Marginal, or complete
low lying The placenta is implanted in the lower uterine segment in proximity to but not covering the OS
Partial The internal OS is partially covered
Marginal The edge of the placenta is covered
Complete The internal OS is completely covered
Created by: Jaycee420
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