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Bleeding
In each trimester of pregnancy
| Question | Answer |
|---|---|
| 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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