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Antepartum Review
| Question | Answer |
|---|---|
| Hyperemesis gravidarum | excessive nausea and vomiting with pregnancy |
| spontaneous abortion | spontaneous loss of a pregnancy before 20 weeks |
| therapeutic abortion | intentional loss of pregnancy before 20 weeks |
| ectopic pregnancy | development of fetus outside uterus |
| hydatidiform mole | chorionic villi abnormally increase and develop vesicles resembling grapes |
| placenta previa | placement attachment in lower uterine section |
| incompetent cervix | failure of cervix to remain closed until fetus mature |
| abruptio placentae | premature separation of the normally implanted placenta |
| What is the primary risk from hyperemesis gravidarum | fetal growth restriction (aka fetal growth retardation) and dehydration |
| what is the most common cause of bleeding in early pregnancy? | spontaneous abortion |
| an ectopic pregnancy usually occurs in the? | fallopian tube |
| priority nursing assessment for a patient with an ectopic pregnancy if monitoring for? | hypovolemic shock |
| why is long term follow up are important for a patient with a hydatidiform mole? | may cause hemorrhage, Hypertension, clotting abnormalities, or cancer (choriocarcinoma) |
| threatened abortion | vaginal bleeding without dilation of cervix or passed tissue |
| inevitable abortion | bleeding and cramping with cervical dilation but no tissue passed |
| incomplete abortion | bleeding and cramping with passage of some tissue |
| complete abortion | passage of all products of conception |
| missed abortion | fetus dies in uterus in first part of pregnancy but expelled later |
| recurrent abortion | two or more consecutive spontaneous abortions |
| three types of placenta previa | Marginal - placenta reaches the edge of cervical opening Partial - placenta partly covers the cervical opening Total - placenta completely covers the cervical opening |
| symptoms of placenta previa | bright red/painless vaginal bleeding fetus may be in abmormal position (breech or transverse) fetus may have anemia or hypovolemic shock fetal hypoxia |
| abruptio placentae types | partial or total marginal (separating at edges) central (separating in middle) |
| symptoms associated with abruptio placentae | concealed bleeding with abdominal or low back pain, dark red vaginal bleeding, uterus tender and board like d/t blood in muscle, uterine cramps DIC (disseminated intervascular clotting) |
| what is PIH | pregnancy induced hypertension |
| two types of PIH | Preeclampsia = hypertension with proteinuria and edema Eclampsia = convulsions occur |
| what drugs are used for patients with PIH | magnesium sulfate = anticonvulsant given IV and continues 12-24 hrs after birth. calcium gluconate = antidote for magnesium toxicity antihypertensive drugs for BP 160/100 or > |
| drug classification of Magnesium sulfate | anticonvulsant as well as a tocolytic |
| what are nursing interventions for patients taking magnesium sulfate | 1:1 nursing, decreasing environmental stimulation, emergency call box, quiet low light environment, padding side rails, admin meds |
| what is the antidote for magnesium sulfate | calcium gluconate |
| what is the importance of BPP (aka Biophysical profile) | identify reduced fetal oxygenation in conditions associated with poor placental function. As fetal hypoxia gradually increases, FHR changes occur first, followed by cessation of fetal breathing movement, gross body movement and finally loss of fetal tone. |
| when can Rh blood incompatibility occur | when RH negative mother births an RH positive baby |
| the drug given to prevent Rh incompatibility is | RhoGAM which is administered at 28 weeks, and with in 72 hrs after birth of Rh positive infant or abortion |
| ABO incompatibility is more likely to occur in which maternal blood groups | if mother is type O and fetus is either A or B |
| which type of diabetes occurs only during pregnancy | gestational |
| what are predisposing factors for acquiring a diabetic condition with pregnancy | obesity, large infant (greater than 9 lbs) maternal age greater than 25 unexplained still birth previous GDM family history of DM fasting glucose 126mg/dl-135 mg/dl or post meal 200 mg/dl |
| How does pregnancy effect glucose metabolism? | hormones and enzymes produced by the placenta increase resistance of cells to insulin and increase speed of insulin breakdown. |
| what diabetic medications would be prescribed to a pregnant woman? | insulin because it does not cross placental barriers like oral medications |
| what is the standard treatments for a patient with heart problems? | consult cardiologist, increase prenatal visits, avoid excessive weight gain, monitor sodium, prevent anemia, frequent rest periods but avoid bed rest, heparin only, antibiotics during labor |
| what is the main risk to the fetus when mother has heart problem | fetus suffers from reduced placental blood flow and oxygen |
| what should the nurse teach a pregnant patient on iron supplements? | 30 mg/ day, take with Vitamin C to help with absorption, do not take with milk or calcium products, |
| what is the most important thing a nurse should teach a newly diagnosed pregnant TB patient? | long term compliance is a most medication treatment of rifampin and isoniazid for 9 months |
| Why is a pregnant woman more prone to UTI's | pregnancy increased pressure on the bladder keeping it from emptying completely and ureters dilate and lose mobility increasing risk |
| three things a nurse can teach a woman to avoid UTI's | increase fluids urinate before and after sex proper perineal cleaning front to back recognize sign and symptoms for early treatment |
| what is treatment for a rubella nonimmune patient? | immunization 3 months prior to conception if possible, if not will immunize post partum |
| why is it best to treat syphilis early | to prevent transplacental transmission |
| if a patient has active herpes at the time of delivery can she deliver vaginally? | no it is only safe to deliver c-section |
| cytomegalovirus | no effective prevention or treatment |
| herpes | deliver infant by cesarean if genital lesions when labor begins |
| hepatitis B | give immune globulin immediately after birth followed by vaccine |
| toxoplasmosis | wash hands and surfaces after handling raw meat, cook meat thoroughly, avoid cat litter |
| group B strep | treat culture positive woman and infant with penicillin |
| cigarette smoking | infant may be smaller than expected for gestation |
| cocaine | severe vasoconstriction causing preterm labor and reduce placental circulation |
| marjiuana | no clearly defined effects |
| heroin | abstinence syndrome may develop in woman or infant |
Created by:
arogers74
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