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 |