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Nursing 332 > Maternity - Antenatal > Flashcards

Maternity - Antenatal Flashcards

1
Q

what does a BMI >35 indicate?

A

most likely to give stillborn birth after 28 wks

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2
Q

is warfarin safe during pregnancy?

A

no it is teratogenic

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3
Q

intrapartum risks for obese pts

A

induce labour, instrument delivery, C section, PPH

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4
Q

post partum risks for obese pts

A

difficulty breastfeeding, delayed wound healing, infection, PPD, PPH, big baby w/ large placental implantation site

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5
Q

anemia

A
  • leads to maternal fatigue
  • iron pills or iron transfusion
  • SE of iron pills = n/v, constipation; encourage increase in fibre and fluids
  • low blood flow and O2 to placenta = IUGR risk
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6
Q

causes of hemorrhagic disorders

A
  • spontaneous abortion
  • ectopic pregnancy
  • placenta previa
  • placenta abruptio
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7
Q

when is betamethasone given?

A

under 34 weeks gestation

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8
Q

when is magnesium sulphate given?

A

under 32 weeks gestation

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9
Q

what is antepartum hemorrhage?

A
  • vaginal bleeding after 20 weeks

- causes: spontaneous abortion, placenta previa, placenta abruptio

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10
Q

s&s of ectopic pregnancy

A

sharp stabbing pain in lower abdominal quadrants

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11
Q

early birth loss

A

before 12 weeks

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12
Q

late birth loss

A

12-20 weeks

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13
Q

what can lead to profuse bleeding and maybe be life-threatening?

A

any bleeding or miscarriage after 12 weeks

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14
Q

causes of spontaneous abortion

A
  • chromosomal issues
  • teratogen exposure
  • poor implantation
  • endocrine imbalances
  • GDM w/ uncontrolled blood sugars
  • anti-phospholipid syndrome
  • TORCH
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15
Q

TORCH

A

toxoplasmosis infections, STIs, rubella, cytomegalovirus, herpes simplex

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16
Q

what can late losses be due to?

A

maternal age, chronic infections, premature dilation of cervix, recreational drug use, poor diet

17
Q

s&s of late loss

A

lower abdo ache, bleeding, passing of conception, cramps, lower back ache

later symptoms = cramping, heavy bleeding

18
Q

types of abortion

A

threatened: woman put on bedrest and monitoring; spotting
incomplete: body expelled part of tissue and products of pregnancy
complete: all tissue opened, fetus lost

19
Q

placenta previa

A

where placenta is implanted in lower segment of uterus; can be completely or partially over cervix

20
Q

risk factors for placenta previa

A 
previous previa 
advanced maternal age 
multipara
multiple gestation 
pregnancy by in vito 
previous uterine surgery
21
Q

manifestations of placenta previa

A

painless (unless in labour)
nontender, soft uterus
bright red vaginal bleeding
fetal HR normal/abnormal depending on O2 flow

22
Q

key points with previa

A
  • no vaginal birth or internal exam
  • if under 34 wks, give betamethasone
  • greatest risk to baby is being IUGR, sitting low in uterus, being preterm, or in malpresentation
  • risk to mom: infection, endometriosis
23
Q

placenta abruptio

A

when placenta is in right place but starts to detach itself, and maybe seals over; if active, will see bleeding

MOST COMMON CAUSE OF PERINATAL DEATH

24
Q

s&s of placenta abruptio

A 
sharp abdominal pain
uterine tenderness 
increased tone 
abnormal FHR
dark red vaginal bleeding
25
Q

when does DIC occur with abruptio?

A

within 8 hrs after signs of pain and bleeding

26
Q

preterm labour

A

less than 37 wks (20-37 wks)

most are late (34-37 wks)

27
Q

causes of preterm labour

A 
dehydration, UTI
periodontal disease
chorioamnionitis
pts experiencing violence or abuse 
lack of prenatal care
hx of preterm birth
bleeding in 2nd trimester 
not increase in weight
28
Q

presenting signs of someone in preterm labour

A 
frequent contractions 
urinary frequency 
low back ache 
spotting 
pelvic pressure 
abdominal tightening
29
Q

what test rules out preterm labour?

A

FFT (fetal fibronectin test)

30
Q

what meds would you administer for preterm labour?

A

Abx, steroids, tocolytics

31
Q

preterm premature rupture of membranes

A

when water breaks under 37 weeks

32
Q

causes of PPROM

A
  • weakening in amniotic sac caused by factors that increase uterine pressure
  • polyhydramnios
  • multiple pregnancies
33
Q

outcome of baby in PPROM

A

IU infection

cord prolapse

34
Q

if mom is in PPROM, what position should they go into?

A

knee-chest position

Nursing 332 (7 decks)

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