Bleeding disorders

Question 1

door of the uterus

Answer 1

cervix

Question 2

another word for bleeding disorders

Answer 2

hemorrhagic disorders

Question 3

termination of pregnancy
before 20 wks
fetus is <500 g

Answer 3

abortion

Question 4

social reasons for abortion (choice)

therapeutic reasons for abortion (illness to mother)

Answer 4

elective abortion

Question 5

abortion due to natural causes

Answer 5

spontaneous

Question 6

cervix is closed

spotting occurs

Answer 6

threatened abortion

Question 7

cervix dilated

contents come out of uterus

Answer 7

inevitable abortion

Question 8

fetus comes out but placenta is contained

problem for risk of infection (retained POC)

Answer 8

incomplete abortion

Question 9

no POC retained

Answer 9

complete abortion

Question 10

3 or more successive abortions

Answer 10

habitual

Question 11

what could be the cause of habitual

Answer 11

cervical incompetence/insufficiency

Question 12

cervix opens for no reason

can put in small suture to attempt to keep it closed

Answer 12

cervical incompetence

Question 13

when do ectopic pregnancies usually occur

Answer 13

first trimester only

Question 14

fertilized ovum s implanted outside uterine cavity

usually tubal but not always

Answer 14

ectopic pregnancy

Question 15

what is the only place capable for developing a fetus

Answer 15

body of uterus

Question 16

can an ectopic pregnancy be transferred

Answer 16

no, will not carry to term

Question 17

what are the types of ectopic pregnancies

Answer 17

cervical, abdominal, ovarian, interstitial, isthmic, ampullar, fimbrial, tuboovarian

Question 18

what are the CC of ectopic pregnancies

Answer 18

unilateral sharp abdominal pain (if tubal preg)

Question 19

what will happen if ectopic pregnancy not identified

Answer 19

will rupture which will lead to SHOCK or massive hemorrhage

Question 20

what are women with ectopic pregnancies given to terminate the pregnancy

Answer 20

methotrexate

Question 21

what does FHT stand for

Answer 21

fetal heart tones

Question 22

what is another word for trophoblastic disease

Answer 22

hydatidiform mole

Question 23

what is important to remember for hydatidiform mole

Answer 23

NO embryo NO fetus

Question 24

benign degenerative process of placenta

chronic villi degenerate into edematus, cystic, avascular transparent vesicles that hang in grape like clusters

Answer 24

trophoblastic disease

Question 25

does trophoblastic disease count as a pregnancy

Answer 25

YES even though no fetus chromosomes were incorrect

Question 26

fertilization of egg with no nucleus and no DNA sperm nucleus duplicates itself mole grows rapidly created degenerative placenta

Answer 26

complete mole

Question 27

what can happen to a degenerative placenta

Answer 27

can rupture uterus | can cause vaginal expulsion of vesicles

Question 28

FERTILIZATION of normal egg with two sperm mole grows rapidly may have embryonic or fetal parts

Answer 28

partial mole

Question 29

what are two sperms (too much) called

Answer 29

triploid

Question 30

S/S of trophoblastic disease

Answer 30

``` abnormal uterine bleeding uterus larger than dates anemia from blood loss excessive vomitting abdominal cramps preeclampsia prior to 20 wks no FHT or fetal skeleton ```

Question 31

sequelae of trophoblastic disease

Answer 31

high risk for choriocarcinoma | malignancy, 15-20 % of women have evidence of persistent gestational trophoblastic

Question 32

what are choriocarcinoma patients given

Answer 32

prohoylactic chemo | methotrexate

Question 33

what position do we want the placenta in

Answer 33

high in fundus

Question 34

what lead to pregnancy loss

Answer 34

abortion, ectopic, and molar

Question 35

women with pregnancy loss need what

Answer 35

support and counseling

Question 36

placenta is malpositioned and attached in the lower uterine segment rather than the fundus

Answer 36

placenta previa

Question 37

placenta may migrate upward during pregnancy | extends to cervical OS

Answer 37

marginal/low lying (placenta previa)

Question 38

placenta partially covers cervical OS

Answer 38

partial (placenta previa)

Question 39

placenta completely covers cervical OS

Answer 39

total (placenta previa)

Question 40

what do you need to do if placenta previa found

Answer 40

C section | CANNOT deliver placenta before baby as baby will not have oxygen

Question 41

S/S of placenta previa

Answer 41

bright red vaginal bleeding uterine tone is normal PAINLESS

Question 42

premature separation of the placenta BEFORE birth

Answer 42

abruptio placenta

Question 43

small tear on placenta which clotted off | no clotting and no apparent vaginal bleeding

Answer 43

partial abruptio placenta

Question 44

placenta completely off uterine wall | may be concealed or frank bleeding

Answer 44

complete abruptio placenta

Question 45

S/S of abruptio placenta

Answer 45

dark uterine bleeding (concealed or apparent) RIGID boardlike abdomen PAINFUL-uterine/abdominal tenderness

Question 46

is abruptio placenta a medical emergency

Answer 46

YES, URGENT | may cause loss of life to mother and fetus

Question 47

this is a key hint of hemorrhage

Answer 47

Wide pulse (catch BEFORE escalates)

Question 48

first bleeding assessment

Answer 48

where is the bleeding coming from

Question 49

second bleeding assessment

Answer 49

how much blood is coming out? | measure in peripad saturation over time

Question 50

third bleeding assessment

Answer 50

change in vital signs?

Question 51

what vital signs are you watching for when bleeding?

Answer 51

1) widened pulse pressure (increase in BP?) 2) elevated HR (tachy) 3) change in BP (decrease in BP, systolic and diastolic)

Question 52

interventions for bleeding

Answer 52

1) call for help 2) give O2 per 10 L non rebreather 3) start IV lines and hang fluid replacement 4) monitor for FHT and be ready for potential surgery 5) monitor VITALS

Question 53

MAJOR responsibility of nurse during bleeding

Answer 53

start 1 or 2 large bore IV lives and hang fluid replacements