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Maternity: Exam 2 > Chapter 28- Hemorrhagic Disorders ( Lecture Review ) > Flashcards

Chapter 28- Hemorrhagic Disorders ( Lecture Review ) Flashcards

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1
Q

What are the causes of early pregnancy bleeding?

A

Miscarriage, ectopic pregnancy, reduced cervical competence, hydatidiform mole

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2
Q

What are the possible complications of miscarriage?

A

Hypovolemia, anemia, infection, preterm labor, impaired oxygen delivery to fetus

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3
Q

What are the fetal risks from maternal hemorrhage?

A

Blood loss, anemia, hypoxemia, hypoxia, anoxia, preterm birth

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4
Q

What is a miscarriage?

A

Pregnancy ends as a result of natural causes before fetal viability

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5
Q

What is the incidence of miscarriage?

A

Approximately 10-15% of pregnancies end in miscarriage

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6
Q

Which types of miscarriage are there?

A
  • Threatened
  • Inevitable
  • Incomplete
  • Complete
  • Missed
  • Recurrent
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7
Q

What is cervical insufficiency?

A

Passive and painless dilation of the cervix during the second trimester

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8
Q

What is the treatment of choice for cervical insufficiency?

A

Cerclage

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9
Q

What are the classic symptoms of ectopic pregnancy?

A
  • Abdominal pain
  • Delayed menses
  • Abnormal vaginal bleeding
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10
Q

What is a hydatidiform mole?

A

Benign proliferative growth of placental trophoblast with cystic, avascular vesicles

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11
Q

What are the two types of hydatidiform moles?

A
  • Complete: no embryonic or fetal parts
  • Partial: has embryonic or fetal parts
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12
Q

What is placenta previa?

A

Placenta implanted in lower uterine segment near or over internal cervical os

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13
Q

What are the risk factors for placenta previa?

A
  • Previous c-section
  • Advanced maternal age
  • Multiparity
  • History of suction curettage
  • Living at high altitude
  • Smoking
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14
Q

What is the incidence of placenta previa?

A

1 in 200 pregnancies

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15
Q

What are the clinical manifestations of placenta previa?

A

Painless bright red vaginal bleeding during second or third trimester

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16
Q

What is placental abruption?

A

Detachment of part or all of placenta from implantation site after 20 weeks gestation

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17
Q

What are the maternal risk factors for placental abruption?

A
  • Hypertension
  • Cocaine use
  • Blunt abdominal trauma
  • Cigarette smoking
  • History of abruption
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18
Q

What is vasa previa?

A

Rare condition where fetal vessels lie over the cervical os

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19
Q

What is the primary goal for managing pregestational diabetes mellitus?

A

Achieving and maintaining constant euglycemia

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20
Q

What are the fetal risks associated with pregestational diabetes mellitus?

A
  • Perinatal mortality
  • IUFD (stillbirth)
  • Congenital malformations
  • Hypoglycemia at birth
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21
Q

What is gestational diabetes mellitus (GDM)?

A

Diabetes diagnosed during pregnancy that was not present prior

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22
Q

What are the risk factors for gestational diabetes mellitus?

A
  • Family history of diabetes
  • Previous unexplained stillbirth
  • Obesity
  • Hypertension
  • Maternal age >25 years
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23
Q

What is the recommended screening method for gestational diabetes?

A

Two step screening: 1 hr 50g oral glucose followed by 3 hr 100g oral glucose if needed

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24
Q

What is hyperemesis gravidarum?

A

Excessive, prolonged vomiting during pregnancy, leading to weight loss and electrolyte imbalance

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25
What are the effects of hyperemesis gravidarum on maternal and fetal well-being?
Weight loss, electrolyte imbalance, nutritional deficiencies, ketonuria
26
What metabolic changes occur during pregnancy?
Decreased tolerance to glucose, increased insulin resistance, decreased hepatic glycogen stores
27
What is the prevalence of diabetes mellitus in pregnancy?
Affects 6-7% of pregnancies
28
What characterizes DIC in pregnancy?
Widespread intravascular activation of coagulation leading to excessive clot formation and hemorrhage
29
What is Hyperemesis Gravidarum?
Excessive, prolonged vomiting during pregnancy, occurring in 0.3-3% of pregnancies ## Footnote Accompanied by weight loss, electrolyte imbalance, nutritional deficiencies, and ketonuria.
30
What percentage of pregnancies experience normal nausea and vomiting?
50% to 80% ## Footnote Typically beginning at 4-10 weeks gestation and usually resolving by 20 weeks.
31
What are the clinical manifestations of Hyperemesis Gravidarum?
Significant weight loss and dehydration, dry mucous membranes, decreased BP, increased pulse rate, poor skin turgor ## Footnote Symptoms can lead to hospitalization.
32
What are the risk factors for Hyperemesis Gravidarum?
* Younger maternal age * Nulliparity * BMI <18.5 or >25 * Low SES * Women with asthma, migraines, pre-existing DM, psychiatric illness, hyperthyroid disorders, GI disorders, or a previous pregnancy complicated by hyperemesis gravidarum
33
What initial care is provided for Hyperemesis Gravidarum?
IV therapy for correction of fluid and electrolyte imbalances ## Footnote Medications and enteral or parenteral nutrition as a last resort are also included.
34
What is the primary cause of hyperthyroidism in pregnancy?
Graves' disease ## Footnote Accounts for 90-95% of cases.
35
What are common symptoms of hyperthyroidism during pregnancy?
* Heat intolerance * Diaphoresis * Fatigue * Anxiety * Emotional lability * Tachycardia * Weight loss * Goiter * Pulse rate >100 bpm
36
What is the occurrence rate of hypothyroidism in pregnancies?
Occurs in 2-12 pregnancies per 1000 ## Footnote Severe hypothyroidism is associated with infertility and increased risk of miscarriage.
37
What nursing interventions are recommended for hypothyroidism in pregnancy?
Education and medication regimen: levothyroxine/Synthroid
38
What can poor glycemic control before and during pregnancy lead to in women with diabetes?
* Miscarriage * Infection * Dystocia caused by fetal macrosomia
39
Fill in the blank: The woman with hyperemesis gravidarum may have significant weight loss and dehydration. Management focuses on restoring _______ and electrolyte balance.
[fluid]
40
What is the recommendation for routine screening for gestational diabetes (GDM)?
All women undergo routine screening by history, risk factors, or lab assessment of blood glucose levels during pregnancy.
41
True or False: Hyperthyroidism is common in pregnancy.
False ## Footnote It is rare, occurring in 2-17 of every 1000 births.
42
What happens to insulin requirements in women with diabetes as pregnancy progresses?
Insulin requirements increase and may quadruple by term due to insulin resistance created by placental hormones, insulinase, and cortisol.
43
What is the significance of thyroid hormone level monitoring during pregnancy?
It is crucial to regulate therapy and prevent fetal insult.
44
45
Which of the following is a major maternal risk associated with antepartal hemorrhagic disorders?
b) Hypovolemia
46
Which type of miscarriage is characterized by passive and painless cervical dilation?
d) Cervical insufficiency
47
The three classic symptoms of an ectopic pregnancy include all of the following EXCEPT:
c) Hypertension
48
What is the primary treatment for cervical insufficiency?
c) Cerclage
49
Placenta previa is characterized by which type of vaginal bleeding?
b) Painless bright red bleeding
50
Which risk factor is strongly associated with placental abruption?
c) Cocaine use
51
What is the primary cause of maternal mortality in pregnancies complicated by diabetes mellitus?
c) Ketoacidosis
52
What is the recommended time frame for screening for gestational diabetes in pregnant women with no risk factors?
b) 24-28 weeks
53
Which fetal complication is most commonly associated with maternal diabetes?
b) Macrosomia
54
A woman with hyperemesis gravidarum is at risk for:
b) Electrolyte imbalance
55
Ectopic pregnancies account for approximately 10-15% of all first-trimester pregnancies in the U.S.
False ## Footnote It accounts for 0.5-1.5%
56
Placenta previa is commonly associated with painless, bright red vaginal bleeding in the second or third trimester.
True
57
Methotrexate is a medical management option for ectopic pregnancy.
True
58
Women with gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes later in life.
True
59
Hyperthyroidism is more common in pregnancy than hypothyroidism.
False ## Footnote Hypothyroidism is more common
60
Placental abruption always presents with visible vaginal bleeding.
False ## Footnote It may present with concealed hemorrhage
61
Women with pregestational diabetes have a lower perinatal mortality rate than women without diabetes.
False ## Footnote Perinatal mortality is three times higher
62
A complete molar pregnancy contains embryonic or fetal parts.
False ## Footnote Complete moles have no fetal parts
63
The primary goal of managing gestational diabetes is maintaining euglycemia.
True
64
Women with hyperemesis gravidarum always require enteral or parenteral nutrition.
False ## Footnote Only severe cases require it

Maternity: Exam 2 (18 decks)

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