High Risk Antepartum Flashcards

Question

purpose of amniotic fluid

Answer 1

temp cushions NO NUTRITION

Answer 2

gestational dm

Answer 3

Carbohydrate intolerance diagnosed during pregnancy Numerous risks to both mother and fetus during pregnancy *A 2-step process *One- or two-hour glucose tolerance test (GTT) at 24-28 weeks *Three-hour GTT if one hour abnormal Screening: Puts mother at risk for Type 2 Diabetes later in life Maternal insulin cannot pass through the placenta. Maternal Glucose passes through the placenta to the fetus. Yum....Glucose! I better make some insulin so I can use it! Perhaps I will save some for later as well! Glycogen = large glucose molecules, created for storage.

Answer 4

Maternal nutrition therapy * Metabolic monitoring * Exercise therapy

Answer 5

Metformin * Glyburide * Insulin

Answer 6

presents b4 20 weeks >140/90

Answer 7

after 20 weeks NO PROTEINURIA >140/90 on 2 occasions at least 4-6 hrs apart

Answer 8

after 20 weeks PROTEINURIA

Answer 9

Increased BP * Proteinuria * Edema * Assess lung sounds! * Hepatic changes * Epigastric pain * Thrombocytopenia * HA, Blurred vision * Small vessels in eyes/brain are affected * Clonus – neuromuscular irritability

Answer 10

Urinalysis – proteinuria * Liver enzymes (ALT, AST) * Elevation indicates liver injury * Serum Creatinine/Uric acid * Increased serum level with kidney disfunction * CBC * Thrombocytopenia * Decreased H&H

Answer 11

Hypertension * Systolic: > 160 Severe Pre-E = DELIVER * Diastolic > 110 * Thrombocytopenia * Platelets < 100,000 * Impaired Liver function – abdominal pain * New development of renal insufficiency * Creatinine > 1.1 * Pulmonary edema * New onset cerebral or visual disturbances * Hyperactive reflexes Preeclampsia + seizures = eclampsia

Answer 12

Hemolysis Due to: Fragmented RBCs trying to pass through narrowed vessels Elevated Liver Enzymes Due to: Endothelial damage and fibrin deposition in liver = necrosis Low Platelets Due to: Vascular damage, vasospasm, aggregation at sites of damage

Answer 13

Seizure prophylaxis: Magnesium sulfate * Labetolol – beta blocker, lowers BP and HR * Hydralazine - vasodilator * Nifedipine – Ca channel blocker

Answer 14

Seizure prevention in preeclamptic patients High-risk medication * VS, I&O, lung sounds, reflexes, neuro checks, assess for side effects, signs of toxicity * Headache, lethargy, N/V are common side effects * Signs of toxicity: * Absent DTRs, decreased respirations/respiratory distress, decreased urine output * Antidote for toxicity: Calcium Gluconate Frequent assessments Monitor fetal heart rate Newborn side effects: sedation, hypotonia, hypothermia, respiratory depression, hypocalcemia

Answer 15

calcium sulfate

Answer 16

placental is covering the cervix cannot deliver

Answer 17

Scars on uterus Hx of previa Drug use multiples

Answer 18

Bleeding/hemorrhage Painless, bright red vaginal bleeding

Answer 19

Dx – by US Pelvic rest – nothing in the vagina Monitor fetal well-being/bleeding Assess need for Rhogam Cesarean birth necessary

Answer 20

Premature separation of the placenta after 20 weeks

Answer 21

Drug use – cocaine, methamphetamines Cigarette use Hypertension disorders Hx of abruption PPROM Uterine anomalies – fibroids Trauma

Answer 22

Uterine pain/rigid abdomen * Increased fundal height * Frequent contractions * Possibly bright red bleeding * FHR changes

Answer 23

preapre for birth

Answer 24

A-ROM = Artificial rupture of membranes S-ROM = Spontaneous rupture of membranes P-ROM = Prelabor rupture of membranes

Answer 25

ROM before labor starts @ any gestational age

Answer 26

ROM before 37 weeks gestation

Answer 27

a combination of both terms (PPROM)

Answer 28

Previous history - Bleeding - Polyhydramnios - Infection - Smoking - Multiples - Drug use

Answer 29

Fetal Sepsis - Pre-term birth - Umbilical cord prolapse - Intraventricular hemorrhage

Answer 30

Chorioamnionitis - Placental abruption - Cord prolapse - Pre-term labor/birth

Answer 31

can lead to PRETERM LABOR weaken wall of amniotic sac

Answer 32

Ferning Salts from amniotic fluid dry in a fern pattern. Nitrazine Basic Amniotic fluid turns pH paper blue * Vaginal pH is 4.5 – 5.5 * Amniotic fluid is more alkaline (6.5-7.5) Speculum exam Visualize pooling of amniotic fluid

Answer 33

Establish gestational age * Ultrasound: fetal growth and fluid levels * Assess for infection, fetal well-being, labor * Reasons for delivery: * Advanced labor * Vaginal bleeding * Non-reassuring fetal heart rate

Answer 34

Increased maternal and/or fetal heart rate * Uterine tenderness * Malodorous amniotic fluid * Maternal fever

Answer 35

Uterine contractions and cervical change between 20-37wks

Answer 36

Bleeding: * Placenta previa * Placental abruption Uterine Stretching: * Polyhydramnios * Multiples * Large for gestational size * Utereine abnormailites Infections/Inflammation: * STIs * UTIs * Amniotic fluid Maternal/fetal stress: * Stress hormones trigger contractions

Answer 37

Fetal Fibronectin (FfN) * “Glue” that holds amniotic sac to uterine lining * Sterile swab of cervical lining * Cervical Length by transvaginal US * Short means increase risk for PTL * Ensure empty bladder * Cervical cultures – r/o infection * GC, Chlamydia

Answer 38

Corticosteroid administration  given to mom for baby Tocolytic medications * Magnesium sulfate * Prostaglandin synthesis inhibitors * Ca Channel blockers * Beta mimetics

Answer 39

Betamethasone 12 mg IM 24 hours apart for 2 doses Dexamethasone given IM every 12 hours for 4 doses Monitor bg

Answer 40

for fetal lung maturity

Answer 41

idomethacin nifedipine mag sulfate

Answer 42

Nonspecific COX inhibitor * Maternal SE: nausea, reflux * Feal SE: Premature narrowing or closure of the ductus arteriosus, oligohydramnios * Not to be used for more than 48 hours

Answer 43

Calcium channel blocker * Maternal SE: nausea, headache, flushin g * Contraindicated in patients with known hypotension

Answer 44

Antidysrhythmic (relaxes smooth muscle) * Maternal SE: Diaphoresis, flushing * Symptoms of Mag Toxicity: Absent DTRs, Decreased RR, Respiratory distr ess * Antidote for Mag toxicity is Calcium Gluconate * This is not a first line tocolytic- More commonly used for preeclmpsia

Answer 45

beta adrenergic receptor agonist

Answer 46

Derived from epinephrine * Acts on beta adrenergic receptors related to flight fight reaction (like epinephrine)  some muscles relax (uterus) while other contract (heart)

Answer 47

Increase HR, flushing, tremors, restlessness

Answer 48

Increase HR, Increase glucose

Answer 49

Hold HR > 120 * HR > 120 causes a decrease in ventricular filling time and can lead to maternal MI

Answer 50

Never give PO (given Sub-Q), Never give for > 72 hrs NEVER GIVE IF MOTHER HAS A CARDIAC ISSUE

High Risk Antepartum Flashcards

(75 cards)