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OB > HIGH RISK ANTEPARTUM - FINAL EXAM > Flashcards

HIGH RISK ANTEPARTUM - FINAL EXAM Flashcards

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1
Q

placenta previa

A

low lying placenta blocking exit requiring c/s

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2
Q

risk factors of previa

A

endometrial scarring, increased placenta mass, mutli c/s

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3
Q

previa risks to women

A

shock, blood loss, Rh sensitization, death

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4
Q

previa risks to fetus

A

prematurity, anemia, hypoxia, compromise

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5
Q

s/s of previa

A

painless bright red vag bleeding, FHR changes

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6
Q

nursing actions of previa

A

monitor labs, bleeding, assess pain, IV, meds

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6
Q

manage previa

A

ultrasound, c/s, monitor bleeding

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7
Q

placental abruption

A

maternal bleeding causing detachment of placenta before delivery

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8
Q

s/s of placental abruption

A

vag bleeding, pain, hypertonic contractions, uterine tenderness, nonreassuring FHR

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9
Q

risk factor of placental abruption

A

cocaine/heroin use, hx of abruption, hypertensive, trauma

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10
Q

abruption risks to women

A

blood loss, death, renal failure

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11
Q

abruption risk to fetus

A

premature, asphyxia, death

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12
Q

manage abruption

A

betameth, steriods

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13
Q

nursing action of abruption

A

s/s, FHR monitor, report blood loss, palpate uterus, oyxgen/IV

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14
Q

acreta

A

placenta goes beyond boundaries and invades wall

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15
Q

increta

A

placenta goes deeper into uterine wall

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16
Q

percreta

A

placenta goes beyond uterine wall and attaches to bladder (other organs)

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17
Q

accreta risks to women

A

hemorrhage, shock, blood loss, infection

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18
Q

accreta risks to fetus

A

prematurity

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19
Q

management of accreta

A

delivery, hysterectomy

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20
Q

nursing actions of accreta

A

monitor labs, support

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21
Q

ectopic preg

A

egg implants outside of uterus, nonviable preg

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22
Q

s/s of ectopic preg

A

pelvic pain, bleeding, weak/dizzy

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23
Q

manage ectopic preg

A

assess HCG levels, metotrexate, medically induced abortions

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24
gestational trophoblastic disease
abnl trophoblast cells grow inside uterus nonmolar: benign molar: cancerous
25
interventions of trophoblastic disease
no sex for up to 1 yr
26
substance use on baby
lbw, developmental disability, PTB, death
27
hyperemesis gravidarum
excessive vomiting from hormone excess
28
hyperemesis leads to
dehydration, fluid/electrolyte imbalance, wt loss, ketonuria
29
hyperemesis time frame
peaks at 9 wks ends around 20 wks w decrease in HCG and increase in HCS
30
nursing actions of hyperemesis
treat N/V, labs, I/O, weight, oral hygiene
31
intrahepatic cholestasis
pruritis of hands and feet due to uric acid and bile duct backup and breakdown in liver
32
causes of intrahepatic cholestasis
PTB, meconium, FHR abnl, death
33
cholestasis risks to fetus
elevated serum bile levels, stillbirth
34
manage cholestasis
antihistamines, NST/BPP, must delivery at 36 wks
35
gestational diabetes
caused by increase HCS, GMDA1: treated by diet/exercise, GMDA2: treated by insulin
36
glucose changes in preg
insulin resistance, hormone shifts, glucose sparing for baby
37
goals of diabetes
maintain euglycemia, minimize comps, prevent prematurity
38
risk to women for pregestational diabetes
preeclampsia, diabetic ketoacidosis, abortion, poly/oligohydraminos, c/s, PPH, infection
39
risks to fetus for pregestational diabetes
macrosomia, congential defects, IUGR, resp distress, polycythemia, premature, death
40
manage pregestational diabetes
HBA1C, screening kidneys, ultrasound, nutrition therapy
41
risks during delivery of pregestational diabetes
transient trachypnea (fluid in lungs), resp distress, hypoglycemia
42
gestational diabetes test GTT (24-28 wks)
1 hr test have 50g drink and test, if above 140 do 3 hr test, 100g drink test hrly, if still 140 = diabetes
43
gestational diabetes risk for women
hypoglycemia, DKA, preeclampsia, c/s, nongestational diabetes
44
gestational diabetes risk to fetus
macrosomia, IUGR, hypoglycemia, hyperbilirubinemia, shoulder dystocia, resp distress
45
manage gestational diabetes
c/s, diet/exercise/insulin, monitor for type 2
46
preeclampsia
HTN after 20 wks w proteinuria 140/90 and higher 160/110 is severe
47
risk factors for preeclampsia
nulliparity, under 20 over 35, multi gestation, hypertension, gestational diabetes, fam hx
48
preeclampsia risks to women
DIC, CHR, HELLP, seizures, pain, vision changes, hemorrhage, sroke, PE
49
preeclampsia risk to fetus
IUGR, premature, death, intolerant to labor
50
presenting pt w preeclampsia
140/90 - 160/110, proteinuria, headache, vision changes, pain
51
manage preeclampsia
mag sulfate, induce labor
52
eeclampsia s/s
severe headache that wont go away, pain, restless, seizures, confusion, hyperreflexia w clonus
53
post seizure care of eeclampsia
assess maternal/fetal status, admin O2/IV, mag
54
HELLP
hemolysis, elevated liver enzymes, low platelets
55
PTL
regular contractions to change cervix and uterus
56
extreme preterm
less than 28 wks
57
very preterm
28-32 wks
58
mod to late preterm
32-37 wks
59
factors of PTL
uterine stretching, decidual activation, infection, maternal/fetal stress, hx of PTL
60
viabil PTB
25wks plus and able to survive outside the womb
61
peri viabil PTB
before 25 wks with low chance of survival
62
risks of PTB
hx of PTB, multiple gestation, uterine/cervical abnl
63
fetal fibronectin
detected in vagina, if present there is risk of delivery in 1-2wks
64
maternal risk for PTB
cardiac arrhytmias, PE, CHF
65
fetal risk for PTB
premature
66
not stopping labor for
intrauterine fetal demise, lethal fetal anomaly, non reassuring fetal status, chorioamniotitis, preeclampsia
67
PROM/PPROM
premature or preterm premature rupture of membranes
68
risk factors of PROM/PPROM
hx, bleeding, STI, multi gestation, hydramnios, short cervix length
69
manage PROM before 32 wks
neuroprotection w mag sulfate
70
manage PROM fore 34 wks
reduce infection, corticosteriods
71
manage PROM after 34 wks
induce labor
72
nursing actions of PROM/PPROM
assess FHR/contractions, assess for infection, NST, BPP
73
cervical insufficiency
painless cervical dilation and explusion preg
74
causes of cervical insufficiency
hx of cervical trauma, D/C, lacerations, LEEP, abnl cervical development, PTB
75
manage cervical insufficiency
activity, rest, pessary, cerclage, birth at 37 wks
76
nursing actions post cerclage
monitor uterine activity, vaginal bleeding/LOF, monitor for infection
77
monozygotic twins
1 zygote that divides in 1st wk with increase risk of cord entanglement and twin/twin transfusion
78
dizygotic twins
2 fertilizations
79
multigestation risks to women
hypertensive disorderes, hemorrhage, gestational diabetes, anemia, cholestasis, c/s
80
multi gestation risks to fetus
PTB, death, prematurity, twin/twin transfusion, IUGR, congenital defects
81
s/s of mutli gestation
increase HCG levels, higher fundal ht, high CO and BV, iron deficiency anemia
82
management of multi gestation
genetic testing, NST, BPP, s/s of PTB, s/s of anemia, hypertensive disorders

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