Hypertensive Complications of Pregnancy

Question 1

PROM

Answer 1

premature rupture of membranes
happens before the onset of labor

Question 2

PPROM

Answer 2

preterm premature rupture of membranes
rupture before 37 weeks

Question 3

what puts a mother at risk for PROM?

Answer 3

previous preterm, UTI, cervical infection, smoking/substance abuse, hydramnios, post amniocentesis

Question 4

what are the #1 risk for mom and baby during PROM?

Answer 4

mom - RF infections
baby- RF impaired gas exchange

Question 5

how to confirm ROM?

Answer 5

visualize, speculum exam, nitrazine, fern test, ultrasound

Question 6

nursing interventions for PROM that are conservative?

Answer 6

bedrest/reposition
relaxation
NO vaginal exams
maintain hydration
monitor for infection (CBC, temp Q2)

Question 7

can a woman go home if she has PROM?

Answer 7

yes only if leaking has ceased or is minimal and compliance is anticipated

Question 8

what at home care is anticipated for PROM?

Answer 8

bedrest
pelvic rest
routine NST
serial CBC
monitor vitals
monitor fetal movement

Question 9

corticosteroids

Answer 9

decreases RDS in preterm infants
single dose w/ second dose in 24hrs (not repeated)
*increases RF infection

Question 10

when is immediate birth indicated for PROM?

Answer 10

signs of infection are present
fever, positive gram stain, organisms in amniotic fluid

Question 11

what social factors put a mother at risk for preterm labor?

Answer 11

domestic abuse, trauma, no prenatal care, extremes in ages

Question 12

what uterine concerns are RF preterm labor?

Answer 12

multiples, polyhydramnios, uterine fibroids, abnormalities

Question 13

what is fetal fibronectin?

Answer 13

protein that attaches the amniotic sac to the uterine lining

Question 14

what does a + fibronectin test indicate?

Answer 14

patient MAY go into preterm labor soon or not for weeks

Question 15

what does a - fibronectin test indicate?

Answer 15

little possibility of preterm labor for 7-10 days

Question 16

primary prevention of PTL?

Answer 16

BV, STI, UTI treatment
cervical cerclage
progesterone

Question 17

secondary prevention of PTL?

Answer 17

early diagnosis
identify as at risk
assessments

Question 18

ritodrine hydrochoride

Answer 18

only tocolytic approved by FDA
not used in clinical practice

Question 19

what does magnesium sulfate do?

Answer 19

decreases frequency and intensity of contractions

Question 20

what is magnesium sulfate exclusively given?

Answer 20

hospital use only!

Question 21

magneisum sulfate antidote

Answer 21

calcium gluconate

Question 22

mag sulfate recommended loading and maintenance dose?

Answer 22

loading 4-6g IV w/ 1000mL over 20 mins
maintenance 1-4g/hr titrated

Question 23

magnesium sulfate side effects for mom

Answer 23

immediate hot flushing, headache, burred vision, N, dry mouth, dizzy, lethargy, sluggish

Question 24

magnesium sulfate side effects for baby

Answer 24

hypotonia
hypermagnesemia

Question 25

mag sulfate nursing implications

Answer 25

monitor BP and RR monitor serum mag assess deep tendon reflexes I&O LOC FHR

Question 26

betamethasone

Answer 26

used w tocolytic to speed up fetal lung development enhances surfactant production deep IM peak effective 2-7 days after admin.

Question 27

what is the 2nd leading cause of maternal death in the US

Answer 27

preeclampsia/ eclampsia

Question 28

preeclampsia

Answer 28

increased BP after 20 wks gestation w proteinuria hypertension

Question 29

eclampsia

Answer 29

acute and life treathening complication of pregnancy, seizures

Question 30

nursing interventions for seizing patient

Answer 30

get pt to lie on side oxygen

Question 31

preeclampisa risk factors

Answer 31

Hx of extremes of age obesity primagravida increased placental mass multiples diabetes kidney disease chronic hypertension

Question 32

what is the only 'cure' for preeclampsia?

Answer 32

birth of fetus

Question 33

preeclampsia manifestations

Answer 33

proteinuria increased sodium retention decreased urine output generalized edema (facial, pre-orbital) increased BP epigastric pain