PREGNANCY Flashcards
(51 cards)
Hep A, Hep B, influenza inactivated), meningococcal, polio, tetanus Tdap (only in 3rd trimester)
Immunizations in pregnancy
Oral polio, HPV, flu mist (influenza), MMR (no pregnancy attempt after 28 days of rubella vaccine), Varicella zoster 3 months
Contraindicated Immunizations in pregnancy
Penicillin’s, cephalosporins, macrolides, and nitrofurantoin (not on patients with glucose 6 phosphate deficiency)
Safe Abx in pregnancy
ARBS, ACEI, Fluoroquinolone, tetracyclines NSAIDS, Sulfa,
Not 100 % safe in pregnancy
PLUS 9 months add 7 days
Naegles rule
primigravida in third trimester, multipara, >35 years old, sudden onset recurrent headaches, blurred vision, pitting edema, weight gain, RUQ pain, shoulder pain, lower back pain, hyperreflexia, decrease in urine output, BP elevated, N/V, occurs after 20 weeks pregnancy induced hypertensive condition, resolves after pregnancy
Preeclampsia
HTN, proteinuria, and edema
Preeclampsia Dx
- hospitalization
- antihypertensive medications- methyldopa/aldomet, CCB, labetalol
- bedrest, laying on left side recumbent position off of vena cava, seizure precautions, balance diet high intake of protein low salt, antihypertensive, education, only CURE deliver fetus, refer to OB
Preeclampsia Tx
Seizures or coma in patient with previous preeclampsia
Eclampsia
Caused by idiopathic, PID, IUD, estrogen/progesterone
Ectopic pregnancy
- 50% no known risk factor,
>35 years of age, nonwhite females, PID, endometriosis, previous ectopic pregnancy, IUD, pelvic or tubal surgery, cigarette smoking, infertility, invitro fertilization, leading cause of death for women in first trimester
Ectopic pregnancy - High risk
Vaginal bleeding, cramping without cervical dilation
Threatened abortion
Vaginal bleeding, cramping with cervical dilation
Inevitable abortion
Moderate to diffuse bleeding, passage of tissue, uterine
contractions
Incomplete abortion
Produced by placenta
Hcg in urine pregnancy test
Produced by fetal liver
Alpha feta proteins
91% effective, estrogen/progestrin disadvantages- pill daily,
thrombophlebitis/embolism, liver adenomas, stroke, gall bladder disease, no std protection, NO smoking may result in cardiovascular side effect, contraindicated in <6- week post-partum, breast cancer,
Oral contraceptives
91% effective, estrogen/progestrin, disadvantages same as above, patch may fall off and must be reapplied, patch once a week
Contraceptive patch
91% effective estrogen/progastrin, insert day after menses, disadvantages- uncomfortable inserting, ring falls out for less than 3 hours, rinse off and reinsert,
Contraceptive vaginal ring
91% effective, disadvantages taken daily, chance of ectopic pregnancy,
Progestin oral
94% effective, injectable progestin for 13 weeks, disadvantage is bone loss,
fertility may not return for 1 year,
Deprovera
99% effective, placed subcutaneously in upper arm and releases hormones for 3 years, quick return to fertility, bleeding is side effect
Etonogestrel implant
Mirena, progesterone, 99.8% effective, disadvantages expel
intrauterine device, sepsis, cervical infection, ectopic pregnancy, infertility.
Intrauterine device
88% effective, spermicide, prevents stds, must be refitted, bladder infections, yeast infection, bacterial infection.
Diaphragm
