pregnancy complications Flashcards
(28 cards)
Placenta Previa
condition that affects the placenta and can occur during the last two trimesters of pregnancy
mild to severe bleeding
“afterbirth first”
placenta implants near or over the cervical os
things that put you at risk for placenta previa
previous c-section(s), and the risk increases with the more c-sections you have
placenta previa is associated with serious complications like:
hemorrhage, emergency c-section, abruption (separation) if the placenta
what is causing cases of placenta previa to rise?
increased number of caesarean births, increasing maternal age, more infertility treatments
how to detect placenta previa
ultrasound provides early detection
pathophysiology of placenta previa
increased surface area for placenta to attach(?)
it is avoided sometimes even if the embryo is implanted low in the uterus bc of trophotropism –>seeking area of higher vascularity and nutrition
management of placenta previa
if fetus and parent are stable->expectant management->wait and see–>can be at home and hospital
ultrasound can determine morbidity
depends on parity, amount of bleeding, is fetus develop enough to survive outside of uterus, risk of hemorrhage
nursing assessment for placenta previa
thorough history–>possible risk factors and a physical examination
risk factors for placenta previa
advanced maternal age (gestational pregnancy over 35 y/o)
cocaine use
previous c-section
multiparity
uterine injury
smoking
previous surgically induced abortion
infertility treatments
prior placenta previa
multiple gestations
short interval between pregnancies
hypertension or diabetes
Bleeding associated with placenta previa
painless, bright red, vaginal occurring during 2nd/3rd trimester
first episode usually occurs around 27-32 weeks gestation
uterus cannot contract properly to stop the blood flow due to mal- implantation thus bleeding continues
chronic hypertension
blood pressure exceeding 140/90 before pregnancy or 22 weeks gestational age
gestational hypertension
begins around 22 weeks gestational age, >140/90, and usually resolves about after 12 weeks postpartum
second stage of preeclampsia
hypertension, edema, proteinuria
things for client to monitor themselves
weight gain (edema), protein in urine, blood presure
signs to watch out for for preeclampsia
headache, visual disturbances, epigastric pain,
solution to preeclampsia
giving birth bc preeclampsia depends on the trophoblastic tissue
subjective assessment findings of preeclampsia when assessing client
unusual bleeding, visual changes, sever headaches, bruising, epigastric pain
how to verify gestational hypertension
take BP twice 15 minutes apart, both must be >140/90
proteinuria
> =300mg of protein in urine or using dipstick would be 1+ or greater
common sites to test DTRs
biceps, triceps, patellar, achilles, plantar
what is hyperflexia associated with
nervous system irritability related to preeclampsia
magnesium toxicity signs
RR less than 12 breaths/min, absence of DTRs, decrease in urinary output
clonus present:
jerky and rapid movement vs smooth movement from the muscle
what is the onset of eclampsia
start of seizure activity
