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Maternal Newborn - Cher > Test 4 Hemorrhagic Disorders > Flashcards

Test 4 Hemorrhagic Disorders Flashcards

(52 cards)

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1
Q

Symptoms of shock

A

rapid thready pulse
pallor
hypotension

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2
Q

Painless cervical effacement and dilation that is not associated with contractions

A

Incompetent cervix

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3
Q

Incompetent cervix usually occurs…

A

2nd trimester

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4
Q

What is the usual result of incompetent cervix?

A

spontaneous abortion or preterm birth

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5
Q

Late sign of shock

A

low BP

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6
Q

Who is at risk for incompetent cervix?

A
  • previous cervical trauma
  • maternal exposure to DES
  • congenital uterine anomalies
  • history of previous unexplained loss
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7
Q

What is DES?

A

Diethylstilestrol

Not used since 1970s. Synthetic form of estrogen used 1938 to 1971 to prevent miscarriages

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8
Q

What is cerclage?

A

?

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9
Q

what is BPP?

A

Biophysical profile

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10
Q

What is NST?

A

Non stress test

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11
Q

Previa or abruption?
A.Hypertensive and vascular diseases can cause?
B.Multiple pregnancies, close together, previous c section?

A

A. abruption

B. Previa

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12
Q

Blood that is not clotting because they have coagulation problems

A

DIC

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13
Q

Purse String Cerclage

A

McDonald

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14
Q

petechiae

A

little blood spots on the surface

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15
Q

Fertilized ovum implanted outside the uterine cavity.

A

ectopic pregnancy

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16
Q

Most common site for ectopic pregnancy?

A

fallopian tube

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17
Q

What can ectopic pregnancy lead to?

A

hemorrhage, collapse and death

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18
Q

Risk factors for ectopic pregnancy

A
  • History of STDs
  • previous tubal pregnancy
  • failed tubal ligation
  • IUD
  • multiple induced abortions
  • maternal age >35
  • assistive reproductive techniques
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19
Q

Symptoms of Ectopic pregnancy

A
  • Positive pregnancy test
  • Vaginal spotting or severe bleeding
  • Sharp abdominal pain, unilateral
  • Classic sign of ruptured site is shoulder pain as a result of internal bleeding irritating the diaphragm and phrenic nerve.
  • Diagnosis confirmed by transvaginal ultrasound
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20
Q

Intervention for ectopic pregnancy ruptured tube

A

salpingectomy

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21
Q

Tubal pregnancy without rupture may give __________ – destroys rapid dividing cells

22
Q

2nd step in ectopic pregnancy

Study These Flashcards
A

teasing out the ectopic pregnancy intact, and then irrigating the incision to make sure it is free of any ectopic tissue

23
Q

Nursing interventions for Ectopic pregnancy

Study These Flashcards
A 
rh immune globulin
fluids
T&C
Monitor for symptoms of shock
emotional care
follow up
24
Q

What is GTD?

Study These Flashcards
A

Gestational Trophoblastic Disease (Hydatiform Mole)

25
Abnormal growth of trophoblastic tissue
Hydatidiform Mole
26
What are the 2 types of GTD
Complete mole : develops from empty ovum | Partial Mole : abnormal embryo that usually aborts in the 1st trimester
27
Complications of GTD
- predisposes client to choriocarcinoma - Cancer develops following evacuation in 20% of clients - Cancer is invasive and usually metastatic
28
Vaginal bleeding of hydatidiform mole looks like:
brown “prune juice” containing grape like vesicles.
29
Complications associated with GTD
- Hyperemesis | - preeclampsia
30
If baby's HR goes up check mom's:
temp
31
Follow up care for Non-malignant GTD
- Weekly HcG levels initially to ensure that any remaining tissue does not turn malignant. - hCG levels monthly for one year - Chemotherapy prophylactic or as treatment - Encourage client to prevent pregnancy for one year
32
Premature detachment of all or part of a normally implanted placenta.
placental abruption
33
Is placental perfusion interrupted with placental abruption
yes
34
How is classification of placental abruption determined?
Level of bleeding | Mild, moderate, severe
35
Apparent placental abruption = (___-___%) | Concealed = (____-____%)
70-80% | 10-20%
36
When does placental abruption occur?
Usually late 3rd trimester or even in labor
37
What is the most frequent cause of placental abruption?
Cocaine use
38
Risk factors for Abruption
``` Hypertensive disorders Cocaine abuse – vasoconstriction High gravity or Previous abruption Abdominal trauma Maternal cigarette smoking PROM Twin gestation ```
39
Signs and symptoms of Abruption
- Bleeding (apparent or concealed) - Abdominal Pain - Uterine Tenderness and contractions - 50% abruptions can be identified on uterine screen
40
3 types of placental abruption
partial concealed partial apparent complete separation
41
Maternal complications of Placental Abruption
- Hemorrhage Hypovolemic shock - Hypofibrinogemia - Thrombocytopenia - Renal failure (due to ischemia)
42
___-____% fetal/neonatal mortality with abruption
20-30
43
Abruption: If 50% of placenta involved, fetal _____ is likely to occur (due to hypoxia)
death
44
Medical management of abrupt placenta
``` monitor blood loss IV fluids Monitor Coagulation Problems Blood and/or Blood products Rhogam ```
45
If mild case of abruption give to mom to help with fetal lung maturity if less than 36 weeks
steroids
46
Care for Abruption?
- External monitoring FHR/Toco… - Monitor BP, HR, and R for impending shock - O2 via face mask at 8-12L/min - Start and maintain IV fluids with 18g needle - Review lab to estimate blood loss (hct and hgb) - Review coagulation studies for potential development of DIC - Prepare for emergency CS -NO VAGINAL EXAMS
47
Vaginal Exams for Placenta Abruptio?
No
48
Placenta implanted in lower uterine segment, near or over the internal cervical os
placenta previa
49
Types of placenta previa
Complete Partial Marginal Low Lying
50
Previa types: -internal os is entirely covered by placenta when the cervix is completely dilated - Incomplete coverage of internal os - Only an edge of the placenta extends to the internal os, but ma extend onto the os as the cervix dilates during labor - Placenta is implanted in the lower uterine segment but does not reach the os
Complete or total – Partial – Marginal – Low-lying –
51
predisposing factors
- multiple gestation - closely spaced pregnancies - maternal age >35 - high parity - asian or african - previous placenta previa - previous c/s or suction
52
sharp pain radiating toward shoulder =
ectopic

Maternal Newborn - Cher (6 decks)

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