-
evaluates the fetus without causing
it any stress.
One monitor checks for contractions; the other records the fetal heartbeat.
nonstress test
-
reason for doing nonstress test
Decreased fetal movements
Going beyond the due date
Diabetes
High blood pressure
-
ways to assess fetal well being
- Amniocentesis
- Chorionic villi sampling
- Contraction stress test
- External fetal monitoring
- Internal fetal monitoring
-
Excessive vomiting during pregnancy.
Physiological and psychological factors may be involved.
hyperemesis gravidarum
-
Treatment goals for hyperemesis gravidarum:
- control vomiting
- correct dehydration
- restore electrolyte balance
- maintain adequate nutrition
-
Termination of a pregnancy before
viability and can be spontaneous or induced
abortion
-
miscarriage =
Spontaneous abortion
-
Symptoms of spontaneous abortion are:
abdominal cramping, vaginal bleeding, and feelings of fear and guilt.
-
_____ is performed to remove products of conception from the uterus
A D&C (dilatation and curettage)
-
_____ is ordered for threatened abortions
bedrest
-
Occurs when a fertilized ovum implants outside the uterine cavity
Pain is noted as the tube stretches with the growing embryo, eventually rupturing.
Rapid surgical treatment is necessary to control bleeding
ectopic pregnancy
-
most common site for ectopic pregnancy
fallopian tubes
-
Abnormality of placenta–chorionic villi
become fluid-filled, grapelike clusters.
Classic signs are bleeding, uterine enlargement, no fetal heart tones, hyperemesis gravidarum, or symptoms of PIH appear before 24 weeks
hydaditiform mole
-
hydatidiform mole should be mfollowed for how long to monitor metastasis
1-2 years
-
Implantation in lower uterine segment with placenta lying over or very near the internal cervical os.
Symptoms include painless bleeding in the
last half of pregnancy.
Treat to maintain the pregnancy until
fetus mature enough to survive outside uterus.
placenta previa
-
SYMPTOMS OF BLEEDING IN PREGNANCY
CAN INDICATE :
PLACENTA PREVIA OR PLACENTA ABRUPTIO
-
3 types of placenta previa
- marginal
- complete
- low lying
-
Premature separation from wall of uterus of a normally implanted placenta.
Symptoms include a rigid, painful abdomen.
Irreversible brain damage or fetal death may occur if hypoxia is not reversed quickly.
abruptio placenta
-
Overstimulation of normal clotting process, occurs as complication of a primary problem that can cause fetal death.
DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
-
symptoms of dissiminated intravascular coagulation
dyspnea, chest pain, restlessness, cyanosis, and spitting frothy, blood-tinged mucous.
-
steps for DIC
correct problem
deliver fetus
IV administration of blood,fibrinogen, or cryoprecipitate is begun.
Heparin is given continuously
Oxygen therapy is begun
-
disorder most common in pregnancy, after 20 weeks’ gestation
Hypertension/PIH
-
cure for PIH
deliver baby
-
Mild preeclampsia–blood pressure increases ____ mm Hg systolic or ____ mm Hg diastolic over baseline on two occasions at least 6 hours apart
-
PIH:
______ is usually the last of the three classic symptoms to appear
proteinuria
-
PIH common findings:
______ noted in face and hands.
Objectively defined as weight gain of _________.
Urine may show __________
Edema noted in face and hands.
- Objectively defined as weight gain of
- more than 1 pound a week.
Urine may show 1+ or 2+ albumin
-
Severe preeclampsia:
blood pressure increases to _____
Generalized edema in _______
Weight gain may be _______.
Urinary albumin may be _______
Severe preeclampsia–blood pressure increases to 160/110 or higher.
Generalized edema in face, hands, sacral area, lower extremities, abdomen.
Weight gain may be 2 pounds a week.
Urinary albumin may be 3+ or 4+.
-
last symptom of severe preeclampsia before client moves into eclampsia
epigastric pain
-
eclampsia is characterized by ______
and convulsions are treated with _______
grand mal seizures
magnesium sulfate
-
when is mag sulfate administrated:
Respirations; at least 14/minute.
Urine output: must be at least 30 cc/hr
-
antidote for mag
calcium gluconate
-
complications of gestational DM
Macrosomia: excessive fetal growth (big baby)
-
used as a prophylaxis for all pregnant women with heart disease
antibiotics
-
PKU phenylalanine level for positive pregnancy outcome
***Client to maintain phenylalanine-free diet
less than 2.0 mg/dL while pregnant
-
inherited disease that can be controlled by diet
No cure. Damage done is irreversible so
early detection is crucial.
PKU
-
PKU progressive conditions:
mental retardation
seizures
-
group of infections that f untreated can cause abortion, congenitalanomalies, fetal infections, IUGR, preterm labor, mental retardation, or death.
(TORCH)
Toxoplasmosis (TO)
Rubella (R)
Cytomegalovirus (C)
Herpes genitalis (H)
-
fetus may contract toxoplasmosis if mother becomes contaminated or infected by
cat litter and contaminated meat
-
chracteristic of cytomegalovirus
"blueberry muffin" lesions
-
Women with active genital herpes at time of delivery will need _______to prevent transmission of virus to infant
c-section
-
if infant has blisters on body _____ should be suspected
herpes becuase it may not be apparent on women
-
_____ is a challenge for pregnant HIV-infected client.
weight gain
-
how can HIV be transmitted to fetus:
- through placenta
- during birth
- during breast feeding.
-
hemolytic disease for Rh incompatibility–can only happen when:
mother is Rh negative and fetus is Rh positive.
-
if mother is Rh negative and fetus is Rh positive what should be administered
rhogam
-
multiple pregnancies pose greater risk for:
fetal anomalies, abnormalpresentations, and preterm birth.
-
when does preterm labor begin
begins after viability but before 38 weeks’ gestation.
-
The process of stopping labor with medications is called
tocolysis
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