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What is Hyperemesis Gravidarum?
excessive nausea and vomiting that interferes with food intake and fluid balance
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How can you tell a women with Hyperemesis Gravidarum is dehydrated?
- Skin tenting
- Dry tongue and mucous membranes
- Scant/concentrated urine
- High Hematocrit level
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What is treatment for a patient with Hyperemesis Gravidarum?
- Oral/IV fluids
- Antiemetic drugs
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Cramping and backache with light spotting; cervix is closed and no tissue is passed?
Threatened abortion
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Increased bleeding, cramping, cervix dilates
Inevitable abortion
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Bleeding, cramping, dilation of cervix, passage of tissue
Incomplete abortion
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Passage of all products of conception; cervix closes and bleeding stops
Complete abortion
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Fetus dies in utero, but is not expelled; uterine growth stops, sepsis can occur.
Missed abortion
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Two or more consecutive spontaneous abortions, usually caused by incompetent cervix or progesterone levels inadequate to maintain pregnancy
Recurrent Abortion
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A pregnancy that occurs when the fertilized ovum is implanted outside the uterine cavity.
ectopic pregnancy
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What are some manifestations of ectopic pregnancy?
- lower abd. pain
- light vaginal bleeding
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What can happen if the tube ruptures in a tubal ectopic pregnancy?
- sudden severe abd. pain
- vaginal bleeding
- hypovolemic shock
- shoulder pain
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Signs ans symptoms of hypovolemic shock ?
- FHR change
- inc. pulse
- inc. irregular resp.
- decr. blood pressure
- decr. urinary output
- cold clammy skin
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Hydatidiform Mole occurs from what?
when chorionic villi abnormally increase and develop vesicles
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What are some manifestations of Hydatidiform Mole?
- Bleeding
- rapid uterine growth
- failure to detect fetal activity
- Hyperemesis Gravidarum
- Early GH
- High hCG levels
- Snowstorm pattern on ultrasound
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What is the treatment for HM.
- Uterine evacuation
- Dilation and evacuation
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What should a women who had HM have monitored?
hCG levels, because she has an increased risk for cancer
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What is placenta previa?
abnormal implantation of the placenta
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What is the manifestation of Placenta previa?
painless bright red bleeding
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3 Degrees of Placenta Previa
Marginal: 2-3 cm within cervical opening
Partial: covers part of cervix
Total: covers cervix completely
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What is Abruptio Placentae?
Normal implantation of the placenta that detaches from the uterine wall
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What is the manifestation of Abruptio placentae
Painful dark red bleeding
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Preeclampsia?
Gestational hypertension with proteinuria
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Ecclampsia?
Gestational hypertension, CNS involvement
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What can be a sign that a women has gestational hypertension?
edema of the hands and face
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Risk factors for GH?
- 1st pregnancy
- obesity
- Family Hx
- Age over 40, under 19
- multifetal pregnancy
- chronic hypertension
- renal disease
- DM
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What is the TX for GH?
- Activity restriction
- BP monitor
- Daily weight
- Monitor Proteinuria
- Antihypertensive
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What is the drug of choice during pregnancy to control seizures?
Magnesium sulfate
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Rh incompatibility occurs when?
- Mom is Rh negative and fetus is Rh positive and fetal blood leaks into moms blood
- the mom then makes antibodies against the RH + erythrocytes
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What is Erythroblastosis Fetalis?
Occurs when the maternal anti Rh antibodies cross the placenta and destroy fetal erythrocytes
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What is the TX for erythroblastosis fetalis?
RhoGAM to women 28 weeks gestation and 72 hours after birth
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Glucose intolerance with the onset during pregnancy
Gestational GM
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True/False:
Glucose usually returns to normal by 6 weeks postpartum
true
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What are some hormones that are produced by the placenta,in regards to GDM?
estrogen, progesterone
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What are the 2 functions of the hormones?
- Increase resistance of the cells to insulin
- Increase speed of insulin breakdown
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What is the preferred medication for GDM
Insulin
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What are some factors linked to GDM
- Maternal obesity
- Large infant
- Maternal age ^ 25 yrs
- Previous still birth
- Hx of GDM
- Family Hx of DM
- Fasting glucose of 126-200
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What is the TX for GDM?
- Diet
- monitor blood glucose
- Ketone monitor
- Exercise
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What are 3 reasons why mom needs iron?
- - to increase blood volume
- - transfer for fetus
- -cushion against expected blood loss during labor
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Food high in iron?
meats, fish, liver, legumes, dark leafy greens, dried fruit
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Foods high in folic acid?
green leafy veggies, whole grains, liver, fruit
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Foods ^ in Vit. C
Citric foods, and juices, strawberry, cantaloupe, cabbage, peppers, potatoes
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What foods are recommended to take with iron supplements.
Citric foods/vitamin C
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What foods should be avoided with intake of iron supplement?
milk/dairy
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What is a TX for Iron deficiency anemia?
- Iron Supplements
- Vitamin C
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Folic Acid Deficiency Anemia TX
Folic Acid supplement
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Autosomal recessive disorder, which causes erythrocytes to become distorted in a sickle shape because of abnormal hemoglobin
Sickle cell anemia
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What can happen to a mom with sickle cell anemia
- Pregnancy can cause a crisis
- also massive RBC destruction and vessel occlusion
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Genetic trait causes abnormality in one or two chains of hemoglobin
Thalassemia
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What should you teach a women who has sickle cell anemia to avoid?
- Avoid dehydration and strenuous activities
- Avoid exposure to infections
- Avoid extreme heat/cold temps
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What does the acronym TORCH describe?
- Toxoplasmosis
- Other (STD)
- Rubella
- Cytomegalovirus
- Herpes
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True or False?
Rubella vaccine is given during pregnancy?
False - no live virus vaccines are given during pregnancy
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Where can a mom pick up toxoplasmosis from?
Cat litter/feces
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