Term
| Risk factor for PIH include what? |
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Definition
-women of color
-mx pregnancies greater than 5
-primiparas (less than 20 or over 40)
-hydramnios
-low socioeconomic backgrounds
-underlying heart disease
-hypertentsion
-diabetes with vessel or renal involvement |
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Term
| What do we assess for in PIH? |
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Definition
| edema (anything greater than hands and feet), BP greater than 140/90, proteinuria 1-2+, weight gain more than 2lbs per week in second trimester and 1lb a week in third, moniter urine output for oliguria, visual disturbances, hepatic dysfunction, epigastric pain, and hyperreflexia |
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Term
| interventions and treatment for PIH |
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Definition
| monitor antiplatelet therapy, promote bedrest, emphasis on nutrition, emotional support,administer prescribed medications , frequent BP assess, daily hematocrit levels, daily wt, monitor fetal health with doppler every 4hr, moderate/high protein diet, monitor FHR, obtain magnesium levels |
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Term
| fetal effects of PIH include what? |
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Definition
| spontaneous abortion, urinary and vaginal infections, ketoacidosis, hypo and hyperglycemia, higher risk of child to develop diabetes later in life, hydramnios |
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Term
| Things to monitor in PIH patients and fetus. |
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Definition
| monitor fetus for respiratory depression, late decal with labor contractions, monitor lung development (once seizure activity happens, fetal development stops.) |
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Term
| Risk factors of Cardiovascular disease if pregnancy include what? |
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Definition
| preterm labor, miscarriage, mental retardation of the fetus, HTN, fetal mortality, and increased risk for blood clots |
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Term
| signs and symptoms of cardiovascular disease in pregnancy include what? |
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Definition
| dizziness, SOB, weakness, fatigue,chest pain with exertion, Arrythmias, irreg heart rate, tachycardia, heart murmur, distended jugular veins, cyanosis of nails or lips, pallor, generalized edema, diaphoresis, increased respirations, cough, hemoptysis, IUGR, decreased amniotic fluid, FHR variability |
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Term
| Interventions and treatment for women with cardiovascular disease in pregnancy include what? |
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Definition
| Echocardiogram, holter monitor, CXR, US, pulse oximetry, NST, biophysical profile, clotting studies, H&H, WBC, Chem profile, Sed rate, maternal ABG's, monitor meds (heparin, digoxin, inderal, garamycin, ampicillin), bedrest, provide nutritional education, instruct pt decreased physical activity, monitor VS, FHR, contractions, O2 as prescribed,monitor daily weight and urinary output, daily kick counts, NST |
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Term
| Normal platelet count in pregnancy |
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Definition
1st trimester: (170-310)
2nd tri (150-360)
3rd tri: (140-370) |
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Term
| Normal WBS's for pregnant women are? |
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Definition
1st tri (5.6-13.8)
2nd tri (6.0-15.7)
3rd tri (5.8-15.1) |
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Term
| symptoms for ectopic pregnancy include what? |
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Definition
| 1-2 missed menses, stabbing pain on the side of the abdomen, scant/dark red/ or brown spotting, frequent n/v after tube rupture, referred shoulder pain, signs of hemorrhage or shock (hypotension, tachycardia, pallor) |
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Term
| treatment for ectopic pregnancies include what? |
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Definition
| rapid surgical treatment, salvage of tube if possible, provide IV fluids, methotrexate, moniter Hcg levels to ensure return to before pregnancy levels, type and cross match, moniter liver and renal function |
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Term
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Definition
placenta is implanted in lower segment of the uterus.
*low, partial, and complete |
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Term
| Risk factors for placenta previa |
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Definition
| increased parity, advanced maternal age, uterin scarring (previous c section or pregnancy), multiple gestation, boys, closely spaced pregnancies |
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Term
| what do we assess for in placenta previa? |
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Definition
| painless bright red vaginal bleeding, nontender uterus with normal tone, palpable placenta, wnl VS, decreasing urinary |
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Term
| interventions and treatments for placenta previa include what? |
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Definition
| H&H, CBC, type and cross, Rh factor, coagulation profile (ptt), US, fetal monitoring, side lying, monitor FHR, vaginal rest |
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Term
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Definition
| premature separation of the placenta from the uterine wall during pregnancy. the degree of separation determines the fetal outcomes. |
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Term
| Risk factors for placenta abruption include what? |
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Definition
| maternal hypertension, cocaine use, previous abruption of placenta, smoking, and abdominal trauma |
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Term
| What needs to be assessed for in abruption placenta? |
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Definition
| sharp abd pain, ridged board like abdomen, bleeding in myometrium (may cause ineffective contractions, fetal distress, signs of hypovolemic shock |
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Term
| Interventions of placental abruption |
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Definition
| cross and type, start large IV, O2, monitor VS for shock, monitor fetal HR (decels), monitor signs of DIC, side lying position, prepare for delivery, emotional support, NO VAG CHECKS! |
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Term
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Definition
| occurs when Rh- mother carries an Rh+ fetus. Antibodies can be made which will affect mother and baby in her next pregnancy |
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Term
| Assessment for Rh factor disease |
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Definition
mom will be checked at her first prenatal visit for Rh+ or Rh- (anti-D antibody titer.) If mom is Rh- Rhogam will be given at 28 weeks and within the first 72 hours after delivery.
-also given after induced abortion, miscarriage, ectopic pregnancy or amniocentesis)*anytime blood mixing is a possibility |
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Term
| premature cervical dilation |
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Definition
| a cervix that dilates prematurely and therefore cannot hold a fetus to term. occurs in 1% of women. happens around 20 weeks gestation |
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Term
| Interventions for premature cervical dilation |
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Definition
Cervical Cerclage (McDonald or Shirodkar procedure) – sutures placed in the cervix to prevent it form dilating, bedrest for a few days in slight trendelenburg after procedure
*sutures are removed at 37-38 weeks gestation
*success rate is 80-90% |
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Term
| Interventions involved in trauma in pregnancy |
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Definition
| quick history of pregnancy as well as trauma history, NG and Foley, hip roll to left side to prevent supine hypotension, large IV, correct hypotension with epinephrine or low dose of dopamine. |
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Term
| What labs need to be checked with pregnant trauma patients? |
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Definition
-liver enzymes
-abdominal bleeding
- maintain BP in face of hemorrhage
- cross and type |
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Term
| Interventions for pregnant adolescence and women over 40 |
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Definition
| -early prenatal care, extra educational support, check blood sugar often (higher chance of getting gestational diabetes), special emotional considerations |
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Term
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Definition
| Inability to successfully get pregnant after one year of trying. |
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Term
| What are your options for infertility? |
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Definition
| adoption, in vitro, artificial insemination, and hormone therapy (Clomid) |
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Term
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Definition
| when a woman becomes diabetic during pregnancy that was not previously diabetic |
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Term
| Risk factors for Gestational Diabetes include what? |
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Definition
| obesity, age over 25, family history, member of population of high risk, history or big babies, POS, congenital anomalies |
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Term
| Treatment for gestational diabetes includes what? |
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Definition
| Insulin (rapid, short, fast, and intermediate) |
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Term
| Effects of Gestational Diabetes |
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Definition
| birth defects of spine, brain, and heart, low BS after birth, increased chance of obesity and diabetes later in life, miscarriage, and Cauda regression syndrome. |
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Term
| At risks for multiple gestations includes what? |
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Definition
| low birth weight, congenital anomalies, twin to twin transfusion, and knotting and twisting of the cord. |
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Term
| complications of multiple gestations includes what? |
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Definition
| PIH, hydramnios, placenta previa, preterm labor, anemia, and post partum bleeding (uterus becomes very stretched making it very hard to come back to size) |
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Term
| interventions for multiple gestations |
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Definition
| bed rest, left lateral position, and encourage six small meals a day |
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Term
| Etiology of Iron deficient anemia |
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Definition
| low iron diet, heavy menstrual periods, unwise weight reduction programs, and recent pregnancy |
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Term
| symptoms of iron deficient anemia include what? |
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Definition
| fatigue, headache, pallor, and PICA |
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Term
| treatment for iron deficient anemia includes what? |
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Definition
| prenatal vitamins, diet rich in iron, medication (ferrous sulfate) ingested with orange juice |
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Term
| Etiology of megablastic anemia |
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Definition
| This occurs in multiple pregnancies, patients taking Hydantoin, oral contraceptives, or patients who have gastric bypass. |
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Term
| Symptoms of megablastic anemia |
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Definition
| early miscarriages and preterm separation of the placenta |
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Term
| treatment for megablastic anemia |
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Definition
| supplement folic acid, leefy green vegetables, oranges, and dried beans |
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Term
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Definition
| given for treatment of HIV and to prevent transmission to neonate. Give loading dose over 1 hour, then infuse at 1mg/kg/hr. Adverse effects: fever, dyspnea, malaise, weakness, myalgia, myopathy, headache, and dizziness. Contraindications: allergy to drug, lactic acidosis, and lactation |
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Term
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Definition
| It works by stimulating an increase in the amount of hormones that support the growth and release of a mature egg (ovulation). Long term use is discouraged. No more than 6 rounds Pregnancy category X. |
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Term
| Women who are HIV positive during pregnancy? |
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Definition
| Woman have a risk of passing disease on to baby. Baby must be delivered C-Section. Must be treated with ZDV (Zidovudin.). Babies cannot breastfeed. Moms will need extra education. |
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Term
| etiology of sickle cell anemia |
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Definition
| inherited. caused when abnormal amino acid replaces the amino acid valine |
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Term
| symptoms of sickle cell anemia |
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Definition
| unusual swelling of fingers and toes, pllor, chronic anemia, severe abd pain, muscle spasms, leg pains, painful swollen joints, fever, vomiting, hematuria, seizures, coma, and paralysis |
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Term
| treatment for sickle cell anemia |
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Definition
| periodic exchange transfusions, control hemoglobin levels, increase fluids, O2, no iron treatment |
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