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Maternal Health Test 1
Unit 1
48
Nursing
Undergraduate 3
09/02/2013

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Term
Risk factor for PIH include what?
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
Term
What do we assess for in PIH?
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
Term
interventions and treatment for PIH
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
Term
fetal effects of PIH include what?
Definition
spontaneous abortion, urinary and vaginal infections, ketoacidosis, hypo and hyperglycemia, higher risk of child to develop diabetes later in life, hydramnios
Term
Things to monitor in PIH patients and fetus.
Definition
monitor fetus for respiratory depression, late decal with labor contractions, monitor lung development (once seizure activity happens, fetal development stops.)
Term
Risk factors of Cardiovascular disease if pregnancy include what?
Definition
preterm labor, miscarriage, mental retardation of the fetus, HTN, fetal mortality, and increased risk for blood clots
Term
signs and symptoms of cardiovascular disease in pregnancy include what?
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
Term
Interventions and treatment for women with cardiovascular disease in pregnancy include what?
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
Term
Normal platelet count in pregnancy
Definition
1st trimester: (170-310)
2nd tri (150-360)
3rd tri: (140-370)
Term
Normal WBS's for pregnant women are?
Definition
1st tri (5.6-13.8)
2nd tri (6.0-15.7)
3rd tri (5.8-15.1)
Term
symptoms for ectopic pregnancy include what?
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)
Term
treatment for ectopic pregnancies include what?
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
Term
Placenta previa
Definition
placenta is implanted in lower segment of the uterus.
*low, partial, and complete
Term
Risk factors for placenta previa
Definition
increased parity, advanced maternal age, uterin scarring (previous c section or pregnancy), multiple gestation, boys, closely spaced pregnancies
Term
what do we assess for in placenta previa?
Definition
painless bright red vaginal bleeding, nontender uterus with normal tone, palpable placenta, wnl VS, decreasing urinary
Term
interventions and treatments for placenta previa include what?
Definition
H&H, CBC, type and cross, Rh factor, coagulation profile (ptt), US, fetal monitoring, side lying, monitor FHR, vaginal rest
Term
Placenta abruption
Definition
premature separation of the placenta from the uterine wall during pregnancy. the degree of separation determines the fetal outcomes.
Term
Risk factors for placenta abruption include what?
Definition
maternal hypertension, cocaine use, previous abruption of placenta, smoking, and abdominal trauma
Term
What needs to be assessed for in abruption placenta?
Definition
sharp abd pain, ridged board like abdomen, bleeding in myometrium (may cause ineffective contractions, fetal distress, signs of hypovolemic shock
Term
Interventions of placental abruption
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!
Term
Rh factor disease
Definition
occurs when Rh- mother carries an Rh+ fetus. Antibodies can be made which will affect mother and baby in her next pregnancy
Term
Assessment for Rh factor disease
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
Term
premature cervical dilation
Definition
a cervix that dilates prematurely and therefore cannot hold a fetus to term. occurs in 1% of women. happens around 20 weeks gestation
Term
Interventions for premature cervical dilation
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%
Term
Interventions involved in trauma in pregnancy
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.
Term
What labs need to be checked with pregnant trauma patients?
Definition
-liver enzymes
-abdominal bleeding
- maintain BP in face of hemorrhage
- cross and type
Term
Interventions for pregnant adolescence and women over 40
Definition
-early prenatal care, extra educational support, check blood sugar often (higher chance of getting gestational diabetes), special emotional considerations
Term
Infertility
Definition
Inability to successfully get pregnant after one year of trying.
Term
What are your options for infertility?
Definition
adoption, in vitro, artificial insemination, and hormone therapy (Clomid)
Term
gestational diabetes
Definition
when a woman becomes diabetic during pregnancy that was not previously diabetic
Term
Risk factors for Gestational Diabetes include what?
Definition
obesity, age over 25, family history, member of population of high risk, history or big babies, POS, congenital anomalies
Term
Treatment for gestational diabetes includes what?
Definition
Insulin (rapid, short, fast, and intermediate)
Term
Effects of Gestational Diabetes
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.
Term
At risks for multiple gestations includes what?
Definition
low birth weight, congenital anomalies, twin to twin transfusion, and knotting and twisting of the cord.
Term
complications of multiple gestations includes what?
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)
Term
interventions for multiple gestations
Definition
bed rest, left lateral position, and encourage six small meals a day
Term
Etiology of Iron deficient anemia
Definition
low iron diet, heavy menstrual periods, unwise weight reduction programs, and recent pregnancy
Term
symptoms of iron deficient anemia include what?
Definition
fatigue, headache, pallor, and PICA
Term
treatment for iron deficient anemia includes what?
Definition
prenatal vitamins, diet rich in iron, medication (ferrous sulfate) ingested with orange juice
Term
Etiology of megablastic anemia
Definition
This occurs in multiple pregnancies, patients taking Hydantoin, oral contraceptives, or patients who have gastric bypass.
Term
Symptoms of megablastic anemia
Definition
early miscarriages and preterm separation of the placenta
Term
treatment for megablastic anemia
Definition
supplement folic acid, leefy green vegetables, oranges, and dried beans
Term
Zidovudine
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
Term
Clomid
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.
Term
Women who are HIV positive during pregnancy?
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.
Term
etiology of sickle cell anemia
Definition
inherited. caused when abnormal amino acid replaces the amino acid valine
Term
symptoms of sickle cell anemia
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
Term
treatment for sickle cell anemia
Definition
periodic exchange transfusions, control hemoglobin levels, increase fluids, O2, no iron treatment
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