Early Pregnancy Bleeding
Development of an embryo or fetus outside of the uterus, unilateral pain that can radiate up to the shoulder.
Ectopic Pregnancy
Placenta partially or completely covering the cervix. Can cause painless bleeding.
Placenta Previa
What medication is used to treat a client with preeclampsia to prevent seizures?
Magnesium Sulfate
What type of diabetes occurs only during pregnancy and resolves after delivery?
Gestational diabetes
Tell me about betamethasone: what, why, route given, precautions
Route: IM
Dose: varies, usually 2 doses Q24 hours
Action: matures fetal lungs; given to mom when gestation 24 - 34 weeks to prevent RDS;
Precautions: possible infection & pregnancy complication with diabetes; mom that previously did not need insulin may need it; BG monitoring
note: given to mom at risk for preterm birth, often given with mag sulfate
4 possible causes of an abortion
infection, ABO/Rh incompatibility, trauma, chromosomal abnormalities
3 causes and 3 signs of placenta abruption
Hypertension, cocaine, trauma
Boardlike contracted abdomen, excruciating pain, excessive bleeding
What are severe signs of preeclampsia?
Blurred vision, persistent headache, RUQ pain, sudden increase in swelling, hyperreflexia in DTRs, oliguria.
Test performed at 24-28 weeks gestation in non-diabetic clients to screen for gestational diabetes.
Glucose tolerance test
How do you support your patient after a spontaneous abortion?
Assess if this was a desired pregnancy, offer chaplain services, allow time for grieving, encourage patient and family to express emotions, address infant by its name.
Name 3 signs of a hydatidiform molar pregnancy
Brownish bleeding, excessive uterine enlargement, N/V
Signs of Disseminated Intravascular Coagulation (DIC)
Bleeding around the IV site, gums, petechiae, bruising
Hemolysis, Elevated Liver Enzymes, and Low Platelets
What is HELLP Syndrome
Mother is treated with zidovudine in pregnancy and labor, baby is treated after delivery.
HIV
What is the preferred route of delivery for a patient with active Herpes Simplex Virus (HSV) lesions?
Cesarean Section
Procedure recommended to reduce the risk of recurrent preterm birth?
Cerclage
Nursing assessment to avoid if a placenta previa is suspected
Sterile vaginal exams
Antidote for Magnesium toxicity
Calcium gluconate
Tested at 36 weeks gestation, mother needs antibiotics in labor if positive. High mortality rate for babies when mom is not treated.
Group Beta Strep (GBS)
What are nursing interventions for a placental abruption?
Establish 2 large bore IVs, have blood cross matched, place patient on left side, monitor for signs of DIC, vitals q15 minimum, continuous fetal monitoring, provide emotional support, prepare for OR.
Bleeding and cramping with some passage of tissue
Incomplete spontaneous abortion
Route of delivery for a patient with a placenta previa
Cesarean section
Respiratory depression, absent deep tendon reflexes, or urine output less than 30 mL/hr while being treated with magnesium sulfate
Magnesium Toxicity
The baby is at risk of this after birth if the glucose is not well managed during pregnancy
Hypoglycemia
Magnesium Sulfate 4gm IV to be given over 20 minutes. Magnesium Sulfate comes in 40gm/1000mL IV bag. You would set your pump at _____mL/hour
300 mL/hr