Complications of Pregnancy
Describe the difference between a threatened and missed miscarriage
Threatened: Bleeding, but pregnancy is still continuing
Missed: Baby has no heartbeat, but pregnancy tissue remains in the uterus
Describe tachycaria and bradycardia in terms of fetal HR
What is
Tachycardia: >160 >10 minutes
Bradycardia: <110 >10 minutes
What is the first chemical marker of pregnancy and when does it peak?
β-hCG (Human Chorionic Gonadotropin)
Peaks at 8-10 weeks, then levels off
A client 1 hour postpartum has heavy vaginal bleeding and a boggy uterus displaced to the right. What is the first nursing action?
What is a fundal massage?
What is the goal of preconceptual care?
The goal of preconceptual care is to improve the health status of women and men before conception and reduce behaviours and environmental factors that could contribute to poor maternal and child outcomes
What is it called when a pregnancy occurs outside the uterus, and where do most occur?
What is an Ectopic Pregnancy
95% occur in the fallopian tube
The 5 P's of Labour
What is passenger, passageway, powers, position, and psychological response
When are the Ovum, embryonic and fetal stages, and which is most critical
- Ovum stage (Conception to Day 14): Cell division, blastocyst formation, start of membranes, three germ layers form.
- Embryonic stage (Day 15 to Week 8): Most critical stage — all major organs and systems form.
-->Ectoderm: Skin, hair, nails, brain, spinal cord, nerves.
--> Mesoderm: Bones, muscles, heart, blood vessels, urinary and reproductive systems.
--> Endoderm: Lining of the stomach, intestines, lungs, pancreas, bladder.
--> Teratogens (harmful substances) are most dangerous during this stage.
- Fetal stage (Week 9 until birth): Growth and refinement of all systems.
You are providing discharge instructions to a patient who received Methotrexate for an ectopic pregnancy. You know the patient understands the instructions when they say what in regard to prenatal supplements? ( and why)
What is "I will stop taking my prenatal vitamin" → the folic acid in the vitamins could cancel out the effects
A Registered Nurse is completing documentation after meeting with a preconception patient. The patient has 2 children, ages 3 and 5, born at 34 and 38 weeks, respectively. The patient also had a miscarriage at 6 weeks of gestation. What is the correct GTPAL?
G3 T1 P1 A1 L2
Name 2 risk factors for Hyperemesis Gravidarum
What is: first pregnancy, very low or very high body weight, abnormal growths in uterus, female fetus.
4cm dilated, with moderate to strong regular contractions.
What stage of labour?
What is first stage, ACTIVE. (4-10cm)
Ren is now 39+4 weeks gestation and presents to the hospital, her midwife will meet her here but hasn’t arrived yet. She is 4 cm dilated, 100% effaced, at spines (station 0). The FHR shows the following: baseline 130, moderate variability, spontaneous accelerations, no decelerations. What is the most appropriate nursing intervention?
What is Continue to monitor and provide supports, as this is a normal classification
State 3 functions of amniotic fluid
- Regulates temperature
- Prevents infection
- Allows for fetal movement
- Waste reservoir
- Aids in lung development
Laura is now 34 weeks gestation. Throughout her pregnancy, 2 additional antihypertensives were prescribed in order to control hypertension. Despite this, Laura reports that her home BPs have all been >160/110 since yesterday. Laura reports feeling RUQ pain, severe headache, and visual disturbances (‘seeing stars’). Following a complete assessment and bloodwork, the following findings are: platelets 42, O2 sats 89% on RA that rise to 98% with 50% O2 administration; BP 170/104, 2+ proteinuria. The nurse knows this means ( diagnosis + intervention)
What is: Severe pre-eclampsia, delivery is warranted
Preferrable fetal position for labour
What is Right occipitoanterior (ROA) or Left occitoanterior (LOA)
Body lean, but fairly well proportioned; skin red and wrinkled; vernix caseosa present; swear glands forming. How many weeks into development?
What is 24 weeks?
Sam (16 y/o) is now 30 weeks gestation and was diagnosed with placenta previa. They presented to L&D with mild bleeding that has now stopped. Sam’s VS are normal, the FHR is normal and there are no concerns for either Sam or the baby. Which type of management is most appropriate?
What is Expectant?
Remember:
Expectant: <36 weeks, no active labour, mild bleeding or no bleeding
Active: At or >36 weeks gestation, or bleeding is excessive/persistent
Expectant management is stopped as soon as fetus is mature, bleeding is active, or other obstetrical indication
What is present in some women, is part of their normal flora, high neonatal mortality rate, if not treated.
What is Group Beta Streptococcus (GBS)?
A patient does the 50g glucose challenge test with PG 1 hour later and gets 8.6mmol/L. What is the next step?
What is: do a 75 OGTT measure FPG, 1hPG and 2hPG, if one or more of the following values ( 5.3, 10.6, 9.0 mmol/L, respectively ) are met or exceeded, patient has gestational diabates
How much oxytocin would be given for IOL and how is it administered?
What is
15 units in 250mL normal saline
Always administered by pump through a secondary line, closest to IV insertion site (proximal)
When do the primary lung buds appear?
What is 4 weeks gestation?