Hyperemesis
Symptoms of hyperemesis
severe nausea, vomiting, weight loss, tachycardia, hypotension, dizziness, fatigue, headache
What are the weight gain recommendations for women who are
Underweight?
Normal?
Overweight?
28-40lbs
25-35lbs
15-25lbs
A 24-year-old pregnant woman at 32 weeks gestation refuses a recommended cesarean section despite the fetus showing signs of distress. Which ethical principle should guide the nurse’s next action?
A low-income pregnant woman misses multiple prenatal appointments because she lacks transportation. Which nursing intervention best addresses this barrier?
Assist with access to transportation. Refer her to community transport or an in-home program
What is the scope of practice for each of the following providers?
OB-GYN?
Nurse Practitioner?
OBGYN- Pre, Ante, Postpartum care. All types of deliveries
NP- Pre, Ante, Postaprtum care. NO DELIVERIES!!
Hyperemesis risk factors
first time pregnancy, multifetal pregnancy, past pregnancy with hyperemesis, hx of migrains, hx of motion sickness
What foods should be avoided during pregnancy?
Alcohol, raw or undercooked foods, soft cheeses, smoked meats/fish, raw milk, excessive caffeine.
A nurse caring for a pregnant patient with gestational diabetes encourages her to adhere to her insulin regimen and diet plan to promote maternal and fetal health. This demonstrates which ethical principle?
Beneficence
What are some social determinant of health facing pragnant women?
Food insecurity, housing issues, limited access to healthcare, no insurance, low education, high crime areas, lack of social support
What are the services offered by a Level 2 care facility?
Moderate risk patients. Can manage preterm deliveries, preE, and have NICU services.
Complications of hyperemesis gravidarum
pertem delivery, fetal death, severe dehydration, IUGR, sore throat (from excessive vomiting)
What is the benefit of taking folic acid during pregnancy?
What foods contain folic acid?
Helps prevent neural tubal defects
Fortified breads/cereals, green leafy veggies, legumes
A nurse is administering a medication known to carry fetal risks but is necessary to stabilize the mother’s life-threatening condition. The nurse ensures that the lowest effective dose is used. This reflects which ethical principle?
Nonmaleficence
What are signs that your pregnant client may be a victim of human trafficking?
late prenatal care, multiple bruises, lack of ID, no knowledge of personal info, partner won't leave, client avoid eye contact, client won't answer for herself.
What services are offered by a Level 3 facility?
High-risk pregnancy, complex maternal and fetal issues, babies with congenital abnormalities, serious cardiac issues, multifetal pregnancies
What are lifestyle recommendations for women who have hyperemesis gravidarum?
Use ginger/peppermint, eat bland dry foods, avoid high fat foods, eat smaller/more frequent meals, wear pressure-point wristbands, avoid triggers (riding in cars), get up slowly in the morning
What are food that contain calcium?
legumes, dairy, nuts, fruits (oranges, kiwi, berries), dark leafy greens
Remember to take vitamin D to increase absorption
A pregnant teenager seeks prenatal care at a community clinic that provides equal access to all clients regardless of age, income, or marital status. Which ethical principle is being demonstrated?
Justice
What things would a nurse identify as being issues associated with a teenage client who is pregnant?
IUGR, Low birthweight babies, lack of knowledge, increased anxiety, preterm labor/delivery, body image issues, nutritional deficits
What type of care can a nurse midwife provide?
Nurse midwife- Pre, Ante, and postpartum care. Low risk patients. No operative deliveries.
Medications that can be used to treat nausea related to hyperemesis gravidarum
doxylamine, vit B6, ondansetron, promethazine, metoclorpramide
A woman who is a vegetarian asks about what what nutrients she may be deficient in. How should the nurse respond?
Protein, calcium, iron, vit B12, vit A
A nurse discusses prenatal screening results with a pregnant woman and honestly explains that the test suggests a possible congenital anomaly. Which ethical principle does this action represent?
Veracity
Signs of intimate Partner violence.
unexplained injuries, missed appointments, reluctance to answer questions, hovering partner low self-esteem
What questions would be inportant to ask a pregnant client and their family duing the preconception and initial pregnancy appointment?
# of pregnancies, what is the housing situation, who lives at home, have you taken or plan to take prenatal classes, immunizations, how do you prefer to get information