Hypertensive Disorders
What distinguishes preeclampsia from gestational hypertension?
Proteinuria is present in preeclampsia but not in gestational hypertension.
What are early signs of placental abruption?
Sudden pain, dark red bleeding, rigid uterus, fetal distress.
What is the significance of positive GBS culture in late pregnancy?
Indicates need for intrapartum antibiotics to prevent neonatal sepsis.
What is the expected fasting glucose for a pregnant patient?
Less than 95 mg/dL.
What gestational age defines preterm labor?
Labor before 37 weeks gestation.
What is a hallmark sign of HELLP syndrome?
Hemolysis, Elevated Liver enzymes, Low Platelets.
How does placenta previa differ from placental abruption?
Placenta previa is painless bleeding; abruption is painful and involves uterine tenderness.
What maternal infection increases risk of congenital defects if acquired during the first trimester?
Rubella (German measles).
What is a serious complication of uncontrolled gestational diabetes? (give 3)
Macrosomia, shoulder dystocia, neonatal hypoglycemia.
What test helps predict preterm labor risk within 7 days?
Fetal fibronectin (fFN) test.
What medication is used to prevent eclampsia and what are its toxicity signs?
Magnesium sulfate; toxicity includes respiratory depression, absent DTRs, low urine output.
What is vasa previa and why is it critical?
Fetal vessels cross the cervix unprotected; rupture can cause fetal exsanguination.
What is the nursing priority for a mother who has PROM and fever?
Monitor for chorioamnionitis; report elevated temp, foul-smelling discharge.
What thyroid condition causes heat intolerance, weight loss, and goiter in pregnancy?
Hyperthyroidism (e.g., Graves’ disease).
What medication is given for fetal lung maturity if preterm birth is likely?
Betamethasone or dexamethasone.
What reflex indicates magnesium sulfate toxicity is worsening?
Loss of patellar (deep tendon) reflexes.
How is postpartum hemorrhage defined and what are the two main causes?
Blood loss >500 mL (vaginal) or >1000 mL (cesarean); causes: uterine atony and retained placenta.
What infections are screened for in TORCH complex?
Toxoplasmosis, Other (syphilis), Rubella, Cytomegalovirus, Herpes simplex.
What is the treatment for overt hypothyroidism in pregnancy?
Daily levothyroxine; adjust dosage based on TSH and free T4.
What are nursing interventions for PROM?
Monitor temp, avoid digital exams, assess amniotic fluid color/odor.
What are priority nursing actions when a patient has severe preeclampsia with headache and visual changes?
Initiate seizure precautions, administer antihypertensives, prepare for delivery.
What is a concealed hemorrhage and which condition is it most associated with?
Internal bleeding without visible blood loss, commonly seen in placental abruption.
What are signs of sepsis in a postpartum client?
Fever, tachycardia, uterine tenderness, foul lochia, malaise.
What metabolic condition is associated with nausea, vomiting, and elevated liver enzymes?
Acute fatty liver of pregnancy (AFLP).
What are tocolytics and give 2 examples.
Drugs that suppress uterine contractions. Examples: Terbutaline, Nifedipine.