PreEclampsia
Define the term PreEclampsia.
It is a pregnancy-specific syndrome that usually occurs after 20 weeks' gestation. It involves gestational hypertension plus proteinuria.
Define the term Placenta Previa.
In placenta previa the placenta is implanted in the lower uterine segment such that it completely or partially covers the cervix or is close enough to the cervix to cause bleeding when the cervix dilates or the lower uterine segment effaces
Define the term Abruptio Placentae.
Premature separation of the placenta.
Define the term Gestational diabetes mellitus.
Gestational diabetes mellitus is defined as carbohydrate intolerance with the onset or first recognition occurring during pregnancy.
What does the acronym HELLP stand for.
hemolysis (H), elevated liver enzymes (EL), and low platelet (LP) count.
The nurse administers a single dose of vitamin K intramuscularly to a newborn after birth to promote?
Blood Clotting
Define the term Eclampsia.
Development of seizures or coma not attributable to other causes in a preeclamptic woman.
Clinical manifestation of Placenta Previa.
Placenta previa is typically characterized by painless bright red vaginal bleeding during the second or third trimester.
Clinical Manifestations of Abruptio Placenta.
Classic symptoms of placental abruption include vaginal bleeding, abdominal pain, uterine tenderness, and contractions.
Explain first trimester insulin needs.
-Increase in estrogen and progesterone
-Increased insulin sensitivity
-Increase in Insulin production
-Increase in synthesis of glycogen
-Hypoglycemia so decreased Insulin requirements
Indirect vs Direct Coombs
•Indirect Coombs – antibody screen on Mother
•Direct Coombs – done on infant for antibody coated RH+ RBC’s
A nurse is teaching a new parent about what to expect for bowel elimination in their newborn. Because the parent is breastfeeding, what should the nurse tell them about the newborn's stools?
Stools should be yellow-gold, loose, and stringy to pasty.
Name a medication that reduces clients blood pressure.
Labetalol Hydrochloride (Normodyne, Trandate)
Hydralazine (Apresoline, Neopresol)
Nifedipine (Adalat, Procardia)
Methyldopa (Aldomet)
Method of delivery
-Delivery always C/S
What causes Abruptio Placenta.
Can be caused by some type of abdominal trauma (MVA, fell of bike)
Could be caused due to vasospasm: HTN, Drug use (cocaine, meth)
Hyperstimultion of the uterus
Explain 2nd & 3rd Trimester Insulin needs.
•HPL= human chorionic somatomammotropin (HCS), increases the resistance to insulin.
•Insulin resistance
•Glucose levels rise (hyperglycemia)
•Insulin requirements rise (x2-4)
HIV Viral Load & Transmission
-high viral load – High rates of transmission
- Low viral load – Low rates of transmission
It does cross the placenta
The nurse is explaining phototherapy to the parents of a newborn. The nurse would include which of the following as the purpose?
Oxidize bilirubin on the skin
Name three clinical manifestations of PreE.
Proteinuria
BP greater than 160/110
DTRs +2 or greater
Headache
Edema: Hands, face, fingers
Blurred Vision
Epigastric Pain
Hydatidiform Mole (Molar Pregnancy) S&S
•Uterus enlarged
•“prune juice”
•+Hcg
•No FHT/FM
•Hyperemesis
•PreE
Interventions and Management of Abruptio Placenta
Continues maternal & fetal monitoring
Prepare for delivery
Remember when the placenta detaches mom is hemorrhage and baby’s heart rate will bottom out (lack of perfusion) so baby start dying as well
Screening Tool for GDM
GTT at 24-28 wks
2hr vs 3hr
What instructions regarding diet and medication regimen should be giving to a client with iron deficiency anemia.
- Prenatal Vitamin
- Iron Supplements
- Vitamin C
- Diet
The nurse is inspecting the mouth of a newborn and finds small, white cysts on the gums and hard palate. The nurse documents this finding as:
Epstein pearls
Name 4 nursing assessments that should be performed for client receiving Mag Sulfate.
• Maternal: Blood pressure, pulse, respiratory rate, DTRs, level of consciousness, urine output (indwelling catheter), headache, visual disturbances, epigastric pain
• Fetal: FHR and activity
Molar Pregnancy Follow Up Care
Follow-up care includes frequent physical and pelvic examinations along with weekly measurements of the β-hCG level until the level decreases to normal and remains normal for 3 consecutive weeks.
-Monthly for 6-12 months
-Making sure normal levels return.
Vasospasm & Abruptio Placenta
Vasospasm (this will make the placenta fall off) HTN, Drug use (cocaine, meth)
Explain fetal risk factors.
•Macrosomia (8-14)
•IUGR
•Rebound hypoglycemia
•RDS (slow surfactant production)
•Congenital Anomalies (Incidence 5-10%)
What are the periods of greatest risk for a client with Cardiovascular Issues during pregnancy?
28-32 weeks gestation
During Labor
1st 48 hours Postpartum
Name and explain 4 types of heat loss infants experience.
Conduction: Loss through contact
Convection: Loss through air flow
Radiation: Loss through proximity
Evaporation: Loss from wet to vapor