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Hemorrhagic Disorders
Hypertensive Disorders
Newborn Complications
Labor and Birth Complications
Other complications of pregnancy/disorders
100
When the fertilized ovum is implanted outside of the uterine cavity
What is ectopic, or tubal pregnancy? The three most classic symptoms are the following: Abdominal pain Delayed menses Abnormal vaginal bleeding (spotting) Tubal rupture and abdominal hemorrhaging can lead to shock
100
Disorder that only occurs during pregnancy and the immediate postpartum period characterized by high blood pressure and proteinuria.
What is pre-eclampsia? Other S/S may include Swelling, sudden weight gain, headaches and changes in vision are important symptoms
100
Infants born before 37 weeks of gestation
What are Preterm infants? At risk due to Organ systems immature Lack of adequate physiologic reserves
100
Group of medications used in PTL to suppress uterine activity.
What are Tocolytics? Relaxes smooth muscle such as the uterus. Brethine (Terbutaline), Magnesium Sulfate (MgSO4), Indocin, Procardia
100
Testing for this disorder is done during weeks 24-28 of pregnancy. Complications of this disorder can result in babies with macrosomia.
What is Gestational Diabetes Mellitus (GDM)? High levels of maternal glucose cross placenta Insulin that the mother makes (or takes) does not cross the placenta The infant will create it's own insulin production, but fetal insulin acts as a growth hormone (extra energy is stored as fat) Concerns for infants born to mothers of GDM include macrosomia, risk for birth trauma/need for cesarean delivery, hypoglycemia after delivery due to high levels of fetal insulin but no longer receiving maternal glucose
200
When the placenta completely covers the cervical os.
What is a complete placenta previa? Clinical manifestations - painless bright red bleeding after 20 weeks Will need to deliver via C-section, goal is after 37 weeks for fetal lung maturity
200
Disorder characterized by hemolysis, elevated liver enzymes, and thrombocytopenia.
What is HELLP syndrome? RUQ pain is another common characteristic of HELLP syndrome.
200
Nasal flaring, grunting, retracting, tachypnea or apnea, central cyanosis or pale color are common symptoms seen in this neonatal disorder
What is Respiratory Distress Syndrome? More severe with decreased gestational age Caused by lack of surfactant Atelectasis, loss of functional residual capacity, and ventilation-perfusion imbalance occurs
200
Spontaneous rupture of amniotic sac and leakage of fluid prior to the onset of labor at any gestational age
What is Premature Rupture of Membranes (PROM)? Watch for further complications Chorioamnionitis is an intra-amniotic infection Cord compression and prolapse Goal to delay labor and birth Inpatient treatment Monitored for s/s of infection or fetal distress (NST/BPPs) Antibiotic administration Provide education and support
200
This condition is related to excessive levels of hCG hormone during pregnancy and presents clinically through excessive prolonged vomiting and accompanying dehydration.
What is Hyperemesis Gravidarum? Clinical manifestations: Weight loss Electrolyte imbalance Nutritional deficiencies Ketonuria Replace fluid/electrolytes Manage symptoms if able
300
This hemorrhagic disorder is a type of gestational trophoblastic disease in which chorionic villi develop into edematous, cystic, avascular transparent vesicles that hang in a grapelike cluster.
What is Hydatidiform Mole (Molar Pregnancy)? Complete: no embryonic or fetal parts Partial: often have embryonic or fetal parts and an amniotic sac Risk of choriocarcinoma (malignant gestational trophoblastic neoplasia) Postpone future pregnancies for at least one year
300
The only cure for pre-eclampsia, eclampsia, or HELLP syndrome
What is delivery of the baby?
300
Encouraging this method of skin-to-skin holding where the infant is dressed only in a diaper and placed on parent's bare chest while covered in a blanket can improve outcomes of the neonate.
What is Kangaroo Care?
300
Bacterial infection of the amniotic cavity.
What is chorioamnionitis? Diagnosed by the clinical findings of maternal fever, maternal and fetal tachycardia, uterine tenderness, and foul odor of amniotic fluid Neonatal risks – pneumonia, bacteremia, sepsis, death (pre-term)
300
This condition can be associated with a higher risk of infertility and miscarriage. Also, women with this condition often need a medication adjustment during their pregnancy.
What is hypothyroidism? Medication adjustment of Synthroid (Levothyroxine) can be up to 40% of a woman's pre-pregnancy dose. Symptoms that accompany hypothyroidism include: weight gain, lethargy, decrease in exercise capacity, and cold intolerance
400
Detachment of part or all of placenta from implantation site after 20 weeks of gestation
What is Abruptio Placentae (Placental Abruption)? Primary risk factor is maternal HTN Clinical manifestations:Vaginal bleeding, abdominal pain, and uterine tenderness and contractions Boardlike abdomen
400
The primary goal of Magnesium Sulfate (MgSO4) in use for hypertensive disorders.
What is prevent seizures?
400
Most common cause of neonatal sepsis and meningitis of the neonate in the United States
What is Group Beta Strep (GBS) infection? EARLY-ONSET OCCURS IN THE FIRST 24 HOURS AFTER BIRTH UP TO 7 DAYS RESPIRATORY ILLNESS (SIMILAR TO RDS), CAN RAPIDLY DEVELOP SEPTIC SHOCK PROPHYLACTIC ANTIBIOTICS IN LABOR IS IMPORTANT TYPICALLY PENICILLIN (UNLESS MOM IS ALLERGIC), GIVEN IV, 2 DOSES MINIMUM PREFERRED, 4 HOURS APART
400
A rating system used to evaluate inducibility or cervical ripeness
What is Bishop Score? Score of 9 and above (up to 12 total) indicates cervical readiness for induction of labor (IOL). If low Bishop Score present will need cervical ripening prior to IOL: Cervidil and Cytotec are common prostaglandin medications used in cervical ripening.
400
This condition can cause pre-term labor and fetal demise and can be caused by an undiagnosed condition or poor glycemic control of the mother.
What is Diabetic Ketoacidosis (DKA)?
500
This is not a hemorrhagic disorder but rather a question regarding care of a woman in PTL: Two parts: The goal of administering this medication during pre-term labor with impending pre-term birth is to allow for time of administering this other medication which should positively effect the premature newborn's lungs. Both medications are given to the mom: the 1st one via IV route and the 2nd one via IM injection, 24 hours apart
What is Magnesium Sulfate (MgSO4) and Antenatal glucocorticoids (Betamethasone and Dexamethasone)?
500
An important assessment for determining irritability of the Central Nervous System.
What is Deep Tendon Reflexes? DTRs: 0 = No respose +1 = sluggish or diminished +2 = Active, expected, normal +3 = Slightly hyperactive +4 = Brisk, hyperactive
500
Due to large surface area in relation to body weight, minimal subcutaneous fat, limited stores of brown fat, environmental exposure, immature CNS infants in the NICU are at an increased risk for this.
What is temperature instability/ineffective thermoregulation? Neutral thermal environment (NTE) is the goal Prevent temp instability Also prevent hyperthermia Causes increased O2 and calorie consumption Unable to sweat and dissipate heat
500
An obstetrical emergency where the head is born but the anterior shoulder cannot pass under the pubic arch.
What is Shoulder Dystocia? Newborn more likely to experience birth injuries related to asphyxia, brachial plexus damage, and fracture (clavicle) Mother’s primary risk stems from excessive blood loss from uterine atony or rupture, lacerations, extension of episiotomy, or endometritis.
500
This condition is associated with intense and pervasive sadness with severe and labile mood swings
What is Post Partum Depression (PPD)? Risk factors: History of anxiety or depression Previous episode of major depressive disorder Younger age Unintended pregnancy Family history of mood disorder Unmarried/marital discord Lack of social support Socioeconomic deprivation Safety is a key concern in PPD for both M/B