OB exam #3: Chapters 16-19
maintain a patent airway
A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first? a. pad the side rails b. place a pillow under the left buttock c. insert a padded tongue blade into the mouth d. maintain a patent airway
uterine atony
A fundal massage is sometimes performed on a postpartum woman. The nurse would perform this procedure to address which condition? a. uterine atony b. uterine prolapse c. uterine subinvolution d. uterine contraction
sharp, stabbing chest pain with shortness of breath
A nurse is assessing a postpartum client. Which finding would cause the nurse the greatest concern? a. leg pain on ambulation with mild ankle edema b. calf pain with dorsiflexion of the foot c. perineal pain with swelling along the episiotomy d. sharp, stabbing chest pain with shortness of breath
oxytocin (pitocin) infusion
A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition? a. medication that will provide sedation b. increased hydration c. oxytocin (pitocin) infusion d. administration of a tocolytic medication
Massage the fundus
A postpartum client saturates a peripad in 30 minutes. What is the nurse's first action in this situation? a. Massage the fundus b. Take a blood pressure c. Call the provider d. Encourage the client to void
respirations of 10 per minute
A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment? a. presence of deep tendon reflexes b. serum magnesium level of 6 mEq/L c. proteinuria of +3 d. respirations of 10 per minute
an amniocentesis to determine L/S ratio and maturation of lung tissue prior to labor
A pregnant client with Gestational Diabetes Mellitus at 36 weeks gestation is at risk for premature labor. The doctor informs her that she may have to conduct which of the following procedures to ensure that the baby is fit to be delivered? a. a biophysical profile to determine L/S ratio and maturation of lung tissue prior to labor b. a contraction stress test to determine L/S ratio and mutration of lung tissue prior to labor c. an amniocentesis to determine L/S ratio and maturation of lung tissue prior to labor
first consul them on lifestyle changes such as diet and exercise
A woman comes in at 24 weeks pregnant and does her oral glucose tolerance test and it shows a blood sugar of 190, they have gestational diabetes what is the first intervention you do as the nurse?
administer oxygen by mask
A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to: a. administer oxygen by mask. b. increase her intravenous fluid infusion rate. c. put firm pressure on the fundus of her uterus. d. tell the woman to take short, catchy breaths
complete abortion (clinical manifestations)
All the products of conception (fetus, membranes, and placenta) are expelled
abruption (abruptio) placentae
A 39 year old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client's complaint of vaginal bleeding? a. placenta previa b. abruptio placentae c. ectopic pregnancy d. spontaneous abortion
hematuria, ecchymosis, and epistaxis
A PP client is being treated for DVT. The nurse understands that the client's response to treatment will be evaluated by regularly assessing the client for: a. dysuria, ecchymosis, and vertigo b. epistaxis, hematuria, dysuria c. hematuria, ecchymosis, and epistaxis d. hematuria, ecchymosis, and vertigo
toxicity begins at 9 mg/dl, the tendon reflexes disappear, respiratory depression, cardiac arrest
At what level is a client becoming toxic after taking magnesium sulfate?
tx habitual recurrent abortion
Attempts are made to determine and treat the cause. For example, cervical insufficiency is often a cause of habitual abortion
placenta previa
Bright red vaginal bleeding PAINLESS
acute hemolytic disease
During a prenatal examination, the nurse draws blood from a young Rh negative client and explain that an indirect Coombs test will be performed to predict whether the fetus is at risk for: a. acute hemolytic disease b. respiratory distress syndrome c. protein metabolic deficiency d. physiologic hyperbilirubinemia
ultrasound
During a prenatal visit at 4 months gestation, a pregnant client asks whether tests can be done to identify fetal abnormalities. Between 18 and 40 weeks gestation, which procedure is used to detect fetal anomalies? a. amniocentesis b. chorionic villi sampling c. fetoscopy d. ultrasound
proteinuria (protein the presence of protein in the urine)
How do you know that gestational hypertension has progressed to preeclampsia?
no (discontinuing could cause more harm)
If a pregnant client comes to the hospital with asthma should the client stop taking there prednisone at any time during pregnancy if they are already on it?
no
If a pregnant client has asthma should they stop taking there inhaled corticosteroid or regular corticosteroid steroid orally?
developing Rh incompatibility
Rho(D) immune globin (RhoGAM) is given to a pregnant woman after delivery and the nurse is giving information to the patient about the indication of the medication. The nurse determines that the patient understands the purpose of the medication if the patient tells that it will protect her baby from which of the following? a. developing german measles b. developing pernicous anemia c. developing Rh incompatibility d. having an RH+ blood
hyperemesis gravidarum
disorder of early pregnancy that is characterized by severe nausea and vomiting that results in weight loss, nutritional deficiencies, and/or electrolyte and acid-base imbalance
congenital defects such as neural tube defects
What affects does maternal hypoglycemia have on the baby?
T- toxoplasmosis O- other infections (hepatitis B, syphilis, varicella, and herpes zoster) R- rubella C- cytomegalovirus (CMV) H- herpes simplex virus (HSV)
What does the acronym TORCH stand for? a special group of infections that can be acquired during pregnancy and transmitted through the placenta to the fetus
decrease or absent tendon reflex
What happens when you become toxic on magnesium after the first time?
Preeclampsia and eclampsia
What is magnesium sulfate used to treat?
RhoGAM
What is the treatment of Rh incompatibility?
abruptio placentae
Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? a. placenta previa b. ectopic pregnancy c. incompetent cervix d. abruptio placentae
severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems
Which of the following statements best describes hyperemesis gravidarum? a. sever anemia leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems b. severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems c. loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients d. severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding
concealed or external dark red bleeding
Which of the following would the nurse assess in a client experiencing abruptio placenta? a. bright red, painless vaginal bleeding b. concealed or external dark red bleeding c. palpable fetal outlined. d. soft and non tender abdomen
poor prenatal care
Why do adolescents have a lot of complications with pregnancy?
fetal lung maturity
Why do you give Betamethasone to a woman who is going to give birth prematurely?
ectopic pregnancy
a pregnancy that occurs outside of the uterus usually in a fallopian tube or "tubal"
abruptio placentae
dark red vaginal bleeding PAINFUL
tx incomplete abortion
expectant management (wait for the miscarriage to occur on own) misoprostol (cytotec) orally to induce contractions surgical removal of the pregnancy; the type of procedure performed depends largely on the gestational age. Dilation and currettage (D&C) is the procedure of choice for pregnancies under 14 weeks
PROM
• Spontaneous rupture of the amniotic sac before the onset of labor or PROM
hypertonic uterine dysfunction
painful frequent and uncoordinated contractions
postpartum (puerperal) infection
refers to any infection that occurs after delivery Happens because of trauma during birth such as from forceps, pt has had an abruption
advise the woman to get adequate rest and avoid strenuous physical activity
Patient who presents with signs and symptoms of exacerbation of heart failure lightheadedness, dizziness, non history of heart disease. What are some interventions would you give this patient?
McRoberts maneuver
Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be born. Stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? a. McDonald maneuver b. McGeorge maneuver c. McRoberts maneuver d. McRonald maneuver
s/sx postpartum depression
Strong feelings of sadness, irritability, anxiety; frequently tearful • Lack of interest/motivation in normal activities • Intense feelings of inadequacy, inability to cope, ambivalence, guilt, unworthiness • Insomnia; loss of libido; decreased appetite; inability to concentrate; overwhelming fatigue; obsessive thinking • May contemplate harming self or baby • Has profound sense of inability to respond to her family and ambivalence toward infant
massage her fundus
The nurse examines a woman one hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action would be to: a. place her on a bedpan to empty her bladder b. massage her fundus c. call the physician d. administer methergine 0.2 mg IM which has been ordered pm
Placental abruption
The nurse is examining a client at 37 weeks' gestation who came to labor and delivery with severe cramps and vaginal spotting. While listening to the fetal heart rate the nurse observes a reddened area of the side of the client's abdomen. When the nurse asks about the area, the client says "I got hit with a broom." The nurse asks who hit her, but the client does not respond. A vaginal examination reveals the cervix is 50% effaced and dilated 1 cm, membranes are intact, no bleeding, and the presenting part is floating. Based on the nurse's assessment, the client is admitted to the observation unit to be monitored for which obstetrical condition? a. Placental abruption b. Preeclampsia c. Premature labor d. Placenta previa
excessive analgesia was given to the mother
The nurse should anticipate that hemorrhage related to uterine atony may occur postpartally if this condition was present during the delivery: a. excessive analgesia was given to the mother b. placental delivery occurred within thirty minutes after the baby was born c. an episiotomy had to be done to facilitate delivery of the head d. the labor and delivery lasted for 12 hours
a recessive inheritance (Individuals who have sickle cell anemia inherit two copies of the genetic mutation for Hgb S, one from the father and one from the mother) (Some people are carriers of the trait because they inherit only one copy of the mutation)
How do you acquire sickle cell anemia?
abruptio "abruption" placentae
If a client comes to the client dark red vaginal bleeding, and severe abdominal cramping and a board like abdomen what is this called?
prepare for a cesarean delivery prenatal antiviral therapy
If a mother has HIV/AIDS how do you prevent the baby from getting it?
RhoGAM
If a patient has a spontaneous abortion what is one of the things you should think about as the nurse if the client is in there first or second pregnancy and 12 weeks along and has a miscarriage what can the nurse give to prevent problems with future pregnancies?
Fundal massage (when the abdominal muscles are massaged)
If the client has a small amount of bleeding with postpartum hemorrhage and you need to stop the bleeding, what would you do as the nurse?
spongy postpartum hemorrhage (want the uterus to firm)
If the client has vaginal bleeding and a boggy uterus what is happening to the patient?
hemolytic anemia
If the mother is Rh (-) and the baby is Rh (+) or the father is Rh (+) means the baby will be large for gestation or could be. The mother's blood recognizes that babies positive antigen and sees their blood as a foreign antigen and attacks them Typically doesn't happen until the delivery process
uterine atony
-Failure of the uterine muscles to contract and stay contracted. failure of uterine muscles to stay relaxed
In the first few months of pregnancy, the woman's insulin requirements fluctuate widely, and she is at risk for episodes of hypoglycemia, or low blood glucose levels, particularly between meals less insulin
In a client that has pre-gestational diabetes, how does their blood sugar in the first trimester of pregnancy fluctuate?
may appear quiet and passive She may avoid eye contact She may have an unkempt appearance and may appear depressed She may exhibit anxiety, nervousness, and suicidal tendencies She may abuse alcohol or drugs in response to the abuse
In intimate partner violence, what are the signs a woman is being abused? What will the woman act like if she is being abused?
an overly protective attitude toward the victim, may accompany the victim to all office visits and may answer questions for the victim. the abuser may seem pleasant and congenial. Conversely, they may make degrading remarks about the victim in front of health care providers or others If the partner refuses to leave the room so that the client cannot be alone, be highly suspicious and look closer for other signs of abuse
In intimate partner violence, what are the signs the male is an abusive partner?
electrolyte imbalance
A 21 year old client, 6 weeks' pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions? a. bowel perforation b. electrolyte imbalance c. miscarriage d. pregnancy induced hypertension (PIH)
imminent abortion (rationale: cramping and vaginal bleeding coupled with cervical dilation signifies that termination of the pregnancy is inevitable and cannot be prevented. thus, the nurse would document an imminent abortion, in a threatened abortion, cramping and vaginal bleeding are present, but there is no cervical dilation. the symptoms may subside or progress to abortion. in a complete abortion all the products of conception are expelled. a missed abortion is early fetal intrauterine death without expulsion of the products of conception)
A client 12 weeks' pregnant come to the emergency department with abdominal cramping and moderate vaginal bleeding.Speculum examination reveals 2 to 2 cms cervical dilation. The nurse would document these findings as which of the following? a. threatened abortion b. imminent abortion c. complete abortion d. missed abortion
clean and maintain an open airway
A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to elclampsia, the nurse's first action is to: a. administer magnesium sulfate intravenously b. assess the blood pressure and fetal heart rate c. clean and maintain an open airway d. administer oxygen by face mask
your baby may have birth defects of the heart, brain, neural tube, and extremities. This is caused by high levels of glycogen in your body, which is actually a teratogen
A nurse is discussing potential health issues that may affect the fetus of a new mother with gestational diabetes mellitus. Which of the following statements by the nurse is the most accurate pertaining to health issues that affect the fetus with a diabetic mother? a. your baby may have birth defects of the heart. This is caused by high levels of glycogen in your body which is actually a teratogen b. your baby may have birth defects of the heart and brain This is caused by high levels of glycogen in your body. Which is actually a teratogen c. your baby may have birth defects of the heart and brain. This is caused by high levels of glycogen in your body which is actually a teratogen d. your baby may have birth defects of the heart, brain, neural tube, and extremities. This is caused by high levels of glycogen in your body, which is actually a teratogen
over the age of 25-30 year old family history previous GDM hypertension and overweight previous large baby, stillborn and pregnancy loss polycystic ovarian syndrome
A nurse is discussing risk factors of Gestational Diabetes Mellitus with a pregnant patient at 24 weeks gestation. Which of the following are all risk factors for GDM that the nurse would discuss with this patient? (select all that apply). a. over the age of 25-30-year-old b. younger than 30 years old c. family history d. previous GDM e. hypotension f. hypertension and overweight g. previous large baby stillborn and pregnancy loss h. polycystic ovarian syndrome
elevated blood pressure facial edema
A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia (select all that apply)? a. elevated blood pressure b. negative urinary protein c. facial edema d. increased respirations
observe the patient for possible uterine contractions administrator RhoGAM to the patient if she is Rh negative
A patient has undergone an amniocentesis for evaluation of fetal well being. Which intervention would be included in the nurse's plan of care after the procedure? Select all that apply. a. perform ultrasound to determine fetal positioning b. observe the patient for possible uterine contractions c. administrator RhoGAM to the patient if she is Rh negative d. perform a mini catheterization to obtain a urine specimen to assess for bleeding
activity limited to bed rest
A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? a. activity limited to bed rest b. platelet infusion c. immediate cesarean delivery d. labor induction with oxytocin
Umbilical cord prolapse
A pregnant woman at term is in the obstetrics unit for induction in the morning. Her membranes rupture, and the external fetal monitor shows deep variable decelerations. For what should the nurse immediately check the patient? a. Amniotic fluid infection b. Amniotic fluid embolus c. Umbilical cord prolapse d. Placental abruption
Bring the client's knees back toward the shoulders, causing hyperflexion of the hips and rotation of the pubic symphysis
A shoulder dystocia situation is called in room 4. The nurse enters the room to help and the health care provider says to the nurse, "McRoberts maneuver." What does the nurse do next? a. Bring the client's knees back toward the shoulders, causing hyperflexion of the hips and rotation of the pubic symphysis b. Move the client into a hands-and-knees position, to straighten the sacral curve and release the posterior shoulder c. Apply downward pressure above the pubic bone of the client, in an attempt to rotate the anterior shoulder d. Push the fetal head back into the uterus and prepare the client for cesarean birth
Risk for fatigue related to chronic bleeding due to subinvolution
A woman arrives at the office for her 4-week postpartum visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which nursing diagnosis is most likely for this client? a. Risk for fatigue related to chronic bleeding due to subinvolution b. Risk for infection related to microorganism invasion of episiotomy c. Risk for impaired breastfeeding related to development of mastitis d. Ineffective peripheral tissue perfusion related to interference with circulation secondary to development of thrombophlebitis
The partner is overly protective of the pregnant client. The partner answers questions for the pregnant client. Poor weight gain during the pregnancy and low-birth-weight infant
A woman arrives at the prenatal clinic and is accompanied by her partner. Which behaviors would be suggestive of intimate partner violence (IPV)? Select all that apply. a. The pregnant client looks at the examiner when asked questions. b. The partner answers questions for the pregnant client. c. The partner is overly protective of the pregnant client. d. Poor weight gain during the pregnancy and low-birth-weight infant e. The client asks questions of the nurse about her pregnancy
elevated blood pressure (systolic ≥140 mm Hg or diastolic ≥90 mm Hg) that develops for the first time during pregnancy after 20 weeks gestation, without the presence of protein in the urine progressive preeclampsia
What are the signs and symptoms of gestational hypertension?
no signs
What are the signs and symptoms of gonorrhea and chlamydia?
large amounts of foamy yellow green vaginal discharge, itching, unusual odors, painful intercourse, dysuria
What are the signs and symptoms of trichomoniasis or Trichomona's?
tachycardia high fever elevated respiratory rate elevated BP
What are the signs and symptoms when a client is a preterm labor and exhibits sepsis or an infection with chorioamnionitis?
dehydration and electrolyte imbalance
What can result from a client that presents with hyperemesis gravidarum that has excessive nausea and vomiting if left untreated?
lower education levels higher levels of poverty more likely to participate in behaviors that increase the risk for poor birth outcomes, such as smoking; late sporadic no prenatal care failure to gain sufficient weigh
What contributes to the high failure rate of contraceptives in adolescents?
take antivirals for 1-2 wks (acyclovir, famvir, valtrex) before delivery no only suppressed
What do you teach your client about herpes simplex virus (HSV) and can it be cured ?
wait until after the baby is born (Nonimmune women should be vaccinated before becoming pregnant and should wait at least 28 days after vaccination before attempting pregnancy-The woman receives the vaccine in the early postpartum period before discharge from the hospital or birthing center with instructions to avoid pregnancy for 28 days)
What instruction should the nurse give to a pregnant client who has not had the rubella titer vaccine?
oxygen therapy
What is the first priority when a client comes into the ER with a pulmonary embolism?
McRoberts maneuver
What is the maneuver that can help you turn the baby in the event of the shoulder dystocia?
miscarriage
What is the most common reason for bright bleeding to the vaginal area in the first trimester of pregnancy?
pulmonary embolism
What is the primary complication involved with DVTs?
prevent seizure (prevents preeclampsia from turning into eclampsia)
What is the purpose of magnesium sulfate in gestational hypertension in pregnant women?
vitamin k
What is the treatment for ABO incompatibility?
gardasil (measured as 2 injections over the coarse of 6 mo helps protect against cervical and genital warts; used in males/females 11-26 yrs old)
What is the vaccine for HPV?
leopold's maneuver
What maneuver is used to determine fetal position?
screen the client at 24-28 weeks in pregnancy and some as early as 20 weeks, if a hx they screen on the first prenatal visit test using oral glucose tolerance test (2nd trimester)
What the diagnostic criteria to test a pregnant woman for gestational diabetes? How would you diagnose someone with gestational diabetes?
ultrasound (can cause a rupture of the placenta)
When a patient comes in with vaginal bleeding that is pregnant do you want to do a vaginal examination?
prevent seizures
When administering magnesium sulfate to a client with preelampsia, the nurse understands that this drug is given to: a. prevent seizures b. reduce blood pressure c. slow the process of labor d. increase dieresis
dietary intake
When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority? a. dietary intake b. medication c. exercise d. glucose monitoring
massaging the fundus firmly
When monitoring a postpartum client 2 hours after birth, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially? a. massaging the fundus firmly b. performing bimanual compressions c. administering ergonovine d. notifying the primary care provider
massage the fundus every hour for the first 24 hours following birth (rationale: the fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax)
Which measure would be least effective in preventing postpartum hemorrhage? a. administer methergine 0.2 mg every 6 hours for 4 doses as ordred b. encourage the woman to void every 2 hours c. massage the fundus every hour for the first 24 hours following birth d. teach the woman the importance of rest and nutrition to enhance healing
inevitable abortion clinical manifestations
cramping and spotting or vaginal bleeding with cervical dilation amniotic fluid may leak
pre-gestational diabetes
describes the condition where a woman enters pregnancy with either type 1 or 2 DM. Usually type 1
amniotic fluid embolism
is a rare obstetric emergency that frequently results in the death or severe neurological and impairment of the lungs
tx UTI (cystitis)
oral Antibiotic therapy based on culture results; supportive therapy woman with pyelonephritis, IV antibiotic therapy
Habitual/Recurrent Abortion clinical manifestations
the loss of three or more consecutive pregnancies before the fetus is visible
tx of missed abortion
ultrasound confirms the diagnosis. If the woman carries the dead fetus for longer than 4 weeks, the risk of hemorrhage is high; therefore, a coagulation profile is drawn. The uterus is surgically evacuated by D&C or medically by inducing labor with oxytocin or prostagladin
threatened abortion clinical manifestations
vaginal bleeding or spotting possibly cramping no cervical dilation Symptoms may resolve and the pregnancy may progress to term
tx threatened abortion
vaginal rest (e.g no intercourse, tampons, douches) bed rest or light activity precautions (report bleeding heavier than normal accompanied cramping or fever) she should save expelled tissue for examination by health care provider
HA blurry vision visual changes in HA
what are the signs and symptoms you as the nurse should look for in a pregnant client with epilepsy that could lead to an impending seizure?
Tx of inevitable abortion
expectant management (wait for the miscarriage to occur on own) misoprostol (cytotec) orally to induce contractions surgical removal of the pregnancy; the type of procedure performed depends largely on the gestational age. Dilation and currettage (D&C) is the procedure of choice for pregnancies under 14 weeks
edema warmth redness calf pain or tenderness in the affected leg. Homans sign (pain on dorsiflexion of the foot) may be positive
What are the signs and symptoms of DVTs?
deep pain, pressure, swelling (edema), and dark red or purple discoloration, most commonly on one side of the perineum
What are the signs and symptoms of a hematoma?
fishy odor white milky discharge
What are the signs and symptoms of bacterial vaginosis?
nursing interventions umbilical cord prolapse
The examiner who discovers the condition should push upward on the presenting part with the fingers to move the fetus away from the cord. Emptying the bladder with an indwelling catheter is another method that can temporarily relieve cord compression while the woman is prepared for delivery, - Place woman's hips higher than her head - Push fetal presenting part away from cord - Oxygen 8-10 L/min per face mask - Closely monitor FHR by EFM - Prepare for rapid vaginal delivery or cesarean section
missed abortion clinical manifestations
The fetus dies, but remains in utero. Signs of pregnancy (e.g. nausea, breast tenderness) decrease and the fundus does not grow as expected in a normal pregnancy and may regress (get smaller). No fetal tones present
tx of complete abortion
surgical procedures are usually unnecessary. The woman goes home with instructions to monitor for complications such as heavy or increased bleeding or fever
uterine contractions, which may be painless pelvic pressure menstrual-like cramps vaginal pain low, dull backache accompanied by vaginal discharge and bleeding
What are signs and symptoms of preterm labor?
chest pain tachycardia dyspnea
What are some signs that your patient has pulmonary embolism?
advanced maternal age autoimmune diseases uterine abnormalities and fibroids cervical incompetence infection endocrine dysfunction coagulation disorders
What are the causes of spontaneous abortion? Select all that apply. a. advanced maternal age b. autoimmune diseases c. uterine abnormalities and fibroids d. cervical incompetence e. infection f. endocrine dysfunction g. coagulation disorders h. all the above
uterine atony (inability of uterus to contract) lacerations to uterus, cervix, vagina, or perineum retained placenta disruption in maternal clotting mechanisms
What are the causes postpartum hemorrhage? Select all that apply.
poor nutrition exposure to tobacco chemicals, or radiation use of alcohol, street drugs certain prescription drugs
What are the environmental factors of spontaneous abortion?
start a large-bore IV start blood and fluids immediately no vaginal birth monitor for shock continuously monitor the fetus if they have not been born administer fluid and blood products
What are the interventions you would do as a nurse for a pregnant client with abruptio placentae? Select all that apply. a. start a large-bore IV b. start blood and fluids immediately no vaginal birth c. monitor for shock d. continuously monitor the fetus if they have not been born e. administer fluid and blood products
painless bright red bleeding between 8-16 wks high Hcg levels preeclampsia before the 24 wk or high BP hyperemesis gravidarum hyperthyroidism
What are the risk factors for a client getting gestational trophoblastic diseases?
incomplete abortion
some, but not all, of the products of conception, are expelled. Most commonly the fetus delivers, and the placenta and membranes are retained