5 Written Questions

1. Tone: uterine atony ~1 in 20 births
   Tissue: retained placental tissue
   Trauma: uterine, cervical or vaginal lacerations
   Thrombin: coagulation disorders
2. Goal: halt cxns and maintain prg ONLY if fetus is healthy
   Fluid load po or IV
   Drugs:
   MgSO4 or terbutaline
   Drug therapy questionable EXCEPT BETAMETHASONE
3. confirmed abortion, but unaware at time; fetal demise; no parts passed
4. HISTORY OF PTL
   low literacy
   "rule of toos"
5. pre-existing
   resistance to insulin
   get off meds is goal
   often moves to insulin during prg for glucose control
   ORAL ANTIDIABETICS too be used with CAUTION as some are teratogenic
   Discharge

5 Matching Questions

1. Abortion types:
2. Abortion: definition
3. Nursing Role in Abortion
4. *PTL Diagnosis via Fetal Fibronectin
5. Diabetes, class D and onward

1. a vascular complications
   very important for mother to maintain very tight control of her diabetes during prg
   the poorer the control of blood glucose, the more severe the disease and complications, the greater the risk for the prg
2. b Cervical swab for protein which acts as "glue" during prg
   attaches the amniotic sac to lining of the uterus
   After 25th week, it begins to break down naturally and is detectable
   If PTL is imminent, fetal fibronectin may be detectable before 35 weeks
3. c spontaneous "miscarriage"
   "medical/therapeutic"
   elective
4. d pregnancy lost before week 20 gestation; most occur in 1st trimester by week 13
5. e BUBBLESH, PAIN, LABS
   PLAN: dependent on type and progression
   INTERVENTION: grief loss support/referral
   EVALUATION

5 Multiple Choice Questions

1. regular uterine cxns (4/20 min or 8/60 min)
   AND
   cervical dilation = or > 2 cm
   Effacement MAY be at 80%, maybe ROM
   1. Threatened Abortion
   2. *PTL Sx
   3. Complete Abortion
   4. *Preterm Labor
2. ALL organ systems (brain, cardiovascular, liver, kidney, placenta, eyes/retina)
   1. GHTN Sequelae
   2. GHTN (PIH)
   3. HTN affects...
   4. GHTN Prevention
3. 1st trimester
   1. UTI and Pregnancy
   2. Elevated BP in pregnancy is chronic if
   3. Elevated BP in pregnancy is GHTN if
   4. Ectopic Pregnancy
4. 2nd and 3rd trimester
   1. UTI and Pregnancy
   2. Ectopic Pregnancy
   3. Elevated BP in pregnancy is chronic if
   4. Elevated BP in pregnancy is GHTN if
5. Miscarriage r/t:
   genetic abnormalities
   endocrine imbalances (progesterone)
   domestic violence
   structural abnormalities ("incompetent cervix" --> cerclage
   1. Complete Abortion
   2. Spontaneous Abortion
   3. Imminent Abortion
   4. Elective Abortion

5 True/False Questions

1. *PP bleeding Tx → 80% is due to UTERINE ATONY!
   First step, ASSESS: PALPATE FUNDUS

   True        False

2. Type III DM → pre-existing
   resistance to insulin
   get off meds is goal
   often moves to insulin during prg for glucose control
   ORAL ANTIDIABETICS too be used with CAUTION as some are teratogenic
   Discharge

   True        False

3. Type I DM → also known as GDM
   hormonal changes causes resistance to insulin
   detected in 2nd or 3rd trimester by GTT (unless obese, then 1st)
   discharge teaching: chances of getting Type II in mid-life is 60%

   True        False

4. Medical/Therapeutic Abortion → D&C dilation and curettage
   D&E dilation and evacuation (suction)

   True        False

5. Chorioamnitis → If HTN before pregnancy or before 20 weeks
   For many women the prenatal visits are the first BP assessments since childhood
   = or > 140 systolic AND/OR = or > 90 diastolic

   True        False