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Maternity Chapter 5

Terms in this set (68)

High-Risk Pregnancies
A high risk pregnancy can be defined as one in which the health of the mother or fetus is in jeopardy
Characteristic Causes of
High-Risk Pregnancies
Can relate to the pregnancy itself

Can occur because the woman has a medical condition or injury that complicates the pregnancy

Can result from environmental hazards that affect the mother or her fetus

Can arise from maternal behaviors or lifestyles that have a negative effect on the mother or fetus
Amniocentesis
Nursing Responsibilities
Preparing the patient properly

Explaining the reason for the test

Clarifying and interpreting results in collaboration with other health care providers

New technologies allow ultrasound pictures to be transmitted by internet to specialists across the country to interpret and collaborate with local physicians
Danger Signs in Pregnancy
Sudden gush of fluid from the vagina

Vaginal bleeding

Abdominal pain

Persistent vomiting

Epigastric pain

Edema of face and hands

Severe, persistent headache

Blurred vision or dizziness

Chills with fever over 38.0° C (100.4° F)

Painful urination or reduced urine output
Pregnancy-Related Complications
Hyperemesis gravidarum

Bleeding disorders

Hypertension

Blood incompatibility between woman and fetus
Hyperemesis Gravidarum
Manifestations

Excessive nausea and vomiting

Can impact fetal growth - may result in a low-birth weight infant

Dehydration - impairs placental perfusion

Reduced delivery of blood, oxygen, and nutrients to the fetus as an end result of dehydration may occur

Hyperemesis Gravidarum differs from morning sickness in a number of ways:

Persistent nausea/vomiting, lasting beyond the first trimester

Significant weight loss

Dehydration - symptoms include dry mouth/tongue, scant/concentrated urine, increased Hct level, decreased skin elasticity

Electrolyte and acid-base imbalances

Treatment

Correct dehydration and electrolyte or acid-base imbalance

Rule out other causes for excessive N/V such as gastroenteritis, or liver/gallbladder/pancreatic disorders

Antiemetic drugs may be prescribed

In extreme cases

TPN may be required

Hospitalization
Bleeding Disorders of Early Pregnancy
Can Include:

Abortion, Ectopic Pregnancy or hydatidiform mole
Abortion
Abortion is the spontaneous (miscarriage) or intentional termination of a pregnancy before the age of viability (20 weeks of gestation)

When a threatened abortion occurs, every effort is made to keep the fetus in utero until the age of viability
Cerclage
The suturing of an incompetent cervix that opens when the growing fetus is putting pressure against it. This procedure is successful in allowing pregnancies to carry to term in many cases.
Types of Abortions
Spontaneous (nonintentional)

-Threatened

-Inevitable

-Incomplete

-Complete

-Missed

-Recurrent

Induced

-Therapeutic

-Elective
Threatened abortion
Pt. may experience cramping, backache, light spotting. Cervix is closed, no tissue is passed at this point.

Treatment: U/S to determine if fetus is living, bed rest, abstain from sex
Inevitable abortion
Increased bleeding, cramping, dilation of cervix has begun.

Treatment: Patient placed on bed rest and monitored, await the natural evacuation of the uterine contents, save peripads for inspection
Incomplete abortion
Bleeding, cramping, dilation of cervix, passage of tissue.

Treatment: Uterus may be emptied by vacuum extraction or D&E (Dilation and Evacuation)
Complete abortion
Passage of all products of conception (POC), cervix closes, bleeding stops.

Treatment: Patient is monitored and emotional support is provided. Give RhoGAM if needed
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