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Is vaginal bleeding in the first trimester always abnormal?
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Is vaginal bleeding in the second and third trimester always abnormal?
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Antepartum:
Complications of pregnancy
| Question | Answer |
|---|---|
| Is vaginal bleeding in the first trimester always abnormal? | No, it could be a result of implantation bleeding (instead of miscarriage, ectopic or molar pregnancy). |
| Is vaginal bleeding in the second and third trimester always abnormal? | Yes |
| Complications associated with bleeding during 1st trimester. | - spontaneous abortion - ectopic pregnancy |
| Complications associated with bleeding during 2nd trimester. | - gestational trophoblastic disease (molar pregnancy) - incompetent cervix |
| Complications associated with bleeding during 3rd trimester. | - placenta previa - abruptio placenta - preterm labor |
| What is spontaneous abortion? | - pregnancy terminated before 20 weeks, or - fetal weight < 500 grams |
| What is dilation and curettage (D&C)? | Dilating and scraping the uterine walls to remove contents from inevitable or incomplete abortions. |
| What is dilation and evacuation (D&E)? | Dilating and evacuating uterine contents after 16 weeks gestation. |
| What hormone drug is administered to induce labor and expulse products of a late term or abortion pregnancy? | Prostaglandin |
| What are S/S of incomplete abortion? | - severe cramps - continuous and severe bleeding - partial fetal tissue or placenta passed - cervix dilated with tissue |
| What are S/S of complete abortion? | - no cramps - minimal bleeding - complete expulsion of uterine contents - closed cervix |
| What is ectopic pregnancy? | Abnormal implantation of fertilized ovum outside of uterus. |
| What are risk factors for ectopic pregnancy? | pelvic inflammatory disease, IUD. |
| What are S/S of ectopic pregnancy? | unilateral stabbing pain, scant dark red - brown bleeding, referred shoulder pain |
| What is gestational trophoblastic disease (molar pregnancy)? | Proliferation and degeneration of the trophoblastic villi in the placenta that takes on a grape-like cluster appearance. |
| What hormone is greatly elevated in molar pregnancy? | hCG |
| What are S/S of molar pregnancy? | rapid uterine growth, vaginal bleeding, hyperemesis |
| What is incompetent cervix? | weak cervix that spontaneously dilates around 16 weeks. |
| What is the treatment for incompetent cervix? | Cervical cerclage (rubber-banding) |
| What are nursing interventions for incompetent cervix? | activity restriction; patient refrain from intercourse, prolonged standing (>90 min), heavy lifting |
| What is placenta previa? | abnormal implantation of placenta in lower uterus or over cervical os. |
| What are S/S of placenta previa? | painless bright red vaginal bleeding, relaxed uterus, unusual fetus lie, decrease UOP |
| What is abruptio placenta? | premature separation of placenta from uterus |
| What are S/S of abruptio placenta? | sudden onset of intense localized pain, vaginal bleeding, uterine hypertonicity, fetal distress, symptoms of hypovolemic shock |
| What is hyperemesis gravidarum? | excessive N/V past 12 weeks with 5% weight loss from prepregnancy weight, dehydration, electrolyte imbalance, ketosis, and acetonuria. |
| What is gestational HTN? | - begins after 20 weeks - Elevated BP >140/90 - no proteinuria or edema - returns to baseline after 6 wks postpartum |
| What is mild preeclampsia? | GH with 1 to 2+ proteinuria, weight gain, mild edema |
| What is severe preeclampsia? | BP >160/100, 3 to 4+ proteinuria, cerebral or visual disturbances, hyperreflexia, peripheral edema, hepatic dis-fx, epigastric pain |
| What is eclampsia? | severe preeclampsia with seizure or coma. |
| What is HELLP syndrome? | a variant of GH consisting of Hemolysis, ELevated liver enzymes, Low Platelets |
| What risks are associated with gestational HTN? | placental abruption, preterm birth, fetal and maternal death |
| What is prophylactic for gestational hypertensive seizures? | IV magnesium sulfate |
| What are the s/s of magnesium sulfate toxicity? | absent DTR, urine output <30 ml/hr, RR <12, decreased LOC |
| What is antidote to magnesium sulfate toxicity? | calcium gluconate |
| What is TORCH? | an acronym for group of infections that can negatively affect pregnant women. Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes Simplex. |
| What are risk factors for toxoplasmosis? | consumption of raw/undercooked meat, handling cat feces. |
Created by:
odbal24
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