Care of high risk mother, MB and family w/special needs/ W. Calley
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High risk pregnancy | show 🗑
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show | state of being diseased. may continure for months or years
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Mortality | show 🗑
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Monozygotic | show 🗑
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dizygotic | show 🗑
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show | is a cause of late abortion, has been traditionally defined as passive and painless dilation of the cervix during the second trimester.
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show | a technique that uses suture material to constrict the internal os fo the cervix. placed at 10-14 wks gestation, woman should refrain from sex, heavy lifting, and prolonged standing.
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show | is a disease encountered during pregnancy or early in the puerperium characterized by increasing blood pressure, albuminuria and generalized edema. It includes preeclampsia and eclampaia, which places mother and fetus at risk.
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show | An abnormal condition of pregnancy characterized by the onset of acute hypertension after the 24 th week of gestation. s/s are proteinuria and edema
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What are some signs of Mild Preeclampsia? | show 🗑
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show | they appear sudden, bp of 160/110 or high 2 times in 6 hrs appart with woman on bedrest, edema in hands, sacral area, abdomen, and lower extremities, significant weight gain (2 lbs in a few days or a week, 3+ or 4+ proteinuria and possible olguria
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Eclampsia | show 🗑
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show | Massive generalized pitting edema. 4+
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Kick Count | show 🗑
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What is considered dangerously low kick counts? | show 🗑
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TORCH | show 🗑
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Gestational Diabetes Mellitus | show 🗑
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show | a combination of hemoglobin adn blood glucose making up about 4-8% of the total hemoglobin.
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show | source fo heat unique to neonates that is capable of greater thermogenic activity than ordinary fat
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Where on the body can you find brown fat? | show 🗑
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Placental barrier | show 🗑
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Erythroblastosis fetalis | show 🗑
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kernicterus | show 🗑
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Hyperbilirubinemia | show 🗑
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Indirect Coombs' test | show 🗑
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Direct Coombs' test | show 🗑
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Phototherapy | show 🗑
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show | maintaining an acid-base and electrolyte balance. monitoring IV feeding, restrict solid intake until vomiting stops, bland solids such as toast, crackers or liquids are introduced slowly as tolerated. In severe cases TPN may be needed.
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Etopic Pregnancy | show 🗑
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What is the medical management for etopic pregnancy? | show 🗑
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Placenta Previa | show 🗑
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What is the most important risk factor in Placenta Previa? | show 🗑
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show | implanted in the lower uterine segment in 45% of pregnancies. as the lewre uterine segment lengthens the placenta moves upward.
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show | painless bright red vaginal bleeding occuring after 20 weeks gestation. may be intermitten or occur in gushes.
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show | cesarean birt is the treatment of choice. pt should be under close supervision, bedrest, if bleeding cannot be controled a hysterectomy is done after birth, give good pt teaching and provide emotional family support.
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Abruptio Placentae | show 🗑
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show | trauma (most common), chronic hypertension, and pregnancy induced hypertension. 3 times more likely in women woth gravidity for more than 5. Cocaine users are also at risk.
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What are the signs and symptoms of abruption placentae? | show 🗑
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What do you assess for in abruptio placentae? | show 🗑
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What test are done to determine blood loss? | show 🗑
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show | delivery by c/s and blood replacement is most common, side lying position with a wedge facilitates uterine placental perfusion. blood and fluid replacement therapy, fetal monitoring, continuous monitoring of both mother and fetus.
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show | is a potentially life threatening disorder that results from alterations in the normal clotting mechanism. it may be seen with abruptio placentae, incomplete abortion, hypertension or infectous process. creates excessive blood loss.
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show | drawing PT, PTT, and platelet count, replace blood and fluids lost, restore normal clotting mechanisms. oxygen therapy(10-12L), heparin therapy, delivery of baby should occur ASAP, monitor I&O, put pt in side lying position to maxamize bloodflow.
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Postpartum Hemorrhage | show 🗑
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show | occurs after the first 24 hours.
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show | uterine atony(lack of normal tone and strength), hydraminos (excessive amount of amniotic fluid), or a very large infant, retained placenta or fragment of the placenta (most common), lacerations of the perineum.
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What is the medical management of postpartum hemorrhage? | show 🗑
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show | deep severe pelvic or rectal pain, abnormal vital signs.
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What is the antidote for magnesium sulfate toxicity? | show 🗑
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What are some infecious diseases most likely to cause complications? | show 🗑
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show | an infection of the lactating breast, occurs most often during the second and third weeks after childbirth, also may develope any time during breastfeeding and usually only affects one breast.
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What is the cause of Mastitis? | show 🗑
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show | flue like symptoms with fatigue and aching muscles. fever may present of 101 or higher, chills, maliaise adn headache. also localized redness and inflammation.
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What are TORCH infections? | show 🗑
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show | can be contracted by eating raw contaminated meats or contacted with the feces or and infected cat, diagnosed by blood studies, can cause spontaneous abortion, stillbirthe, neonate blindness, and retardation. woman feels fluelike symptoms.
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show | hep A is a virus spresd by droplets or hands. can cause spontaneous abortion and fluelike symptoms; fever, malaise and nausea. Hep B is a virus transmitted through blood and bodily fluids, signs and symptoms include rever, rash, anorexia, malaise.
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Rubella, German Measles and 3-day measles | show 🗑
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show | is a viral disease like herpesvirus group can be spread through sex, kissing, and breastfeeding, more than half of adutlts have the antibioties for it. capable of crossing the placental barrier and can cause congenital impairment, congenital anomalies
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show | also called herpes type 2, caused painful lesions on external genitalia and could involve the cervix, intrauterine infection is possible if membranes rupture or vaginal delivery takes place when active lesions are present.
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show | nursing care is directed at maintained a normal glucose status. the pt insulin requirements will change throught pregnancy, labor and delivery. a thourough assessment is done. oral hypoglycemica are dc'd, give good pt teching
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show | during pregnancy the body may not be able to produce enough insulin to meet the demands, this could result in dangerously high levels, fetal complications could include stillirth, preeclacpsia, alteration in size (larger), congenital anomalies.
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What are some problems of the Cardiovascular system related to pregnancy? | show 🗑
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What are the physiological concerns in adolescent pregnancies? | show 🗑
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What are the physiological concerns in an older adult pregnancy? | show 🗑
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show | was devised by lilly and victor dobowitz, estimating gestational age of and infant based on 21 strictly defined physical and neurological signs. is done between 2-8 hours of birth.
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What is the preterm infants greates potential problem? | show 🗑
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What are the clinical manifecstations for a preterm infant? | show 🗑
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Hemolytic Disease | show 🗑
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show | fetal monitoring, non stress test, blood tests, ultrasound, alphafetaprotein, and bpp
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What are some maternal nursing interventions for hemolytic disease? | show 🗑
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What are some newborn nursing interventions for hemolytic disease? | show 🗑
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show | cocaine raises blood pressure of the mom and puts both of them at risk for intracrainal bleeding, tachycardia, prematurity, low birth weight, stillbirth, poor feeding reflexes, decreased intellectual development, prune belly syndrome(no abd muscles)
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What does alcohol abuse do to the unbourn infant? | show 🗑
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Where do you assess deep tendon reflexes? | show 🗑
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show | Hyperactive response(brisk with intermittent or transient clonus); 4+, more than normal (brisk) slightly hyperactive; 3+, Normal, active, expected response;2+, sluggish or dininished; 1+, no response; 0
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show | woman may be hospitalized, mild preeclampsia may be managed at home, bed rest, say on left lateral recumbent position to reduce pressure on inferior vena cava, well balanced diet w/ adequate protein, low sodium, iv therapy of magnesium sulfate (seizures)
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show | related to maternal or placental problems, baby less than 37 wks gestation, infant is developmentally immature, lungs not producing adequate o2, lack of brown fat, problems absorbing nutrients, renal system is immature, neurologically immature,
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show | corrrestly position infant to avoid nipple trauma and milk stasis, feed infant every 2-3 hrs, avoid formula supplements and nipple sheilds, change nipple pads when wet, avoid continuous pressure, empty breasts completly after feeding, 3000 mL daily intake
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show | quiet non stimulating environment, seizure precautions, emergency meds ready, emergency birth pack accessible, reduce noise, restrict visitors, provide uninterupted rest.
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show | hydralazine (antihypertensive vasodilator, Magnesium sulfate, Calcium gluconated immediatly after to prevent magnesium toxicity.
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What is HELLP syndrome? | show 🗑
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