MCN 273 CH 20: YOUR A+ GUIDE THROUGH QUESTIONS
AND ANSWERS.
threatened abortion
-unexplained bleeding, cramping, backache, cervix closed; placenta attached
-may resolve, may be a partial/complete abortion
imminent abortion
-increased bleeding and cramping, cervical os opens; placenta separates
incomplete abortion
-parts of products of conception retained, usually placenta, cervix opened
complete abortion
-all products or conception expelled
abortion assessment
-speculum exam for bleeding source
-ultrasound for cardiac activity
abortion therapy prescribed
-bed rest
-abstinence from coitus
-IV, blood transfusion
-RhoGAM
-D&C or suction evacuation
-patient teaching and support
ectopic pregnancy
-implantation of a fertilized ovum in a site other than the uterine endometrium
-most common location: ampulla of tube
-normal S/S
-risk factors (tubal damage, PID, previous pelvix/tubal Sx, endometriosis, previous ectopic, IUD,
high levels of progesterone, use of ovulation-inducing drugs)
symptoms of ectopic pregnancy
, -one-sided lower abd pain, fainting/dizziness
-rigid, tender abd with slow bleed
-right shoulder pain from blood irritating the subdiaphragmatic phrenic nerve
ectopic pregnancy clinical therapy
-differentiate from other disorders (careful assessment of LMP, pelvix exam, serial labs,
ultrasound, laparascopy)
-methotrexate
-surgery (salpingostomy, salpinectomy); risk for hemorrhage
care of woman with hyperemesis gravidarum
-disabling N/V (affects hydration/nutrition)
-pathology (cause unclear, possible link to hCG)
-diagnostic criteria (intractable vomiting, dehydration, ketonuria, weight loss of 5% PP weight)
hyperemesis gravidarum clinical therapy
-ultrasound to r/o molar pregnancy
-control vomiting (pyridoxine, phenergan, reglan, zofran)
-correct dehydration/restore electrolytes
-NPO, IV fluids
-maintain adequate nutrition,
-TPN if no response
chronic HTN
-BP 140/90 mmHG (before pregnancy or before 20 wks GA), or persists 42 days after childbirth
-counseling at first visit (nutrition, BR, medication, BP monitoring)
-more frequency prenatal visits
-lab work
gestational HTN
-transient elevation of BP after 20 wks GA
-returns to baseline within 6 wks PP
-no proteinuria, or S/S preeclampsia
preeclampsia diagnostic criteria
->20 weeks GA, 2 BPs over 140/90 on 2 occasions, at least >6 hrs apart
mild preeclampsia
AND ANSWERS.
threatened abortion
-unexplained bleeding, cramping, backache, cervix closed; placenta attached
-may resolve, may be a partial/complete abortion
imminent abortion
-increased bleeding and cramping, cervical os opens; placenta separates
incomplete abortion
-parts of products of conception retained, usually placenta, cervix opened
complete abortion
-all products or conception expelled
abortion assessment
-speculum exam for bleeding source
-ultrasound for cardiac activity
abortion therapy prescribed
-bed rest
-abstinence from coitus
-IV, blood transfusion
-RhoGAM
-D&C or suction evacuation
-patient teaching and support
ectopic pregnancy
-implantation of a fertilized ovum in a site other than the uterine endometrium
-most common location: ampulla of tube
-normal S/S
-risk factors (tubal damage, PID, previous pelvix/tubal Sx, endometriosis, previous ectopic, IUD,
high levels of progesterone, use of ovulation-inducing drugs)
symptoms of ectopic pregnancy
, -one-sided lower abd pain, fainting/dizziness
-rigid, tender abd with slow bleed
-right shoulder pain from blood irritating the subdiaphragmatic phrenic nerve
ectopic pregnancy clinical therapy
-differentiate from other disorders (careful assessment of LMP, pelvix exam, serial labs,
ultrasound, laparascopy)
-methotrexate
-surgery (salpingostomy, salpinectomy); risk for hemorrhage
care of woman with hyperemesis gravidarum
-disabling N/V (affects hydration/nutrition)
-pathology (cause unclear, possible link to hCG)
-diagnostic criteria (intractable vomiting, dehydration, ketonuria, weight loss of 5% PP weight)
hyperemesis gravidarum clinical therapy
-ultrasound to r/o molar pregnancy
-control vomiting (pyridoxine, phenergan, reglan, zofran)
-correct dehydration/restore electrolytes
-NPO, IV fluids
-maintain adequate nutrition,
-TPN if no response
chronic HTN
-BP 140/90 mmHG (before pregnancy or before 20 wks GA), or persists 42 days after childbirth
-counseling at first visit (nutrition, BR, medication, BP monitoring)
-more frequency prenatal visits
-lab work
gestational HTN
-transient elevation of BP after 20 wks GA
-returns to baseline within 6 wks PP
-no proteinuria, or S/S preeclampsia
preeclampsia diagnostic criteria
->20 weeks GA, 2 BPs over 140/90 on 2 occasions, at least >6 hrs apart
mild preeclampsia
