NURS 4750 Exam
FRANU NURS 4750 EXAM 2 QUESTIONS
AND ANSWERS GRADED A
Hyperemesis Gravidarum
-Persistent uncontrollable vomiting of unknown etiology
Associated With:
-Multiple gestations
-Thyroid dysfunction
-High hCG & Estrogen
-Trophoblastic disease (Mole)
Hyperemesis Gravidarum Assessment
-Uncontrollable vomiting
-Weight loss of 5% or greater
-Dehydration
-Ketonuria (pts body eats itself bc malnutrition)
-Hypokalemia (bc prolonged vomiting)
-Acid/Base imbalances (metabolic alkalosis & acidosis)
Hyperemesis Gravidarum Treatment
-Monitor I&O's, labs, daily weights, electrolytes, kidney function, urine amount and
characteristics
-Reduce N/V (pharma & nonpharma)
-Maintain adequate nutrition (bland diet, drink btwn meals not during, IVF LR bc
electrolytes, TPN maybe)
-Provide emotional support/comfort care bc these pts are miserable
Pharmacologic & Nonpharmacologic Treatment of Hyperemesis Gravidarum
Pharma:
-Antiemetics (Zofran or Phenergan)
-H2 Blockers to decrease acid production (Cimetidine & Famotidine)
NURS 4750 Exam
,NURS 4750 Exam
-Vitamin B6 (it helps)
-Benadryl (it helps also)
Nonpharma:
-Aromatherapy (lavender & pepermint)
-Eliminate noxious odors
-Eat small freq meals
-Eat Ginger
-Sit the pt up
-Decrease the room temp
-Cool rag on the head/neck
Hydatidfiorm Mole "Molar Pregnancy"
-Instead of forming into a human chorionic villi develop into edematous fluid filled cystic
avascular transparent vesicles that hang in grapelike clusters
-Can be complete (no fetal parts) or partial (some human parts like fingernails, skin,
bones mixed in)
-Both types are not viable with pregnancy and have a 0% chance of becoming successful
Hydatidiform Mole Assessment
-Bleeding/Spotting
-Uterine size larger than normal for GA (uterus may be palpable or already at umbilicus
at 8 weeks)
-Replication/growth is extremely rapid
-Extremely high hCG lvl (can cause N/V & HTN)
-Pt's may have hypertensive crisis/pre-eclamptic type symptoms (due to hCG lvls)
Hydatidiform Mole Diagnosis
-No visible fetus (snowstorm like pattern)
-Beta hCG is extremely high (will have positive preg test)
Hydatidiform Mole Treatment
NURS 4750 Exam
,NURS 4750 Exam
-Trophoblastic Tissue must be evacuated (so prep the pt for surgery)
-Pt is at risk for hemorrhage & choriocarcinoma
-Manage symptoms before surgery (Antiemetics & HTN meds)
-Serial hCG monitoring after surgery
Hydatidiform Mole Pt Teaching
-Pts must have hCG monitored for 6-12 months after surgery
-Pts will have there hCG lvls drawn monthly for 6 months then every 2-3 months until it
goes down to 0 and stays there
-If the hCG lvls dont go down to 0 it could mean some trophoblastic tissue was left
behind, they might have choriocarcinoma, or they might be pregnant again
-Teach the pt to avoid future pregnancy until cleared by their provider
Hemorrhagic Conditions of Pregnancy
Early:
-Spontaneous Abortion
-Ectopic Pregnancy
-Trophoblastic Disease
Late:
-Placenta Previa
-Placental Abruption
Spontaneous Abortion Types
-Threatened
-Inevitable (can be complete or incomplete)
-Missed
-Recurrent
Threatened Spontaneous Abortion
Membranes still intact & cervix is still closed (unknown if it will end in loss of
pregnancy)
Assessment:
-Vaginal bleeding (spotting to moderate)
NURS 4750 Exam
, NURS 4750 Exam
-Cramping/backache/pelvic pressure
Diagnosis:
-hCG & progesterone lvls consistent with GA (if pt is 7 weeks GA but hormone lvls are
at 4 weeks GA its not a good outlook)
-Transvaginal US (to see & hear FHR and see if membranes are intact)
Management:
-Teach pt to not have sex while bleeding/cramping
-Monitor bleeding and report changes in amnt/color/tissues passing
-Pt's are gonna be destroyed so psych support is important
Inevitable Spontaneous Abortion
Nothing we can do at this point
Assessment:
-May be complete or incomplete
-Rupture of membranes
-Uterine contractions
-Cervical dilation
-Active bleeding
Management:
-Natural expulsion is common (like a really bad period, pts return to baseline after
everything is expelled)
-1pad/hr at home (come back bc may need surgery)
-Surgical management for hemorrhaging pt (vacuum curtilage and dilation + curtilage
D+C)
Complete vs Incomplete Inevitable Spontaneous Abortions
Incomplete
Assessment:
NURS 4750 Exam
FRANU NURS 4750 EXAM 2 QUESTIONS
AND ANSWERS GRADED A
Hyperemesis Gravidarum
-Persistent uncontrollable vomiting of unknown etiology
Associated With:
-Multiple gestations
-Thyroid dysfunction
-High hCG & Estrogen
-Trophoblastic disease (Mole)
Hyperemesis Gravidarum Assessment
-Uncontrollable vomiting
-Weight loss of 5% or greater
-Dehydration
-Ketonuria (pts body eats itself bc malnutrition)
-Hypokalemia (bc prolonged vomiting)
-Acid/Base imbalances (metabolic alkalosis & acidosis)
Hyperemesis Gravidarum Treatment
-Monitor I&O's, labs, daily weights, electrolytes, kidney function, urine amount and
characteristics
-Reduce N/V (pharma & nonpharma)
-Maintain adequate nutrition (bland diet, drink btwn meals not during, IVF LR bc
electrolytes, TPN maybe)
-Provide emotional support/comfort care bc these pts are miserable
Pharmacologic & Nonpharmacologic Treatment of Hyperemesis Gravidarum
Pharma:
-Antiemetics (Zofran or Phenergan)
-H2 Blockers to decrease acid production (Cimetidine & Famotidine)
NURS 4750 Exam
,NURS 4750 Exam
-Vitamin B6 (it helps)
-Benadryl (it helps also)
Nonpharma:
-Aromatherapy (lavender & pepermint)
-Eliminate noxious odors
-Eat small freq meals
-Eat Ginger
-Sit the pt up
-Decrease the room temp
-Cool rag on the head/neck
Hydatidfiorm Mole "Molar Pregnancy"
-Instead of forming into a human chorionic villi develop into edematous fluid filled cystic
avascular transparent vesicles that hang in grapelike clusters
-Can be complete (no fetal parts) or partial (some human parts like fingernails, skin,
bones mixed in)
-Both types are not viable with pregnancy and have a 0% chance of becoming successful
Hydatidiform Mole Assessment
-Bleeding/Spotting
-Uterine size larger than normal for GA (uterus may be palpable or already at umbilicus
at 8 weeks)
-Replication/growth is extremely rapid
-Extremely high hCG lvl (can cause N/V & HTN)
-Pt's may have hypertensive crisis/pre-eclamptic type symptoms (due to hCG lvls)
Hydatidiform Mole Diagnosis
-No visible fetus (snowstorm like pattern)
-Beta hCG is extremely high (will have positive preg test)
Hydatidiform Mole Treatment
NURS 4750 Exam
,NURS 4750 Exam
-Trophoblastic Tissue must be evacuated (so prep the pt for surgery)
-Pt is at risk for hemorrhage & choriocarcinoma
-Manage symptoms before surgery (Antiemetics & HTN meds)
-Serial hCG monitoring after surgery
Hydatidiform Mole Pt Teaching
-Pts must have hCG monitored for 6-12 months after surgery
-Pts will have there hCG lvls drawn monthly for 6 months then every 2-3 months until it
goes down to 0 and stays there
-If the hCG lvls dont go down to 0 it could mean some trophoblastic tissue was left
behind, they might have choriocarcinoma, or they might be pregnant again
-Teach the pt to avoid future pregnancy until cleared by their provider
Hemorrhagic Conditions of Pregnancy
Early:
-Spontaneous Abortion
-Ectopic Pregnancy
-Trophoblastic Disease
Late:
-Placenta Previa
-Placental Abruption
Spontaneous Abortion Types
-Threatened
-Inevitable (can be complete or incomplete)
-Missed
-Recurrent
Threatened Spontaneous Abortion
Membranes still intact & cervix is still closed (unknown if it will end in loss of
pregnancy)
Assessment:
-Vaginal bleeding (spotting to moderate)
NURS 4750 Exam
, NURS 4750 Exam
-Cramping/backache/pelvic pressure
Diagnosis:
-hCG & progesterone lvls consistent with GA (if pt is 7 weeks GA but hormone lvls are
at 4 weeks GA its not a good outlook)
-Transvaginal US (to see & hear FHR and see if membranes are intact)
Management:
-Teach pt to not have sex while bleeding/cramping
-Monitor bleeding and report changes in amnt/color/tissues passing
-Pt's are gonna be destroyed so psych support is important
Inevitable Spontaneous Abortion
Nothing we can do at this point
Assessment:
-May be complete or incomplete
-Rupture of membranes
-Uterine contractions
-Cervical dilation
-Active bleeding
Management:
-Natural expulsion is common (like a really bad period, pts return to baseline after
everything is expelled)
-1pad/hr at home (come back bc may need surgery)
-Surgical management for hemorrhaging pt (vacuum curtilage and dilation + curtilage
D+C)
Complete vs Incomplete Inevitable Spontaneous Abortions
Incomplete
Assessment:
NURS 4750 Exam
