Chapter 25 - Complications of Pregnancy question n answers graded A+

Chapter 25 - Complications of PregnancyMost Common Pregnancy-Related Complications - correct answer -hemorrhagic conditions that occur in early pregnancy -hemorrhagic complications of the placenta in late pregnancy -hyperemesis gravid arum -hypertensive disorders of pregnancy -blood incompatibilities between the mother and fetus 3 Most Common Causes of Hemorrhage (first half of pregnancy) - correct answer 1. abortion 2. ectopic pregnancy 3. gestational trophoblastic disease spontaneous abortion - correct answer Causes: - advanced parental age - congenital anomalies (most common) * chromosomal abnormalities * maternal infections * hypothyroidism * insulin dependent diabetes Abortion - correct answer -loss of pregnancy before the fetus is viable or capable of living outside the uterus (< 20 weeks or < 500 g) -miscarriage (spontaneous) or induced abortion Hemorrhagic Conditions of Early Pregnancy - correct answer *Abortion* -*spontaneous* (6 subgroups of spontaneous abortions): -*threatened*: vaginal bleeding occurs followed by uterine cramping, persistent backache, feelings of pelvic pressure - cervix is closed -*inevitable*: membranes rupture, and cervix dilates, active heavy bleeding -*incomplete*: some products of conception have been expelled, but some remain, cervix is open, may need D&E -*complete*: all products are expelled from the uterus, cervix closes after -*missed*: fetus died, but remained in the uterus, INFECTION AND DIC CAN OCCUR -*recurrent spontaneous*: 3 or more spontaneous abortions (miscarriages), R/T bicornate uterus (two horns) Threatened Abortion - correct answer *s/sx's*: -first sign in vaginal bleeding -bleeding is followed by uterine cramping, persistent backache, feelings of pelvic pressure -labs show ↑ levels of beta hCG and uterine size increases with embryonic growth IF the pregnancy REMAINS viable *Therapeutic Management* -bleeding in first half of pregnancy must be considered a threatned abortion and women shold be advised to notify provider if they note brownish/ red vaginal bleeding -nurse obtains detailed hx (length of gestation and bleeding, any discomfort) -vaginal U/S to determine whether a fetus is present and alive -check beta hCG levels -limit sexual activity until bleeding has ceased -count number of peripads used and note quantity and color of blood -drainage with foul odor = infection Inevitable Abortion - correct answer -can't be stopped *s/sx's*: - membranes rupture and cervix dilates -loss of fluid, uterine contractions, and active bleeding -incomplete evacuation = excessive bleeding or infection