NUR 236 Exam 4 Guide With
Complete Solution
What are the three most common pregnancy complications in the first
trimester? - ANSWER ectopic pregnancy, gestational trophoblastic disease,
and spontaneous abortion (miscarriage)
true or false: all bleeding in early pregnancy indicates a complication -
ANSWER false
fertilized egg implants outside the uterine cavity - ANSWER ectopic
pregnancy
where can an ectopic pregnancy implant? - ANSWER fallopian tube, on the
ovary, on the cervix, on the outside of the fallopian tube, on the abdominal
wall, bowel
what is the hallmark sign of ectopic pregnancy - ANSWER unilateral stabbing
pain in the lower quadrant
what are signs and symptoms of ectopic pregnancy - ANSWER unilateral
abdominal pain, vaginal bleeding, a missed period, abdominal tenderness
what puts you at risk of having an ectopic pregnancy? - ANSWER history of
STIs
prior ectopic pregnancy
previous tubal, pelvic, or abdominal surgery
endometriosis
,current use of exogneous hormones
use of IUD
IVF
why is a ruptured ectopic pregnancy an emergency - ANSWER must be
diagnosed before the onset of hypotension, bleeding, pain, and overt rupture
to prevent major morbidity and death
what labs need to be worked up for ectopic pregnancy - ANSWER
beta-human chorionic gonadotropin
blood type
Rh
CBC
complete metabolic panel
WBC
diagnostic tools used to assess an ectopic pregnancy - ANSWER transvaginal
US
serial BhCG
pelvic exam
what is a salpingectomy - ANSWER removal of the rupture fallopian tube
(done by lapartotomy)
what is salpingostomy - ANSWER incision into the fallopian tube to remove
the pregnancy
,what medication is used for an ectopic pregnancy - ANSWER methotrexate
chemotherapeutic drug and folic acid inhibitor that stops all rapid cell
production, inhibiting the growth of the embryo and destroying remaining
trophoblastic tissue. used in the management of ectopic pregnancy -
ANSWER methotrexate
when is someone considered eligible for methotrexate for ectopic pregnancy
- ANSWER if the ectopic mass is unruptured and measures 1.6 cm or less on
an US exam
what pregnancy category is methotrexate - ANSWER category X and needs
special handling (chemo sharps)
what are educational points for patients on methotrexate? - ANSWER - side
effects such as nausea and vomiting
- discontinuation of prenatal vitamins and other folic acid supplements,
which can act as antagonists
- the need for alcohol abstinence
- avoidance of NSAIDs
- the need for sunscreen and protective clothing to prevent photosensitivity
- required follow up lab work to monitor hCG levels and other side effects
what is methotrexate commonly used for? - ANSWER calming the immune
system, to help stop it attacking your body's cells. This helps reduce the
inflammation that causes swollen and stiff joints in Rheumatoid arthritis,
thickened skin in psoriasis or damage to your bowel in Crohn's disease
, what are the different pathologies of gestational trophoblastic disease -
ANSWER can also be called molar pregnancy
locally invasive mole, metastatic mole, and choriocarcinoma
characterized by an abnormal placental development that results in the
production of fluid-filled grapelike clusters and a vast proliferation of
trophoblastic tissue. - ANSWER GTD/molar pregnancy
what is usually the end result of a molar pregnancy - ANSWER associated
with loss of pregnancy, and in rare cases, cancer
what increases risk of molar pregnancy - ANSWER increased age, history of
molar pregnancy, blood types A and AB, and becoming accidentally pregnant
while on BC
what is the cause of molar pregnancy - ANSWER the cause is unknown, but it
is thought that complete moles result from the fertilization of an empty
ovum by a normal sperm
what type of mole has trophoblastic proliferation and the absence of fetal
Complete Solution
What are the three most common pregnancy complications in the first
trimester? - ANSWER ectopic pregnancy, gestational trophoblastic disease,
and spontaneous abortion (miscarriage)
true or false: all bleeding in early pregnancy indicates a complication -
ANSWER false
fertilized egg implants outside the uterine cavity - ANSWER ectopic
pregnancy
where can an ectopic pregnancy implant? - ANSWER fallopian tube, on the
ovary, on the cervix, on the outside of the fallopian tube, on the abdominal
wall, bowel
what is the hallmark sign of ectopic pregnancy - ANSWER unilateral stabbing
pain in the lower quadrant
what are signs and symptoms of ectopic pregnancy - ANSWER unilateral
abdominal pain, vaginal bleeding, a missed period, abdominal tenderness
what puts you at risk of having an ectopic pregnancy? - ANSWER history of
STIs
prior ectopic pregnancy
previous tubal, pelvic, or abdominal surgery
endometriosis
,current use of exogneous hormones
use of IUD
IVF
why is a ruptured ectopic pregnancy an emergency - ANSWER must be
diagnosed before the onset of hypotension, bleeding, pain, and overt rupture
to prevent major morbidity and death
what labs need to be worked up for ectopic pregnancy - ANSWER
beta-human chorionic gonadotropin
blood type
Rh
CBC
complete metabolic panel
WBC
diagnostic tools used to assess an ectopic pregnancy - ANSWER transvaginal
US
serial BhCG
pelvic exam
what is a salpingectomy - ANSWER removal of the rupture fallopian tube
(done by lapartotomy)
what is salpingostomy - ANSWER incision into the fallopian tube to remove
the pregnancy
,what medication is used for an ectopic pregnancy - ANSWER methotrexate
chemotherapeutic drug and folic acid inhibitor that stops all rapid cell
production, inhibiting the growth of the embryo and destroying remaining
trophoblastic tissue. used in the management of ectopic pregnancy -
ANSWER methotrexate
when is someone considered eligible for methotrexate for ectopic pregnancy
- ANSWER if the ectopic mass is unruptured and measures 1.6 cm or less on
an US exam
what pregnancy category is methotrexate - ANSWER category X and needs
special handling (chemo sharps)
what are educational points for patients on methotrexate? - ANSWER - side
effects such as nausea and vomiting
- discontinuation of prenatal vitamins and other folic acid supplements,
which can act as antagonists
- the need for alcohol abstinence
- avoidance of NSAIDs
- the need for sunscreen and protective clothing to prevent photosensitivity
- required follow up lab work to monitor hCG levels and other side effects
what is methotrexate commonly used for? - ANSWER calming the immune
system, to help stop it attacking your body's cells. This helps reduce the
inflammation that causes swollen and stiff joints in Rheumatoid arthritis,
thickened skin in psoriasis or damage to your bowel in Crohn's disease
, what are the different pathologies of gestational trophoblastic disease -
ANSWER can also be called molar pregnancy
locally invasive mole, metastatic mole, and choriocarcinoma
characterized by an abnormal placental development that results in the
production of fluid-filled grapelike clusters and a vast proliferation of
trophoblastic tissue. - ANSWER GTD/molar pregnancy
what is usually the end result of a molar pregnancy - ANSWER associated
with loss of pregnancy, and in rare cases, cancer
what increases risk of molar pregnancy - ANSWER increased age, history of
molar pregnancy, blood types A and AB, and becoming accidentally pregnant
while on BC
what is the cause of molar pregnancy - ANSWER the cause is unknown, but it
is thought that complete moles result from the fertilization of an empty
ovum by a normal sperm
what type of mole has trophoblastic proliferation and the absence of fetal
