NCM 109: GESTATIONAL CONDITIONS
Hyperemesis Gravidarum (Description) - Answers - nausea and vomiting of pregnancy
prolonged past week 16 of pregnancy or that is so severe that dehydration, ketonuria,
and significant weight loss occur within the first 12 weeks of pregnancy
Hyperemesis Gravidarum (Etiology) - Answers - Unknown cause
- may be related to HCG and H.pylori infection
Hyperemesis Gravidarum (Signs and Symptoms) - Answers - - Persistent,
uncontrollable vomiting
- Weight loss
- Electrolyte imbalances
- Ketonuria
- Elevated HCT
- Dehydration
Hyperemesis Gravidarum (Complications) - Answers - - fetal growth restriction
- thromboembolism
- hypokalemic alkalosis
- B1 deficiency
- preterm birth
Hyperemesis Gravidarum (Nursing Management) - Answers - - Hospitalization for 24
hours
- monitor I/O and blood chemistries
- NPO -> Clear liquid -> dry crackers -> soft diet -> regular diet, proceed with diet if no
vomiting
Hyperemesis Gravidarum (Medical Treatment) - Answers - - IV fluids, NPO (to allow GI
to rest)
- Antiemetics
Ectopic Pregnancy (Description) - Answers - pregnancy out of usual area, HCG
released and corpus luteum
Ectopic Pregnancy (Etiology) - Answers - hx of infection or sx, IUD, synthetic estrogen
exposure
Ectopic Pregnancy (Risk factors) - Answers - - narrowing of fallopian tube
- prev ectopic
- Age >35
- Hx of infertility
- IVF
, - prev tubal surgery (scarring narrows the tube)
- use of IUD
- Pelvic Inflammatory dx (PID)
Isthmal/ Tubal Pregnancy - Answers - most common, fertilized egg gets stuck in
fallopian tube
Cervial Pregnancy - Answers - rare
Abdominal Pregnancy - Answers - grow in the peritoneum, not seen in TVS, only in
MRI, occurs after fallopian tube rupture
Ovarian Pregnancy - Answers - rupture before the end of the first trimester
Ectopic Pregnancy (S/S) - Answers - Amenorrhea/abnormnal menstrual period
- Tubal rupture: sudden sharp low abd. pain radiating to shoulder Kehr's sign
- N/V positive pregnancy test
- Cullen sign
- Rectal pressure
- Shock
Kehr's sign - Answers - severe left shoulder pain in patient with tubal rupture (referred
pain due to diaphragmatic irritation)
Cullen sign - Answers - bluish sign in the umbilicus, end stage
Ectopic Pregnancy (Lab signs) - Answers - Low Hgb, Hct, and HCG
Elevated WBC
Ectopic Pregnancy (Diagnostic Tests) - Answers - Pellvic UTZ
Culdocentesis
Ectopic Pregnancy (Medical Treatment) - Answers - Methotrexate
Salpingectomy
BT
Antibiotics
Methotroxate - Answers - DOC for ending ectopic pregnancy, anticancer, destroys
rapid proliferating cells
Salpingectomy - Answers - removal of fallopian tubes, treats a large ectopic pregnancy
Ectopic Pregnancy (Nursing Management) - Answers - Assess for shock
modified Trendelenburg
Infuse IV fluids as ordered
Provide physical and psychological support
Hyperemesis Gravidarum (Description) - Answers - nausea and vomiting of pregnancy
prolonged past week 16 of pregnancy or that is so severe that dehydration, ketonuria,
and significant weight loss occur within the first 12 weeks of pregnancy
Hyperemesis Gravidarum (Etiology) - Answers - Unknown cause
- may be related to HCG and H.pylori infection
Hyperemesis Gravidarum (Signs and Symptoms) - Answers - - Persistent,
uncontrollable vomiting
- Weight loss
- Electrolyte imbalances
- Ketonuria
- Elevated HCT
- Dehydration
Hyperemesis Gravidarum (Complications) - Answers - - fetal growth restriction
- thromboembolism
- hypokalemic alkalosis
- B1 deficiency
- preterm birth
Hyperemesis Gravidarum (Nursing Management) - Answers - - Hospitalization for 24
hours
- monitor I/O and blood chemistries
- NPO -> Clear liquid -> dry crackers -> soft diet -> regular diet, proceed with diet if no
vomiting
Hyperemesis Gravidarum (Medical Treatment) - Answers - - IV fluids, NPO (to allow GI
to rest)
- Antiemetics
Ectopic Pregnancy (Description) - Answers - pregnancy out of usual area, HCG
released and corpus luteum
Ectopic Pregnancy (Etiology) - Answers - hx of infection or sx, IUD, synthetic estrogen
exposure
Ectopic Pregnancy (Risk factors) - Answers - - narrowing of fallopian tube
- prev ectopic
- Age >35
- Hx of infertility
- IVF
, - prev tubal surgery (scarring narrows the tube)
- use of IUD
- Pelvic Inflammatory dx (PID)
Isthmal/ Tubal Pregnancy - Answers - most common, fertilized egg gets stuck in
fallopian tube
Cervial Pregnancy - Answers - rare
Abdominal Pregnancy - Answers - grow in the peritoneum, not seen in TVS, only in
MRI, occurs after fallopian tube rupture
Ovarian Pregnancy - Answers - rupture before the end of the first trimester
Ectopic Pregnancy (S/S) - Answers - Amenorrhea/abnormnal menstrual period
- Tubal rupture: sudden sharp low abd. pain radiating to shoulder Kehr's sign
- N/V positive pregnancy test
- Cullen sign
- Rectal pressure
- Shock
Kehr's sign - Answers - severe left shoulder pain in patient with tubal rupture (referred
pain due to diaphragmatic irritation)
Cullen sign - Answers - bluish sign in the umbilicus, end stage
Ectopic Pregnancy (Lab signs) - Answers - Low Hgb, Hct, and HCG
Elevated WBC
Ectopic Pregnancy (Diagnostic Tests) - Answers - Pellvic UTZ
Culdocentesis
Ectopic Pregnancy (Medical Treatment) - Answers - Methotrexate
Salpingectomy
BT
Antibiotics
Methotroxate - Answers - DOC for ending ectopic pregnancy, anticancer, destroys
rapid proliferating cells
Salpingectomy - Answers - removal of fallopian tubes, treats a large ectopic pregnancy
Ectopic Pregnancy (Nursing Management) - Answers - Assess for shock
modified Trendelenburg
Infuse IV fluids as ordered
Provide physical and psychological support
