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Exam (elaborations)

NURS 629 Exam 1 Maternal Hyperemesis Gravidarum and Antenatal Hemorrhagic Disorders

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NURS 629 Exam 1 Maternal Hyperemesis Gravidarum and Antenatal Hemorrhagic Disorders Excessive vomiting with dehydration, ketoacidosis, electroyte imblances is called - Hyperemesis Gravidarum Hyperemesis Gravidarum's etiology is unkown but it is suspected that the increased hormonal levels of ___ or _____ levels plays a part - HCG Prolactin Care management of Hyperemesis Gravidarum includes (three options) - Oral Hygeine Medications BRAT diet (bananas, rice, applesauce and toast,)or High Protein Low carb diet and advance as tolerated Low Fat Small frequent meals Zofran used to be the go to and is still used for hyperemesis gravidarum (especially after 14 wks gestation) however keep in mind that it has been known to cause ____ ___ and ____ ____ - cardiac annomilies facial deformities Studies have shown that ___ can improve nausea and B12 can reduce the episodes of vomiting. - B6 (pyridoxine) Unisom is the brand name of a sleeping drug called doxylamine. _____ is a delayed-release combination of doxylamine and pyridoxine (B6). approved by the FDA for the treatment of nausea and vomiting in pregnancy - Diclegis Herbal options for hyperemesis gravidarum - ginger pepermint Signs and symptoms of hyperemisis gravidarum include (4 options) - decreased urine output weight loss dry mucus membranes poor skin turgor What do you expect to seee on a urinalysis for someone who is dehydrated or starving (an occurance that can happen with hyperemesis gravidarum) - Ketonuria with normal glucose levels Increased specific gravity (urinalysis) Treatment for hyperemesis gravidarum (3 options) - IVF, TPN antiemetics advance diet as tolerated Early bleeding during pregnancy can be benign (spotting esp. early on) but what are the 3 reasons that this can also occur - Miscarriage Ectopic Pregnancy Incompetent cervix Vaginal bleeding but no true miscarrage; nothing we can do to prevent miscarrage (NO FALSE REASSURANCE) - Threatened Abortion Membrane rupture and cervix dilated (matter of time) cerclage is an option kept to term before removing and done in as a hospital procedure with a doctor - Inevitable abortion Some products of conception have been expelled, but some remain. - Incomplete abortion IF HCG levels is decreasing or not meeting the 1.4- 2 increases per day until leveling out in 60 to 90 days or ultrasound not showing heart beat at week 10-12 treat with ____ or ____ but don't be quick with this decision, bring them back in a week to confirm before acting. - D&C medication

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