NUR 254 EXAM 1
Presumtive signs of pregnancy
SUBJECTIVE
-Nausea/vomiting
-amenorrhea
-breast changes
-fatigue
-urinary frequency
-quickening (fetal movement)
Probable signs of pregnancy
EXAMINER OBJECTIVE FINDING
-Hegar's sign
-Goodell's sign
-Chadwick's sign
-Positive pregnancy test
-Braxton hicks contractions
-Ballotment
nonstress test
A method for evaluating fetal status during the antepartum period by
observing the response of the fetal heart rate to fetal movement.
accelerations should be 15x15 at 36wks
Cerclage
suturing of the cervix to prevent it from dilating prematurely during
pregnancy, thus decreasing the chance of a spontaneous abortion or
premature birth
Estrogen
,- Responsible for enlargement ofuterus, breasts, and genitals
- supports melanocyte-stimulating hormone in hyperpigmentation of
skin
- vasular changes
- alters sodium and water retention
Progesterone
- inhibits uterine contractility
- promotes the development of secretory ducts for lactation
- Reduced smooth muscle tone (inc. risk for heartburn, constipation,
UTI)
Human chorionicsomatomammotropi
- produced by placenta
- Affects glucose and protein metabolism
- Decreases maternal metabolism of glucose
- increases resistance to insulin
Relaxin
- softens cervix (goodells sign)
- causes connective tissues of symphysis pubis to be more moveable
- inhibits uterine activity
Oxytocin
- produced by posterior pituitary
- stimulates uterine contractions
- stimulates milk ejection
Eclampsia
Tonic clonic Seizure with pre-eclampsia
Ectopic pregnancy
Pregnancy that is located outside of the uterus
S/S of ectopic pregnancy
,three classic signs and symptoms before rupture: abdominal pain,
delayed menses, abnormal vaginal bleeding.
Methotrexate
- dissolves ectopic (tubal) pregnancies by destroying cells
- urine and stool could contain toxic levels of drug for up to 7
days. double flush toilet
-
What to avoid on methotrexate
- folic acid
- "gas forming" foods
- sun
avoid sex unti beta-hCG levels are undetectable
- Do not take any analgesics stronger than Tylenol (they will mask
symptoms of tubal rupture)
Antidote for Magnesium Toxicity
calcium gluconate
gestational diabetes diagnosis criteria
Failed 1hr OGTT, and met 2 or more of the criteria in the 3hr OGTT
Magnesium sulfate
Medication used for prevention of seizures and neonatal
neuroprotection
S/S of DIC
- signs of thrombosis
- bleeding from at least 3 unrelated sites
- epitaxis
- hypotension
- tachycardia
, Interventions for DIC
Monitor for bleeding and signs of shock
insert foley- watch I&O and renal function
Oxygen, volume replacement, blood therapy, possible heparin
Disseminated Intravascular Coagulation (DIC)
- Activation of coagulation which is widespread and can lead to
excessive clotting and hemorrhage
It is never a primary diagnosis, most often triggered by placental
abruption
Preterm labor
The progressive dilation of the cervix prior to 36wks of pregnancy
and after 20 weeks gestation.
Pre-eclampsia diagnosis criteria
BP greater than 140/90 2x greater than 4 hours apart, often with
proteinuria.
molar pregnancy
also known as gestational trophoblastic disease; abnormal
proliferation of trophoblastic cells in the first trimester
not a viable pregnancy
-dark brown discharge
-cannot become pregnant within one year and have frequent checks
for cancer
Presents often with a "snowstorm" pattern
Hegar's sign
softening of the lower uterine segment
Goodell's sign
Presumtive signs of pregnancy
SUBJECTIVE
-Nausea/vomiting
-amenorrhea
-breast changes
-fatigue
-urinary frequency
-quickening (fetal movement)
Probable signs of pregnancy
EXAMINER OBJECTIVE FINDING
-Hegar's sign
-Goodell's sign
-Chadwick's sign
-Positive pregnancy test
-Braxton hicks contractions
-Ballotment
nonstress test
A method for evaluating fetal status during the antepartum period by
observing the response of the fetal heart rate to fetal movement.
accelerations should be 15x15 at 36wks
Cerclage
suturing of the cervix to prevent it from dilating prematurely during
pregnancy, thus decreasing the chance of a spontaneous abortion or
premature birth
Estrogen
,- Responsible for enlargement ofuterus, breasts, and genitals
- supports melanocyte-stimulating hormone in hyperpigmentation of
skin
- vasular changes
- alters sodium and water retention
Progesterone
- inhibits uterine contractility
- promotes the development of secretory ducts for lactation
- Reduced smooth muscle tone (inc. risk for heartburn, constipation,
UTI)
Human chorionicsomatomammotropi
- produced by placenta
- Affects glucose and protein metabolism
- Decreases maternal metabolism of glucose
- increases resistance to insulin
Relaxin
- softens cervix (goodells sign)
- causes connective tissues of symphysis pubis to be more moveable
- inhibits uterine activity
Oxytocin
- produced by posterior pituitary
- stimulates uterine contractions
- stimulates milk ejection
Eclampsia
Tonic clonic Seizure with pre-eclampsia
Ectopic pregnancy
Pregnancy that is located outside of the uterus
S/S of ectopic pregnancy
,three classic signs and symptoms before rupture: abdominal pain,
delayed menses, abnormal vaginal bleeding.
Methotrexate
- dissolves ectopic (tubal) pregnancies by destroying cells
- urine and stool could contain toxic levels of drug for up to 7
days. double flush toilet
-
What to avoid on methotrexate
- folic acid
- "gas forming" foods
- sun
avoid sex unti beta-hCG levels are undetectable
- Do not take any analgesics stronger than Tylenol (they will mask
symptoms of tubal rupture)
Antidote for Magnesium Toxicity
calcium gluconate
gestational diabetes diagnosis criteria
Failed 1hr OGTT, and met 2 or more of the criteria in the 3hr OGTT
Magnesium sulfate
Medication used for prevention of seizures and neonatal
neuroprotection
S/S of DIC
- signs of thrombosis
- bleeding from at least 3 unrelated sites
- epitaxis
- hypotension
- tachycardia
, Interventions for DIC
Monitor for bleeding and signs of shock
insert foley- watch I&O and renal function
Oxygen, volume replacement, blood therapy, possible heparin
Disseminated Intravascular Coagulation (DIC)
- Activation of coagulation which is widespread and can lead to
excessive clotting and hemorrhage
It is never a primary diagnosis, most often triggered by placental
abruption
Preterm labor
The progressive dilation of the cervix prior to 36wks of pregnancy
and after 20 weeks gestation.
Pre-eclampsia diagnosis criteria
BP greater than 140/90 2x greater than 4 hours apart, often with
proteinuria.
molar pregnancy
also known as gestational trophoblastic disease; abnormal
proliferation of trophoblastic cells in the first trimester
not a viable pregnancy
-dark brown discharge
-cannot become pregnant within one year and have frequent checks
for cancer
Presents often with a "snowstorm" pattern
Hegar's sign
softening of the lower uterine segment
Goodell's sign
