High Risk Antepartum-Student Version Fall 21.pptx -...

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Pregnancy RelatedComplicationsHyperemeisis GravidarumHemorrhagicComplicationsInfectionsNURS 368
ExpectedIndividualStudentLearningOutcomesDiscussDiscuss medications used to treat various high riskantepartum patients.DescribeDescribe Rh isoimmunization and prevention.DiscussDiscuss nursing care management of women with ableeding problem associated with pregnancy.DiscussDiscuss the care of pregnant women who use,abuse, or are dependent on alcohol or illicit orprescription drugs.DelineateDelineate the effects of selected pre-gestationmedical conditions (such as anemia, HIV, infection)on pregnancy.IdentifyIdentify maternal and fetal risks or complicationsassociated with diabetes in pregnancy.ExplainExplain the effects of heart disease duringpregnancy.ListList factors that can be considered high risk duringpregnancy.
If a pregnant women is nauseated and vomitbut continues to gain weight and is notdehydrated, she has hyperemesis gravidarum?
HyperemesisGravidarumSevere nausea & vomitingElectrolyte imbalance,wt. loss(5% or >), dehydrationCause unknown - maybe relatedto highhCGlevels (twins, molarpregnancy)Treatment - hospitalization, NPO, IVtherapy until 48 hrs after vomitingstops, gradually increase diet27% require recurrent treatment
NursingActionsAntiemetics as orderedE.g. zofranFacilitate nutritional/dietary consultsMay need TPN (total par.. nutrition)Encourage good oral hygieneDaily weightI and oMonitor dehydrationMonitor lab valuesComplementary Therapies: Gingerhas shown to decrease n/v for somewomen. Vitamin B6TPN and steroids(methylprednisolone)Small frequent meals
Early Pregnancy BleedingThe 3 most common reasons for bleedingin the first half of pregnancy:AbortionEctopic PregnancyGestational Trophoblastic Disease(including hydatiform mole)Moler pregnancyMay have hyperemesis gravidarum
QUp to 25% of pregnancies have “spotting”About 50% of those pregnancies will not survive
Number 1 reason for abortion and losing pregnancy=chromosal abnormalities
AbortionLoss of pregnancy before20 weeksMay be spontaneous or inducedSpontaneous: occurs without actionby the mother or provider (Alsoreferred to as miscarriage) Increaseswith age of parents, most occur infirst 12 weeks of pregnancyInduced: Also referred to as electivetermination of pregnancy
Causes ofSpontaneousAbortionsSeverecongenital abnormalities50-60% are due tochromosomal abnormalitiesMaternal infectionsEndocrine disorders: Esp.hypothyroidism & IDDMAnatomic defects of the uterusor cervixBad cervixWill have to do cerclage
6 Types of SpontaneousAbortions1. Threatened2. Imminent/Inevitable3. Incomplete4. Complete5. Missed6. Recurrent

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Term
Spring
Professor
ConnieMiller
Tags
Obstetrics, vaginal bleeding, Threatened abortion

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