Lecture 3.docx - Cervical Insufficiency complete pelvic...

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Cervical Insufficiency – complete pelvic rest, no nipple stimulation. Pink tinge vaginal discharge. Placenta Previa - placenta implanted on cervical os. Caesarian section is scheduled because cervix is not supposed to be dilating. Unknown cause. Bright red vaginal bleeding; painless . FHR needs to be assess frequently. Fetal kick counts 10 movements in an hour twice a day. S/S no contraction. CBC and crossmatch. Abruptio Placentae - emergent situation; separation of placenta leading to compromised fetal blood supply. Cocaine can cause this- stimulant that causes vasocontraction causing placenta to tear away. Unknown cause; 50% maternal or fetal death. Dark red bleeding ; knife like pain with contraction. CBC and crossmatch. Left lateral position; assess fundal height because with bleeding it will increase. Hyperemesis Gravidarum severe n/v. Dehydration, metabolic acidosis, alkalosis and hypokalemia. Lemonade, ginger, small meals. Medications: Phenegran- makes you sleepy. Zofran- can cause dental issues. IV fluids as indicated. Current weight. Increase risk for gingivitis; oral care. Hypertensive Disorders of Pregnancy Gestational hypertension – after 20 weeks 145/90; high blood pressure in two occurrences; come back next week if its high then she is diagnosed with this. Decrease salt. Chronic hypertension – before 20 weeks Preeclampsia - systemic involvement because of hypertensive state; vessels constricted; kidney issues and liver issues causing headache. Magnesium Sulfate – it can get worse and it can get to eclampsia - prevents seizure. CNS depressants; totally relax the body to get better blood flow; incredibly hot severe flushing. Baby can come out lethargic; decrease respiration of maternal and fetal; baby might need to be intubated. Antidote: Calcium Gluconate right next to
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