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Nursing Management of the Patient with Pregnancy Complications rtf.rtf

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Nursing Management of the Patient with Pregnancy ComplicationsChaps. 15 & 16, 21Hyperemsis Gravidarum ch 16 pg 330May be mild at first but true hyperemesis may progress ti a point at which the women not only vomits everything she swallows but also retches between meal Excessive vomiting in the first trimester that leads to dehydration, fluid and electrolyte imbalance, metabolic acidosis, hypovolemia, tachycardia, increased hematocrit and BUN and decrease urinary outputstarvation if untreated metabolic acidosis may developdeath of mother and fetus in severe cases. Exact cause of hyperemesis is unclearIncreased levels of hCG may play a roleManagementInitial CareNPO – until dehydration is corrected Control vomiting: antiemetics (phenothihistamines, metoclopramide) and pyridoxine (vitamin b6)Correct fluid and electrolyte imbalance - potassium chloride Correct dehydration: Intravenous (IV) fluidsStress-reduction techniquesFollow-up CareSmall frequent mealsAvoid greasy highly-seasoned foodsImprove nutritional statatus Vitamin supplementsTotal parenteral nutritionNursing Assessment and DiagnosisCharacter of any emesis, I and O, FHR, signs of jaundice or bleeding and her emotional stateNutritional imbalamce r/t less than body requirementsFluid volume deficient Nursing ResponsibilitySupportiveDirected at maintaining a relaxed environmentMaintaining oral hygiene (mouth may be dry)Monitoring weightMonitoring for signs of complicationsOnce oral feedings resume, food needs to be attractively servedRefer to dietitian Bleeding DisordersAbortion
Expulsion of the fetus prior to 20 weeks gestation usually weighs less than 500 gTwo typesSpontaneous abortion: occurring naturally Induced abortion: as a result of medical or surgical intervention.CausesChromosomal abnormalitiesTeratogenic drugsFaulty implantation (caused by abnormalities’ of the female reproductive tract)Weaken cervixEndocrine imbalance Placental abnormalitiesMaternal infectionsWomen who use hot tubs or Jacuzzis may be increases risk for miscarriage bc hyperthermia resulting from increased core body tempSigns and SymptomsUnexplained bleedingCrampingBackacheClassifications of SABs spontaneous abortion pg 325Threatened abortion - Unexplained bleeding: spotting of blood. Bleeding may persist for days. Cervical os is closedCramping, backacheProducts of conception: bleeding followed by complete explusion of the embryo or fetus, placenta, and membranesCervix is not dilated and the placenta is still attached to the uterine wall, but some bleeding occurs figure AImminent abortion: bleeding and cramping increase, internal cervical os dilates, membranes may rupture (term inevitable abortion) placenta has separated from the uterine wall, the cervix has dialated, and the amount of bleeding has increases figure B

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Term
Fall
Professor
NoProfessor
Tags
Nursing, Obstetrics, vaginal bleeding, pulmonary edema

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