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ymptoms appear after 20 weeksoManagementDelivery of fetus only cure
12Nursing Assessments—PreeclampsiaoIdentify hypertensionoProteinuria:excretion of 300mgor more of protein every 23 hoursoEdemaoCNS alterationsEclampsia:seizuresEclampsiaoOccurrence of grandmal seizuresin women who have gestational hypertension or preeclampsiaoMost maternal deaths occur in eclampsiaoMaternal complications:Cerebral hemorrhageAspiration pneumonia, hypoxic encephalopathy, coma, thromboembolic events and maternal deathEclamptic seizures are tonic-clonic in natureHELLP SyndromeoSerious complication of preeclampsiaoHemolysis, Elevated Liver enzymes and Low PlateletsoLiver ruptureis an ominous sign of preeclampsia & HELLPoOccurs more in Caucasians older than 35- multi-parasoTreatmentImprove platelets with a blood transfusion of fresh-frozen plasma (FFP) Delivery of fetus as soon as feasibleDisseminated Intravascular Coagulopathy (DIC)oMost common cause isblood loss - external or internal bleedingoResults in a depletion of platelets and clotting factors causes excessive bleedingoNursing careMeticulous maternal and fetal assessmentPlace indwelling catheterOxygen—rebreathing maskBlood and blood productsEmotional supportMultiple GestationoHaving more than one babyMonozygotic: Identical Twins – product of one eggDizygotic:Fraternal Twins – product of two eggsoHigh-risk pregnancyoMorbidity and mortalityMorbidity high in women with multiple gestationsHigh risk for hypertension, placental abruption, anemia and UTIPerinatal morbidity is also high with more than one babyoManagementDelivery at Level III facilityInfectionsoUTI:most common- caused by E.colioDiagnostics: C & SoGroup B streptococcus (GBS)
13Causes of UTI It’s treated with penicillinCan be harmful to the baby – that’s why we give them erythromycin when they are bornoTORCHCan harm development of the babyoSTIsSexually Transmitted InfectionsChlamydia-vaginal discharge & dysuria- can cause conjunctivitis in infantGive erythromycin on the eyes at birth is only 80% effectiveGonorrhea- often coexist with chlamydiaInfection site is on the Skene’s and the Bartholin’s gland, endocervix, endometrium and fallopian tubesSymptoms:Vaginal discharge, dysuria and vaginal bleedingIf mothers are untreated infants can get ophthalmia neonatorum(eye inflammation) than can lead to permanent blindnessSyphilis- A painless chancre appears on the vulva, cervix and the vaginaCause preterm labor or fetal deathHPV- Causes condylomata acuminata (genital warts)70% of cervical cancer are from HPVHighest among 16-25 year oldsHIV and AIDS-Patients need to on Zidovudine (ZDV)therapy to reduce risk of transmission to the babyCounseled on cesarean delivery to reduce vertical transmission of HIV Amniocentesis should be avoidedTuberculosis- INH, ethambutol and Rifampin is safe during pregnancy and