ymptoms appear after 20 weeks o Management Delivery of fetus only cure 12

Ymptoms appear after 20 weeks o management delivery

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ymptoms appear after 20 weeks o Management Delivery of fetus only cure
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12 Nursing Assessments—Preeclampsia o Identify hypertension o Proteinuria: excretion of 300mg or more of protein every 23 hours o Edema o CNS alterations Eclampsia: seizures Eclampsia o Occurrence of grandmal seizures in women who have gestational hypertension or preeclampsia o Most maternal deaths occur in eclampsia o Maternal complications: Cerebral hemorrhage Aspiration pneumonia, hypoxic encephalopathy, coma, thromboembolic events and maternal death Eclamptic seizures are tonic-clonic in nature HELLP Syndrome o Serious complication of preeclampsia o H emolysis, E levated L iver enzymes and L ow P latelets o Liver rupture is an ominous sign of preeclampsia & HELLP o Occurs more in Caucasians older than 35- multi-paras o Treatment Improve platelets with a blood transfusion of fresh-frozen plasma (FFP) Delivery of fetus as soon as feasible Disseminated Intravascular Coagulopathy (DIC) o Most common cause is blood loss - external or internal bleeding o Results in a depletion of platelets and clotting factors causes excessive bleeding o Nursing care Meticulous maternal and fetal assessment Place indwelling catheter Oxygen—rebreathing mask Blood and blood products Emotional support Multiple Gestation o Having more than one baby Monozygotic: Identical Twins – product of one egg Dizygotic: Fraternal Twins – product of two eggs o High-risk pregnancy o Morbidity and mortality Morbidity high in women with multiple gestations High risk for hypertension, placental abruption, anemia and UTI Perinatal morbidity is also high with more than one baby o Management Delivery at Level III facility Infections o UTI: most common- caused by E.coli o Diagnostics: C & S o Group B streptococcus (GBS)
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13 Causes of UTI It’s treated with penicillin Can be harmful to the baby – that’s why we give them erythromycin when they are born o TORCH Can harm development of the baby o STIs Sexually Transmitted Infections Chlamydia- vaginal discharge & dysuria- can cause conjunctivitis in infant Give erythromycin on the eyes at birth is only 80% effective Gonorrhea- often coexist with chlamydia Infection site is on the Skene’s and the Bartholin’s gland, endocervix, endometrium and fallopian tubes Symptoms: Vaginal discharge, dysuria and vaginal bleeding If mothers are untreated infants can get ophthalmia neonatorum (eye inflammation) than can lead to permanent blindness Syphilis- A painless chancre appears on the vulva, cervix and the vagina Cause preterm labor or fetal death HPV- Causes condylomata acuminata (genital warts) 70% of cervical cancer are from HPV Highest among 16-25 year olds HIV and AIDS- Patients need to on Zidovudine (ZDV) therapy to reduce risk of transmission to the baby Counseled on cesarean delivery to reduce vertical transmission of HIV Amniocentesis should be avoided Tuberculosis- INH, ethambutol and Rifampin is safe during pregnancy and
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