Fetal movement hr rr activity placental grading

Fetal movement, HR, RR, activity
 Placental grading (maturation)
 Client is bleeding
 Questionable fundal height
 Decreased fetal movements
 Preterm labor

Questionable ROM

Nursing actions for a Abdominal Ultrasound:

Drink 1-2 quarts prior (in order to fill the bladder)

Place client in supine position with wedge under right hip (to displace
uterus)

Apply gel to abdomen (room temp or warmer)

Empty bladder at the end of procedure

Nursing actions for a transvaginal Ultrasound:


Place client in lithotomy position, lubricate probe, insert (by client or
examiner)
 Tilt table or probe to gain new image
 Inform client that pressure will be felt when probe is moved
 Point out what you are looking at
 1A- Complications of Pregnancy (8 questions)
o Gestational Diabetes (1 question)
 Maternal/Fetal Complications
 Normal BG is 70-110 during pregnancy
 Occurs in 50% of women
 Increases risk for spontaneous abortion, infections, hydramnios, ketoacidosis,
hypoglycemia, and hyperglycemia
Symptoms:
 Hypo/hyperglycemia
 Excessive weigh gain
 Vomiting

Rapid pulse
Labs:

Routine UA with glycosuria
Diagnostics:
 BPP
 Amniocentesis with alpha-fetoprotein

NST
Nursing:

Insulin

Blood glucose

Daily kick counts
o
Complications (3 questions)

Prenatal Complications

Infections (TORCH)

Toxoplasmosis

Findings similar to influenza

Other Infections

Rubella

Symptoms of joint and muscle pain

Cytomegalovirus

Asymptomatic or mononucleosis-like manifestation

Herpes Virus
 Symptoms consisting of painful blisters and tinder lymph nodes
 Gonorrhea
 Women are frequently asymptomatic
 Can be transmitted to the newborn
 Administer erythromycin to infants following delivery
 Symptoms
 Dysuria
 Vaginal bleeding between periods and dysmenorrhea

UTI
 Placental Abruption

Premature separation of the placenta from the uterus


Occurs after 20 weeks and has significant morbidity and mortality, leading cause
of maternal death
 Best to do C-section
Risk factors include HTN, trauma, cocaine, smoking, ROM, or multiple babies
Symptoms:
 Intense pain
 Dark red vaginal bleeding
 Hypovolemic shock symptoms
 Fetal distress
Labs:

Hgb and Hct decreased

Coag factors decreased

Clotting defects (DIC)

Cross type and match for blood

Kleihauer-Betke test: detects fetal blood in maternal circulation
Nursing:
 Administer oxygen 8-10L per minute

Assess urinary output and monitor fluid balance

Preterm Labor

Uterine contraction & cervical changes that occur between 20-37 wks

Risk factors:

Infections of UT, vagina, chorioamnionitis (amniotic sac infection)

Previous preterm birth

Multifetal pregnancy

Hydramnios (excessive amniotic fluid)

Age below 17 or above 35

Low socioeconomic status

Smoking

Substance use

Domestic violence

History of multiple miscarriages or abortions

Diabetes mellitus or hypertension
