Abruptio placentae - Answer--Premature separation of a normally implanted placenta
after 20th week of gestation, which leads to hemorrhage
-Can be a partial or total separation
-Baby can be deprived of nutrients and oxygen, which can lead to fetal death
-Occurs when maternal vessels tear away from placenta and bleeding occurs between
uterine lining and maternal side of placenta
-Knife-like abdominal pain
,Abruptio placentae risk factors - Answer--Prior abruption
-Chronic HTN
-Preeclampsia, gestational HTN
-Seizure activity
-Advanced maternal age
-Trauma to abdomen
-Smoking/cocaine use
-PROM (premature rupture of membranes)
-Previous pregnancies
-Multiples (twins, triplets)
Abruptio placentae S&S - Answer--Dark red bleeding
-Extended fundal height from concealed bleeding
-Tender uterus
-Abdominal pain/contractions
-Concealed bleeding (can stay inside uterus and back-flow into fallopian tubes, mom
can enter shock)
-Hard abdomen
-Experiences DIC
-Distressed baby (fetal heart tone abnormalities)
Active phase - Answer--4-7 cm dilation
-Contractions every 3-5 mins lasting 45-60 secs
-Lasts 4-8 hours
-Water may break
-Mom is in pain, serious, and anxious
-NIs: provide comfort (pharm and non-pharm), encourage frequent voiding, monitor for
meconium stained fluid if H2O breaks, perform Nitrazine paper test to confirm H2O
broke
Amniocentesis - Answer-Transabdominal puncture of the amniotic sac to obtain a
sample of amniotic fluid for analysis
APGAR score - Answer--A = appearance (color)
-P = pulse (HR)
-G = grimace (reflex irritability)
-A = activity (muscle tone)
-R = respiratory (respiratory effect)
-Evaluates a newborn's physical condition at 1 and 5 minutes after birth
-Done at 10 mins if the assessment at 5 minutes is <7
-Each parameter is assigned a score of 0-2 (0 = absent/poor response; 2 = normal)
-Normal score should be 8-10 (8-10 = no intervention needed, 4-7 = moderate difficulty,
0-3 = severe distress in adjusting to extrauterine life)
Assessment of fetal well being - Answer--Ultrasonography (ultrasound)
-Doppler flow studies
, -Alpha-fetoprotein analysis
-Marker screening tests
-Nuchal translucency screening
-Amniocentesis
-Chorionic villus sampling (sample of chorionic villi from placenta to eval for
chromosomal disorders)
-Non-stress test (non-invasive; indirectly measures uteroplacental function)
-Biophysical profile
Bacterial vaginosis - Answer--Sexually associated bacterial infection of the vagina due
to Gardnerella vaginalis (anaerobic)
-Most prevalent cause of vaginal discharge
-Associated with multiple partners, douching, and lack of vaginal lactobacilli
-Can increase a woman's susceptibility to other STIs (ex. HIV, herpes, chlamydia,
gonorrhea)
Bacterial vaginosis nursing management - Answer-Primary prevention and education to
limit recurrences (changing sexual behaviors that put women at risk for infection)
Bacterial vaginosis S&S - Answer--Primary symptoms are a thin, white homogeneous
vaginal discharge and a characteristic "stale fish" odor
-3 of 4 must be met for diagnosis: thin, white homogeneous vaginal discharge; vaginal
pH 4.5; positive "whiff test" (secretion is mixed with a drop of 10% KOH on a slide,
producing a characteristic stale fishy odor); presence of clue cells on wet-mount exam
Bacterial vaginosis treatment - Answer-Metronidazole (oral or gel) or clindamycin cream
Ballottment - Answer-examiner pushes against the women's cervix during a pelvic exam
and feels a rebound from the floating fetus
Bleeding during pregnancy - Answer--Spontaneous abortion (most common
complication of early pregnancy; loss of a fetus from natural causes, not elective or
therapeutically induced)
-Abortion (early loss of pregnancy (before 20 weeks), can be spontaneous or induced)
-Stillbirth (loss of fetus after 20th week)
-Miscarriage (loss of fetus before 20th week)
BUBBLE-EE - Answer--Used for PP head-to-toe assessment
-Breasts and chest
-Uterus
-Bowels
-Bladder
-Lochia (vaginal discharge after birth)
-Episiotomy/perineum/epidural site
-Extremities
-Emotional
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