Norsingg

• Management of Pregnancy at Risk is defined as a condition where there is jeopardy to the mother, fetus, or both, due to a condition present before or during pregnancy, resulting in higher morbidity and mortality.
• Conditions Complicating Pregnancy include Perinatal Loss, Bleeding, Hyperemesis gravidarum, Gestational hypertension, HELLP syndrome, and Gestational diabetes.
• Perinatal Loss refers to the death of a fetus or newborn no matter when it occurs, which is devastating to the mother and family.
• Fetal Demise is a condition where a fetus dies in utero but is not expelled.
• Causes of Bleeding include Spontaneous abortion, Ectopic pregnancy, GTD/Hydatidiform mole, Cervical insufficiency, Placenta Previa, and Abruptio placenta.
• Spontaneous Abortion is the termination of pregnancy before viability prior to 20wks; less than 500g, and can be due to factors such as abnormal fetal development, incompetent cervix, anomaly of the uterine cavity, hypothyroidism, diabetes mellitus, drug use, and infection.
• Abnormal fetal development, incompetent cervix, anomaly of the uterine cavity, hypothyroidism, diabetes mellitus, drug use, and infection are factors that can cause Spontaneous Abortion.
• Pregnancy and substance abuse can lead to preterm labor, abortion, low birth weight infant, CNS and fetal anomalies, long term developmental issues, and the effects of common substances.
• These women will often seek prenatal care late in the pregnancy.
• Nursing management for a woman over age 35 involves promotion of a healthy pregnancy, education, regular prenatal care, dietary teaching, and fetal surveillance.
• Fetal alcohol spectrum disorder (FSDA) is a condition associated with cognitive and behavioral problems.
• Women with substance abuse commonly abuse several substances.
• Social attitudes often prohibit some women from seeking help and admitting they have a problem.
• Alcohol is a teratogen and is toxic to human development.
• Nursing management for pregnancy and substance abuse involves referral for intervention and counseling, a nonjudgmental approach, notification of the state protection agency of a positive newborn drug screen, and education.
• Nursing assessment for a woman over age 35 includes preconception counseling and laboratory and diagnostic testing for baseline, amniocentesis, and quadruple blood test screen.
• Nursing assessment for pregnancy and substance abuse includes a history and physical, screening questions, and urine toxicology.
• Categories of Abortions include Complete, Incomplete, Threatened, Imminent, Missed, Habitual, and Inevitable.
• Nursing care for Spontaneous Abortion includes assessing bleeding and signs of shock, pain level, infection, and providing emotional support.
• Dizygotic twins are a type of multiple gestation where multiple fertilized ova split.
• HELLP Syndrome is a condition characterized by hepatic dysfunction, which includes hemolysis of red blood cells (H), elevated liver enzymes (EL), and low platelets (LP).
• • Dizygotic( fraternal)- multiple fertilized ova that split.
• Eclampsia is a condition that occurs when preeclampsia progresses to a seizure state.
• Management of HELLP Syndrome includes transfusion of fresh or frozen plasma (FFP) or platelets to reverse thrombocytopenia (count below 100,000), and delivery of the baby.
• HELLP Syndrome increases the risk for placental abruption, acute renal failure, subcapsular hepatic hematoma, hepatic rupture, fetal and maternal death, and DIC.
• Symptoms of eclampsia include marked proteinuria, seizures/coma, hyperreflexive, and possible HELLP syndrome.
• Monozygotic twins are a type of multiple gestation where a single fertilized ovum splits.
• In the event of eclampsia, stabilize the client, monitor their continuous FHR, implement seizure precautions, initiate magnesulfate therapy, evaluate lab results for HELLP syndrome, and prepare for delivery.
• Multiple gestation refers to the situation where more than one fetus is being born to a pregnant woman, and the number of multiple gestations have increased due to the use of fertility drugs.
• 20 million women are HIV positive and 2.5 million children have acquired HIV via mother to child transmission.
• If positive, the mother should be given antibiotics in labor.
• Herpes Simplex Virus (HSV) causes oral lesions (fever blisters) and genital lesions and transmission occurs by direct contact.
• Infants born from positive mothers need to receive single-antigen HBV vaccine & hepatitis B immunoglobulin within 12 hrs of birth.
• Nursing assessment for hepatitis B virus includes history focused on behavior that puts her at risk, prenatal testing, ability to breast feed, no need for surgical delivery, and teaching guidelines.
• Pregnant adolescents are 11-19 years old and vacillate between being children and young adults.
• Nursing assessment for pregnant adolescents includes vision of self in future, role models, emotional support, level of education, financial/community resource, anger/conflict resolution skills, and knowledge of health and nutrition for self and child.
• Nursing management for pregnant adolescents includes support, future planning, frequent evaluation of physical and emotional well-being, stress management; self-care, and teaching topics.
• HIV is a retrovirus that is transmitted by blood and body fluids and is a threat to the mother, fetus, and newborn.
• Group Beta Strep (GBS) causes neonatal sepsis and according to CDC guideline, vaginal and rectal culture should be done at 35-37 weeks gestation.
• Adolescents, pregnant woman over age 35, and women who abuse substances are considered vulnerable populations.