QUIZ (02/28/24)

• Abruptio Placenta:

  • Usually happens in the 2nd or 3rd trimester of pregnancy
  • Premature separation of the placenta late in pregnancy
  • Signs of internal bleeding include distended, rigid, and tender abdomen
  • Signs of placental separation: sudden gush of blood, lengthening of the cord, and a globular shape of the uterus

  
• Types of Placental Separation:

  • Fetal anoxia can result from inadequate oxygenation of the mother, low maternal blood pressure, or abnormalities in the uterus, placenta, or umbilical cord that lead to inadequate blood flow to the fetus
  • Risk factors include high parity, short umbilical cord, advanced maternal age, direct trauma, and chorioamnionitis (maternal infection)

  
• Diagnostic and Medical Management of Abruptio Placenta:

  • Diagnostic tests include hemoglobin and fibrinogen levels to rule out disseminated intravascular coagulation
  • Medical management involves intravenous therapy, oxygen inhalation to prevent fetal anoxia, and fibrinogen determination to detect DIC
  • Surgical management may include cesarean delivery or hysterectomy (removal of the uterus)

  
• Nursing Interventions for Abruptio Placenta:

  • Place the patient in a lateral position
  • Monitor fetal heart sounds and vital signs

  
• Premature Rupture of Membrane (PROM):

  • Rupture of fetal membrane with loss of amniotic fluid before 37 weeks
  • Risk factors include chorioamnionitis, vaginal infections, cervical abnormalities, smoking, intrauterine infections, multiple pregnancy, and cervical incompetence

  
• Complications of PROM:

  • Immediate risks include cord prolapse, cord compression, and placental abruption
  • Delayed risks include high cesarean section rate, chorioamnionitis, intrapartum and postpartum fever, fetal pulmonary hypoplasia, neonatal sepsis, fetal pneumonia, and preterm birth

  
• Diagnosis and Management of Premature Rupture of Membrane (PROM):

  • Diagnosis involves history of warm fluid gushing, examination findings, and special tests like ultrasound and litmus, ferning, and nitrazine tests
  • Management includes emotional support for the patient and partner, screening for lower genital tract infections, and monitoring for maternal and neonatal infections

  
• Pregnancy-Induced Hypertension (PIH):

  • Vasospasm during pregnancy in small and large arteries
  • Most common medical problem in pregnancy, affecting 8% of pregnancies
  • PIH is a form of high blood pressure in pregnancy that can hinder blood flow in various organ systems

  
• Multiple Pregnancy:

  • Occurs when more than one fetus simultaneously develops in the uterus
  • Twin pregnancy is the simultaneous development of two fetuses, with the commonest variety being dizygotic twins (fraternal) and monozygotic twins (identical)

  
• Therapeutic Management of Preterm Labor:

  • Medical attempts to stop labor if fetal membranes are intact, fetal distress is absent, no evidence of bleeding, and cervix is not dilated more than 4 to 5 cm
  • Therapies include bed rest, intravenous fluid therapy, tocolytic agents like Terbutaline, and corticosteroids for lung surfactant production

  
• Medications for Preterm Labor:

  • Terbutaline and magnesium sulfate are common medications used
  • Betamethasone and Dexamethasone are corticosteroids administered to accelerate lung surfactant formation in the fetus

  
• Drug Administration for Preterm Labor:

  • Administering corticosteroids to the fetus accelerates lung surfactant formation
  • Magnesium sulfate may reduce the risk of specific brain damage before 32 weeks

  
• Cesarean Birth for Preterm Labor:

  • A cesarean birth may be planned to reduce pressure on the fetal head and hemorrhage from vaginal birth

  
• Risk Factors for Premature Rupture of Membrane (PROM):

  • Chorioamnionitis, vaginal infections, cervical abnormalities, smoking, intrauterine infections, multiple pregnancy, cervical incompetence, vaginal exams, and nutritional deficiencies

  
• Diagnosis and Management of Pregnancy-Induced Hypertension (PIH):

  • Diagnosis involves monitoring blood pressure and organ function
  • Management includes bed rest, monitoring, and sometimes medications like magnesium sulfate

  
• Types of Twin Pregnancy:

  • Dizygotic twins result from fertilization of two ova, leading to fraternal twins
  • Monozygotic twins result from fertilization of one ova, leading to identical twins

  
• Therapeutic Management of Pregnancy-Induced Hypertension (PIH):

  • Emotional support for the patient and partner, screening for lower genital tract infections, and monitoring for maternal and neonatal infections

  
• Symptoms and Management of Preterm Labor:

  • Symptoms include persistent backache, vaginal spotting, and uterine contractions
  • Management involves bed rest, intravenous fluid therapy, and tocolytic agents like Terbutaline

  
• Diagnosis and Management of Multiple Pregnancy:

  • Diagnosis involves ultrasound and monitoring for complications
  • Management includes monitoring for maternal and fetal well-being, and sometimes interventions like cesarean delivery

  
• Complications of Multiple Pregnancy:

  • Complications can include cord prolapse, cord compression, placental abruption, cesarean section, chorioamnionitis, intrapartum and postpartum fever, fetal pulmonary hypoplasia, neonatal sepsis, fetal pneumonia, and preterm birth

  
• Diagnosis and Management of Diabetes Mellitus in Pregnancy:

  • Diagnosis involves monitoring blood sugar levels and managing with appropriate medications and diet
  • Management includes insulin therapy, monitoring for complications, and ensuring fetal well-being

  
• Symptoms and Management of Premature Rupture of Membrane (PROM):

  • Symptoms include warm fluid gushing, examination findings, and special tests like ultrasound and litmus, ferning, and nitrazine tests
  • Management includes emotional support, screening for infections, and monitoring for complications

  
• Attachment is a strong reciprocal emotional bond between an infant and a primary caregiver

  
• Schaffer and Emerson's 1964 study on attachment:

  • Aim: identify stages of attachment / find a pattern in the development of an attachment between infants and parents
  • Participants: 60 babies from Glasgow
  • Procedure: analysed interactions between infants and carers
  • Findings: babies of parents/carers with 'sensitive responsiveness' were more likely to have formed an attachment
• Freud's superego represents internalized societal values and standards
• Dizygotic twins result from fertilization of two ova, leading to fraternal twins, while monozygotic twins result from fertilization of one ova, leading to identical twins

  
• Factors increasing the risk of multiple pregnancies include increasing maternal age, increasing parity, nutritional factors, pituitary gonadotropin, infertility therapy, assisted reproductive therapy, and genetic/hereditary factors
• Monozygotic twins usually have one placenta, one chorion, two amnions, and two umbilical cords, and always of the same sex
• Complications of multiple pregnancies can include maternal issues like nausea, anemia, pre-eclampsia, hydramnios, antepartum hemorrhage, and fetal issues like miscarriage, prematurity, growth problems, intrauterine death, and fetal anomalies
• Hydramnios is an excess of amniotic fluid volume during pregnancy, which can lead to fetal malpresentation and premature rupture of membranes
• Oligohydramnios refers to a pregnancy with less than the average amount of amniotic fluid, often caused by a bladder or renal disorder in the fetus
• Rh sensitization can occur when a pregnant woman is Rh-negative and her fetus is Rh-positive, leading to the mother's immune system producing antibodies against the fetus's blood cells
• Rh sensitization can be prevented by giving the mother Rh immunoglobulin (RhoGAM) during pregnancy and after delivery