U World Maternal Health Nursing- Med Surg: Exam Study Guide with Last minute Information you NEED to pass the UWorld Maternal Health Exam.
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U World Maternal Health Nursing- Med Surg Ectopic pregnancy Symptoms include lower abdominal and pelvic pain; amenorrhea, possibly followed by vaginal Important preconception education topics Folic acid supplementation at least 400 mcg per day reduce the incidence of neural tube defects. Normal laboratory values during third trimester Hemoglobin >11 g/dL (110 g/L) Placenta previa an abnormal implantation of the placenta resulting in partial or complete covering of the cervical Hyperemesis gravidarum (HG) severe, persistent nausea and vomiting during pregnancy. Excessive loss of gastric contents leads Indirect Coombs testing screens for Rh sensitization in Rh-negative mothers. If the test results are positive, the fetus and Postpartum hemorrhage defined as maternal blood loss of >500 mL after a vaginal birth or >1000 mL after a cesarean Uterine atony Excessive postpartum bleeding is most commonly caused by uterine atony. fundus is elevated Signs of pregnancy Subjective (presumptive) Are self-reported by a client. This client's symptoms could originate from pathologic causes (eg, Objective (probable) • Uterine & cervical changes o Goodell sign o Chadwick sign o Hegar sign o Uterine enlargement • Braxton Hicks contractions • Ballottement • Fetal outline palpation • Uterine & funic souffle • Skin pigmentation changes o Chloasma o Linea nigra o Areola darkening • Striae gravidarum • Positive pregnancy tests Positive (diagnostic) • Fetal heartbeat heard with Doppler device Iron deficiency anemia common complication during pregnancy. Discomfort of pregnancy Constipation is a common. It is best treated with 10-12 cups of fluid daily, a high-fiber diet/supplementation, and regular exercise. Pyrosis, or heartburn. Lifestyle changes to reduce symptoms include maintaining an upright Morning sickness- characterized by nausea with or without vomiting, is a common problem Prescriptions are contraindicated in pregnancy Doxycycline- can impair bone mineralization in the fetus Uterotonic drugs eg, oxytocin [Pitocin]) are used to induce or augment labor and to stop postpartum hemorrhage Preterm birth defined as birth before 37 weeks and 0 days gestation. Infection (eg, periodontal disease, urinary Zika infection in a pregnant woman can cause birth defects and developmental dysfunction. Current guidelines Naegele's rule Provides a quick determination of the estimated date of birth (EDB). EDB = (LMP - 3 months) + 7 days. Urinary tract infection (UTI) Most common bacterial infection during pregnancy Postpartum endometritis Fever >100.4, chills, tachycardia, uterine tenderness, and foul-smelling lochia Oligohydramnios a condition characterized by low amniotic fluid volume Amniotic fluid is produced by the fetal kidney and serves 2 major purposes - to prevent cord Pulmonary embolism (PE) Pregnancy is a hypercoagulable state that provides protection from hemorrhage after birth, but also greatly augments risk of thrombus formation. Measles-mumps-rubella (MMR) is a live attenuated vaccine. Live vaccines are contraindicated in pregnancy due to the HIV infection Transmission of HIV infection from mother to baby can occur during antepartum, intrapartum, or postpartum periods. Postpartum depression May feel intense and persistent irritability, anxiety, anger, guilt, and sadness. Such feelings Postpartum blues ("baby blues") is a common, milder form of depression characterized by emotional lability, sadness, anxiety, and difficulty sleeping. Nutrition Pregnant clients should avoid deli meats and hot dogs (unless steaming hot), liver, unpasteurized Supine hypotensive syndrome usually seen in the third trimester of pregnancy when the weight of the uterine contents Preeclampsia Complications Hydralazine (Apresoline), methyldopa (Aldomet), or labetalol (Trandate) is used to lower blood - Placental abruption is a possible complication can be life-threatening to mother and baby. It occurs when the placenta tears away from the wall pain, uterine contractions, uterine rigidity, and dark red vaginal bleeding. Tachysystole (ie, - HELLP a more serious condition indicated by elevated liver enzymes (Hemolysis, Elevated Liver enzymes, Low Platelets). This client will need additional laboratory - Eclampsia Seizures are a potential complication of worsening preeclampsia, also known as eclampsia Magnesium sulfate a central nervous system depressant used to prevent/control seizure activity in Gestational hypertension new-onset high blood pressure (≥140/90 mm Hg) that occurs after 20 weeks gestation without Mastitis a common infection in postpartum women due to multiple risk factors leading to inadequate milk Pica the constant craving for and consumption of nonfood and/or nonnutritive food substances that GTPAL system G - gravida indicates the number of pregnancies, delivered or undelivered T - term deliveries are from 37 wk 0 days and beyond P - preterm deliveries are from 20 wk 0 days to 36 wk 6 days gestation A - abortions (spontaneous or elective) occur prior to 20 wk 0 days gestation L - living children are counted individually regardless of multiple birth status. Fetal tachycardia is a baseline of >160 beats/min for >10 minutes. Tachycardia needs evaluation and continued Breast engorgement often painful, and the following treatments are recommended to relieve discomfort: Genital herpes simplex virus (HSV) Painful genital lesions can be indicative of an outbreak. are a priority assessment finding to report The fundus rises above the symphysis pubis at approximately 12 weeks gestation, Toxoplasmosis A parasitic infection acquired by exposure to infected cat feces or ingestion of undercooked meat