Complications of Pregnancy Quiz
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Questions and Answers

Which of these is a possible cause of a first-trimester spontaneous miscarriage?

  • Inadequate endometrial formation (correct)
  • Successful implantation
  • Absence of teratogenic factors
  • Normal fetal development

    • What is the definition of a viable fetus?

  • A fetus that has reached the age of 16 weeks gestation
  • A fetus that is capable of surviving outside the womb without medical assistance
  • A fetus that has reached the age of 24 weeks gestation and weighs at least 500 g (correct)
  • A fetus that has reached the age of 20 weeks gestation and weighs at least 1 kg

    • What is the term for a planned medical termination of a pregnancy?

  • Induced labor
  • Elective abortion (correct)
  • Miscarriage
  • Spontaneous abortion

    • Which of these is NOT a systemic infection that can cause a spontaneous miscarriage?

    <p>HIV (B)</p> Signup and view all the answers

    What is the most common cause of spontaneous miscarriage?

    <p>Abnormal fetal development (C)</p> Signup and view all the answers

    Which of these medications is known to be a teratogenic drug that can cause spontaneous miscarriage?

    <p>Isotretinoin (Accutane) (A)</p> Signup and view all the answers

    Which of these is NOT a symptom associated with spontaneous miscarriage?

    <p>Severe back pain (B)</p> Signup and view all the answers

    What is the term for the tissue from a pregnancy that has been removed from the uterus?

    <p>Products of conception (A)</p> Signup and view all the answers

    What is the role of progesterone in maintaining a pregnancy?

    <p>Progesterone helps to maintain the uterine lining (B)</p> Signup and view all the answers

    What is the most likely cause of the inability to retain food and fluids in a high-risk pregnancy?

    <p>Persistent nausea and vomiting (D)</p> Signup and view all the answers

    During the initial 48 hours of treatment for hyperemesis gravidarum, what is the recommended dietary approach?

    <p>Nothing by mouth (NPO) (D)</p> Signup and view all the answers

    What is the primary goal of replacing parenteral fluids, electrolytes, and vitamins in the treatment of hyperemesis gravidarum?

    <p>To correct dehydration and electrolyte imbalances (B)</p> Signup and view all the answers

    In severe cases of hyperemesis gravidarum, what might be necessary for extended nutritional support?

    <p>Placement of a central line for total parenteral nutrition (TPN) or lipids (D)</p> Signup and view all the answers

    What is the recommended frequency of meals after the initial NPO phase of hyperemesis gravidarum treatment?

    <p>Six small meals with liquid nourishment every one to two hours (D)</p> Signup and view all the answers

    What is the significance of monitoring weight loss in a high-risk pregnancy due to hyperemesis gravidarum?

    <p>It indicates the severity of the condition and the need for medical intervention (B)</p> Signup and view all the answers

    Why is it important to monitor electrolyte imbalances in hyperemesis gravidarum?

    <p>Electrolytes are essential for maintaining fluid balance, muscle function, and nerve impulse transmission (C)</p> Signup and view all the answers

    Which of the following is NOT a type of shock that can occur during pregnancy?

    <p>Neurogenic shock (A)</p> Signup and view all the answers

    What causes cardiogenic shock during pregnancy?

    <p>Pulmonary embolism, anemia, hypertension, or cardiac disorders (A)</p> Signup and view all the answers

    What is the initial blood pressure change observed in a patient experiencing shock?

    <p>A narrowing pulse pressure (falling systolic and rising diastolic pressure) (D)</p> Signup and view all the answers

    What is the main goal of medical management for shock during pregnancy?

    <p>To increase blood flow to the vital organs (D)</p> Signup and view all the answers

    What happens to the skin and mucous membranes as blood flow to essential organs decreases?

    <p>They become pale, cold, and clammy (B)</p> Signup and view all the answers

    What is the effect of a decrease in blood flow to the kidneys during shock?

    <p>Decreased urine output and eventual stoppage (A)</p> Signup and view all the answers

    What is the primary role of IV fluids in managing shock during pregnancy?

    <p>To maintain circulating volume and replace fluids (B)</p> Signup and view all the answers

    What is the purpose of giving oxygen to a pregnant patient experiencing shock?

    <p>To increase the saturation of remaining blood cells (A)</p> Signup and view all the answers

    What is the significance of assessing urine output in a patient experiencing shock?

    <p>To assess kidney function (B)</p> Signup and view all the answers

    Hypovolemic shock during pregnancy is typically caused by:

    <p>Postpartum hemorrhage or blood clotting disorders (C)</p> Signup and view all the answers

    What are the main nursing interventions for the prevention of thrombi in pregnant women?

    <p>Encourage early ambulation or range of motion, and antiembolic stockings are indicated if varicose veins are present. (D)</p> Signup and view all the answers

    What is the primary treatment for Pulmonary Embolism (PE)?

    <p>Anticoagulants and observation in an ICU. (D)</p> Signup and view all the answers

    Which of the following are clinical manifestations of Pulmonary Embolism (PE)?

    <p>Sudden chest pain, cough, dyspnea, and decreased level of consciousness. (A)</p> Signup and view all the answers

    What nursing care measures should be implemented for a patient in anticoagulant therapy?

    <p>Teach the patient about potential signs of excessive anticoagulation, and use soft toothbrushes to prevent bleeding. (C)</p> Signup and view all the answers

    What is a potential complication of PE?

    <p>Congestive heart failure. (B)</p> Signup and view all the answers

    What is a key characteristic of a threatened miscarriage?

    <p>Painless vaginal bleeding (B)</p> Signup and view all the answers

    When a woman experiences inevitable miscarriage, what is the typical management approach?

    <p>Induction of labor with prostaglandins and oxytocin (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended management step for a woman experiencing inevitable miscarriage?

    <p>Uterine camping (A)</p> Signup and view all the answers

    What is the typical time frame for a miscarriage to occur spontaneously if it is not actively terminated?

    <p>Within 2 weeks (C)</p> Signup and view all the answers

    What is the primary purpose of performing a D&E in a woman experiencing inevitable miscarriage?

    <p>To ensure that all products of conception are removed (C)</p> Signup and view all the answers

    Which of the following medications is commonly used to dilate the cervix during the management of inevitable miscarriage?

    <p>Misoprostol (Cytotec) (B)</p> Signup and view all the answers

    What is a significant complication that can arise during a miscarriage, as mentioned in the content?

    <p>Disseminated intravascular coagulation (DIC) (B)</p> Signup and view all the answers

    Which of the following is a true statement about threatened miscarriage?

    <p>Up to 50% of women with threatened miscarriage continue the pregnancy. (A)</p> Signup and view all the answers

    What is the recommended course of action if a woman experiencing an inevitable miscarriage has tissue fragments passed?

    <p>Save the fragments for analysis and examination. (B)</p> Signup and view all the answers

    If no fetal heart sounds are detected during an ultrasound and the uterus appears empty or contains a nonviable fetus, what is the appropriate next step in management?

    <p>Perform a D&amp;E procedure. (B)</p> Signup and view all the answers

    Flashcards

    High-Risk Pregnancy

    A pregnancy categorized as having factors that increase complications.

    Persistent Nausea and Vomiting

    Inability to retain food and fluids, often severe.

    Weight Loss in Pregnancy

    Significant decrease in weight during pregnancy, indicating risk.

    Dehydration Symptoms

    Loss of body fluids leading to weakness and other issues.

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    Electrolyte Imbalances

    Disruption of normal electrolyte levels in the body, often dangerous.

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    NPO

    Nothing by mouth for a designated time to allow recovery.

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    Total Parenteral Nutrition (TPN)

    Nutrition provided intravenously for patients unable to eat.

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    Pulmonary Embolism (PE)

    A blockage in the pulmonary artery by a blood clot that can cause chest pain, dyspnea, and heart failure symptoms.

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    Symptoms of PE

    Includes sudden chest pain, cough, dyspnea, and decreased consciousness.

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    DVT Treatment

    Treated with anticoagulants, leg elevation, and analgesics; prevents further clot formation.

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    Postpartum Considerations

    Women should avoid leg pressure and early ambulation is encouraged to prevent thrombi after childbirth.

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    Anticoagulant Monitoring

    Teach signs of excessive anticoagulation like prolonged bleeding and easy bruising.

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    High-Risk Pregnancy Effects

    Increases respiratory rate to enhance oxygen circulation.

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    Cardiovascular Shock

    A life-threatening state where the heart can't supply enough blood and oxygen.

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    Narrow Pulse Pressure

    Condition with falling systolic and rising diastolic pressure due to shock.

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    Signs of Shock

    Cold, clammy skin; pale mucous membranes indicating reduced blood flow.

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    Cardiogenic Shock Causes

    Results from pulmonary embolism, anemia, hypertension, or cardiac disorders.

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    Hypovolemic Shock Causes

    Caused by significant blood loss, like postpartum hemorrhage.

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    Anaphylactic Shock

    Shock caused by severe allergic reactions to drugs.

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    Septic Shock

    Shock from severe infections leading to body-wide inflammation.

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    Neurogenic Shock

    Shock due to damage to the nervous system affecting blood flow.

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    Medical Management of Shock

    Includes stopping blood loss, IV fluids, and blood transfusions.

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    Threatened Miscarriage

    A condition where there is vaginal bleeding during early pregnancy but the fetus may still survive.

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    Symptoms of Miscarriage

    Signs indicating potential miscarriage, including painless vaginal bleeding.

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    Imminent Miscarriage

    A stage of miscarriage characterized by active uterine contractions and cervical dilation.

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    Management of Imminent Miscarriage

    Steps taken when a miscarriage is inevitable, including ultrasound and D&E.

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    D&E (Dilation and Evacuation)

    A surgical procedure to remove retained products of conception during a miscarriage.

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    Prostaglandin Suppository

    A medication used to induce labor and dilate the cervix after 4 weeks of pregnancy.

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    Misoprostol (Cytotec)

    A medication used in miscarriage management, typically for cervical dilation.

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    Ultrasound in Miscarriage

    An imaging technique used to confirm fetal demise or an empty uterus during pregnancy issues.

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    Spontaneous Miscarriage

    A natural loss of pregnancy that typically occurs within two weeks if not actively terminated.

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    DIC (Disseminated Intravascular Coagulation)

    A serious complication that can result from a miscarriage, affecting blood clotting.

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    Abnormal Fetal Development

    Most common cause of miscarriage, often due to teratogenic factors or chromosomal aberrations.

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    Corpus Luteum Failure

    When the ovary fails to produce enough progesterone for pregnancy maintenance.

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    Implantation Abnormalities

    Issues with the endometrium or the site of embryo implantation.

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    Systemic Infections

    Infections like rubella or cytomegalovirus that can cause miscarriage.

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    Teratogenic Drugs

    Medications that can cause birth defects if taken during pregnancy.

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    Elective Abortion

    The planned termination of a pregnancy through medical intervention.

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    Vaginal Spotting

    A common symptom of early pregnancy complications, often the first sign.

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    Associated Symptoms

    Physical signs accompanying bleeding, such as cramping or sharp pain.

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    Study Notes

    Complications of Pregnancy

    • High-risk pregnancy is one in which a concurrent disorder, pregnancy-related complication, or external factor compromises the health of the woman, fetus, or both.
    • Factors categorizing a pregnancy as high risk include psychological (e.g., history of drug dependence, mental illness, abuse), social (e.g., low socioeconomic status, lack of support), and physical (e.g., chronic illness, history of poor pregnancy outcomes, or inherited disorders) factors before, during, and after pregnancy.
    • Hyperemesis gravidarum: Excessive nausea and vomiting during pregnancy, resulting in dehydration and electrolyte imbalance. This interferes with food intake.

    Bleeding During Pregnancy

    • Vaginal bleeding: is a deviation from the normal and requires investigation. It can impact pregnancy outcomes and the woman's health.
    • First trimester bleeding disorders:
      • Threatened miscarriage: Vaginal spotting, possibly with slight cramping, and no apparent loss of pregnancy.
      • Imminent (inevitable) miscarriage: Vaginal spotting, cramping, cervical dilation, and incomplete expulsion of uterine contents.
      • Complete miscarriage: Vaginal spotting, cramping, cervical dilation, and complete expulsion of uterine contents.
      • Incomplete miscarriage: Vaginal spotting, cramping, cervical dilation, but incomplete expulsion of uterine contents.
      • Missed miscarriage: Death of the fetus in utero without expulsion.
      • Ectopic pregnancy: Implantation of a fertilized ovum outside the uterus, typically the fallopian tube, causing sudden unilateral lower abdominal quadrant pain, minimal vaginal bleeding, and possible signs of shock or hemorrhage.
      • Gestational trophoblastic disease (Hydatidiform mole): Excessive growth of trophoblast cells, no fetus present, and vaginal bleeding with cyst formation.
    • Second-trimester bleeding disorders:
      • Premature cervical dilation: Cervix begins to dilate, and pregnancy is lost; cervical trauma may be associated.
      • Placenta previa: Low implantation of the placenta, possibly due to uterine abnormalities, causing painless bleeding.
      • Abruptio placentae: Premature separation of the placenta from the uterus, resulting in sharp abdominal pain, uterine tenderness, vaginal bleeding, possible maternal shock, and fetal distress.
    • Third-trimester bleeding disorders:
      • Preterm labor: Many possible causes. Risk is increased in multiple pregnancies, maternal illness, or cervix problems. This can result in preterm birth if the cervix is dilated less than 4 cm and membranes are intact. Prevention with corticosteroid use to aid lung maturity.

    Emergency Interventions for Bleeding in Pregnancy

    • Alert the medical care provider about the situation immediately.
    • Put the patient in a side-lying position.
    • Start an IV with lactated Ringer's using a 16-18 gauge catheter.
    • Administer oxygen as needed at 6-10 L/min (via a face mask).
    • Monitor and track uterine contractions and fetal heart rate via an external monitor.
    • Avoid vaginal examinations during this time.
    • Do not give any oral fluids.
    • Order blood typing and crossmatching for 2 units of whole blood.
    • Measure intake and output.
    • Monitor the patient's vital signs.

    Spontaneous Miscarriage

    • Occurs in 15-30% of pregnancies from natural causes.
    • Early miscarriage: Before week 16
    • Late miscarriage: Between weeks 16 and 20.
    • Placental attachment degree:
      • First 6 weeks: Tentative attachment
      • Weeks 6-12: Moderate attachment
      • After week 12: Deep and penetrating attachment

    Ectopic Pregnancy

    • Implantation of a fertilized ovum outside the uterine cavity, typically the fallopian tube.

    Medical Management of Pregnancy Complications

    • Threatened Miscarriage: Bed rest, no strenuous activity.
    • Imminent Miscarriage: Dilation and curettage (D&C)/Suction curettage (often needed if the fetus has a nonviable fetal heartbeat).
    • Complete Miscarriage: Spontaneous expulsion of all products of conception; often resolved without intervention.
    • Incomplete Miscarriage: D&C/Suction curettage is often required to remove retained products of conception.
    • Missed Miscarriage: D&C, suction curettage.
    • Gestational Trophoblastic Disease: D&C is needed to remove the abnormal uterine tissues.
    • Premature cervical dilation: Cervical sutures and/or tocolytics (drugs that stop contractions)

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    NCM 109: Maternal & Child Nursing Week 2 PDF

    Description

    Test your knowledge on high-risk pregnancies and related complications. This quiz covers various factors that may categorize a pregnancy as high risk and discusses non-bleeding and bleeding complications during pregnancy. Understand the implications of these conditions for maternal and fetal health.

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