High-Risk Pregnancy Factors Quiz
46 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which factor falls under the biophysical category of high-risk pregnancy?

  • Emotional distress
  • Abnormal placental attachment (correct)
  • Inadequate support system
  • Advanced maternal age

    • A pregnant patient who smokes heavily throughout their pregnancy is categorized as high risk, due to which factor?

  • Sociodemographic
  • Genetic
  • Psychosocial (correct)
  • Biophysical

    • Which situation is considered a sociodemographic risk factor in pregnancy?

  • History of preterm labor
  • Domestic violence
  • Patient under the age of 15 (correct)
  • Chronic hypertension

    • Which of the following is the MOST accurate definition of a high-risk pregnancy?

    <p>Any pregnancy where potential factors could negatively impact the health of the mother, the baby, or both. (A)</p> Signup and view all the answers

    Which of the following may classify a pregnancy as 'high risk'?

    <p>History of alcohol consumption (A)</p> Signup and view all the answers

    What is the primary recommendation for women with pre-existing diabetes who are planning to become pregnant?

    <p>Schedule a preconception visit to assess glycemic control. (A)</p> Signup and view all the answers

    A pregnant woman has pregestational diabetes. Which of the following fetal risks is most closely associated with this condition?

    <p>Delayed lung maturation (D)</p> Signup and view all the answers

    Why do pregnant women develop gestational diabetes mellitus?

    <p>The placenta produces insulin-resistant hormones. (A)</p> Signup and view all the answers

    Which of the following is an appropriate screening procedure for gestational diabetes mellitus?

    <p>1-hour glucose tolerance test (GTT) without fasting, followed by a 3-hour GTT if elevated (A)</p> Signup and view all the answers

    A woman with gestational diabetes is at an increased risk for needing a C-section due to:

    <p>Baby growing too fast and the development of macrosomia. (A)</p> Signup and view all the answers

    Which of the following factors is considered an environmental factor contributing to spontaneous abortion?

    <p>Exposure to radiation (B)</p> Signup and view all the answers

    A patient presents with vaginal bleeding, a closed cervical os, and confirmed fetal cardiac activity. Which type of abortion is most likely occurring?

    <p>Threatened abortion (A)</p> Signup and view all the answers

    Which finding is most indicative of an inevitable abortion?

    <p>Dilated cervical os with vaginal bleeding (C)</p> Signup and view all the answers

    After experiencing heavy vaginal bleeding and severe cramping, a patient passes some, but not all, fetal tissue. The cervical os is dilated. This is most consistent with which type of abortion?

    <p>Incomplete abortion (D)</p> Signup and view all the answers

    A patient who has completely expelled the products of conception would be classified as having which type of abortion?

    <p>Complete (D)</p> Signup and view all the answers

    Which of the following best describes a 'missed abortion'?

    <p>No vaginal bleeding, a closed cervical os, and no fetal cardiac activity. (C)</p> Signup and view all the answers

    What is the defining characteristic of cervical insufficiency?

    <p>Premature dilation of the cervix in the absence of contractions (B)</p> Signup and view all the answers

    Which of the following is a recommended management strategy for cervical insufficiency?

    <p>Cerclage placement to reinforce the internal os (B)</p> Signup and view all the answers

    A patient with recurrent pregnancy loss due to cervical insufficiency is being considered for cerclage. What is an important risk associated with this procedure?

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

    A patient is diagnosed with cervical insufficiency at 20 weeks gestation. Besides cerclage placement, what other conservative management options should initially be discussed?

    <p>Strict bed rest and pelvic rest (B)</p> Signup and view all the answers

    Which of the following interventions is NOT typically associated with managing shoulder dystocia?

    <p>Fundal pressure (A)</p> Signup and view all the answers

    A labor that completes in under three hours is referred to as which of the following?

    <p>Precipitous labor (A)</p> Signup and view all the answers

    What is the primary rationale for emptying the bladder during the management of shoulder dystocia?

    <p>To create more space in the pelvis and aid fetal descent (D)</p> Signup and view all the answers

    Which of the following fetal presentations is most likely to cause labor dystocia?

    <p>Left Occiput Posterior (LOP) (B)</p> Signup and view all the answers

    What clinical sign is most indicative of shoulder dystocia during delivery?

    <p>Turtle sign (A)</p> Signup and view all the answers

    A macrosomic infant is defined as weighing more than:

    <p>4000-4500 g (B)</p> Signup and view all the answers

    A patient at 30 weeks gestation presents with complaints of low back ache, pelvic pressure, and vaginal discharge. Which test would be most helpful in determining risk of preterm delivery?

    <p>Fetal Fibronectin (fFN) (A)</p> Signup and view all the answers

    What is the primary mechanism by which hydramnios can lead to hypotonic uterine dysfunction?

    <p>Uterine overdistention (D)</p> Signup and view all the answers

    A pregnant patient presents with a blood pressure of 150/95 mmHg and 1+ proteinuria at 24 weeks gestation. Which condition is most likely?

    <p>Mild preeclampsia (D)</p> Signup and view all the answers

    Which assessment finding differentiates severe preeclampsia from mild preeclampsia?

    <p>Blood pressure of 160/110 mmHg (A)</p> Signup and view all the answers

    A pregnant patient with preeclampsia reports epigastric pain. What is the most concerning potential cause of this symptom?

    <p>Liver or kidney damage (HELLP syndrome) (C)</p> Signup and view all the answers

    A patient diagnosed with chronic hypertension is at what point during the pregnancy?

    <p>Diagnosed before pregnancy or within the first 20 weeks of gestation. (B)</p> Signup and view all the answers

    Which intervention is most appropriate for a pregnant patient experiencing hyperemesis gravidarum who is initially unable to tolerate oral intake?

    <p>Maintaining NPO status initially and providing intravenous hydration (A)</p> Signup and view all the answers

    What instruction should be included in the teaching plan for a client with mild preeclampsia who is being managed at home?

    <p>Monitor fetal kick counts daily. (A)</p> Signup and view all the answers

    A pregnant patient at 35 weeks' gestation is diagnosed with severe preeclampsia. What is the priority intervention?

    <p>Prepare the patient for delivery. (A)</p> Signup and view all the answers

    Which of the following assessment findings is indicative of severe preeclampsia?

    <p>Blurred vision and hyperreflexia (D)</p> Signup and view all the answers

    During an assessment of a patient with severe preeclampsia, the nurse observes rhythmic muscle contractions and relaxation in the patient's ankle when the foot is dorsiflexed. How should the nurse document this finding?

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

    What is the primary difference between gestational hypertension and preeclampsia?

    <p>Preeclampsia includes proteinuria, while gestational hypertension does not. (D)</p> Signup and view all the answers

    What is the primary characteristic of painless bleeding in a pregnant woman?

    <p>Painless, bright red bleeding (A)</p> Signup and view all the answers

    What is the recommended management for a pregnant woman diagnosed with placenta previa?

    <p>Bedrest and monitoring per doctor's order (C)</p> Signup and view all the answers

    What type of bleeding is associated with placenta abruption?

    <p>Painful, dark red blood (C)</p> Signup and view all the answers

    What is the first action to take when an amniotic fluid embolism occurs?

    <p>Prepare for an emergency Cesarean section (A)</p> Signup and view all the answers

    In which situation is amnioinfusion absolutely contraindicated?

    <p>When there is vaginal bleeding or cord prolapse (A)</p> Signup and view all the answers

    Which risk is associated with the use of forceps during delivery?

    <p>Neonatal injury (D)</p> Signup and view all the answers

    What is a significant symptom of uterine rupture?

    <p>Sudden and severe abdominal pain (A)</p> Signup and view all the answers

    What is a primary factor that increases the risk of cord prolapse during delivery?

    <p>Fetal presentation in breech position (D)</p> Signup and view all the answers

    Flashcards

    High risk pregnancy

    Pregnancy with factors that can jeopardize the baby's or mom's life.

    Biophysical complications

    Health issues related to the body affecting pregnancy.

    Psychosocial complications

    Behavioral and social factors impacting pregnancy outcomes.

    Sociodemographic factors

    Socioeconomic factors affecting pregnancy risks.

    Signup and view all the flashcards

    Examples of Biophysical issues

    Genetic conditions, chronic health issues, multiple pregnancies.

    Signup and view all the flashcards

    Environmental Factors

    Elements that can cause health risks, like pollution and smoking.

    Signup and view all the flashcards

    Missed Abortion

    Pregnancy loss without vaginal bleeding or fetal heart activity; cervix closed.

    Signup and view all the flashcards

    Threatened Abortion

    Vaginal bleeding present, but fetal heart activity noted; cervix closed.

    Signup and view all the flashcards

    Inevitable Abortion

    Vaginal bleeding and dilated cervix with products of conception at the cervix.

    Signup and view all the flashcards

    Incomplete Abortion

    Vaginal bleeding and dilated cervix with some tissue retained in the uterus.

    Signup and view all the flashcards

    Complete Abortion

    Vaginal bleeding with a closed cervix; all products of conception expelled.

    Signup and view all the flashcards

    Habitual Abortion

    A history of two or more spontaneous abortions in a patient.

    Signup and view all the flashcards

    Cervical Insufficiency

    Premature dilation of the cervix without contractions, usually before 37 weeks.

    Signup and view all the flashcards

    Management for Cervical Insufficiency

    Includes bedrest, pelvic rest, and possible cerclage for protection.

    Signup and view all the flashcards

    Cervical Cerclage

    A surgical suture to reinforce the cervix during pregnancy to prevent loss.

    Signup and view all the flashcards

    Pregestational Diabetes Mellitus

    A more serious form of diabetes occurring before pregnancy, associated with higher risks.

    Signup and view all the flashcards

    Glycemic Level Target

    Women with diabetes should maintain a glycemic level under 6.5 before pregnancy to reduce risks.

    Signup and view all the flashcards

    Maternal Risks of Diabetes

    Includes kidney damage, cardiovascular issues, and risks of preeclampsia and C-section.

    Signup and view all the flashcards

    Fetal Risks of Diabetes

    Includes miscarriage, congenital anomalies, and underdeveloped lungs.

    Signup and view all the flashcards

    Gestational Diabetes Mellitus

    A common form of diabetes arising during pregnancy, typically diagnosed around 24-28 weeks.

    Signup and view all the flashcards

    Decreased uterine contractions

    A reduction in the frequency and intensity of uterine contractions, which can indicate complications during labor.

    Signup and view all the flashcards

    Precipitous labor

    Labor that occurs in less than 3 hours, often very painful and leading to risks like hypoxia in the baby.

    Signup and view all the flashcards

    Macrosomia

    A condition where the baby weighs more than 4000-4500 g, often linked to diabetic mothers.

    Signup and view all the flashcards

    Shoulder dystocia

    A delivery complication where the baby's shoulders get stuck behind the mother's pubic bone, creating an emergency situation.

    Signup and view all the flashcards

    McRoberts maneuver

    A technique used in shoulder dystocia where the mother's legs are flexed and abducted to relieve pressure.

    Signup and view all the flashcards

    Suprapubic pressure

    Light pressure applied above the pubic bone to help dislodge a stuck shoulder during delivery.

    Signup and view all the flashcards

    Factors for decreased contractions

    Causes include overstretching due to large fetus, multiple fetuses, and high amniotic fluid levels.

    Signup and view all the flashcards

    Fetal Fibronectin (fFN)

    A glycoprotein test predicting premature delivery in pregnant women with symptoms between 22 and 35 weeks.

    Signup and view all the flashcards

    Placenta previa

    A pregnancy complication where the placenta covers the cervix, risking bleeding.

    Signup and view all the flashcards

    Diagnosis of placenta previa

    Placenta previa is diagnosed using an ultrasound.

    Signup and view all the flashcards

    Management of placenta previa

    Bedrest and monitoring per doctor's orders are critical to managing placenta previa.

    Signup and view all the flashcards

    Placenta abruption

    A serious condition where the placenta separates from the uterus prematurely, leading to painful bleeding.

    Signup and view all the flashcards

    Symptoms of uterine rupture

    The primary symptom is severe pain; immediate intervention is needed.

    Signup and view all the flashcards

    Amniotic fluid embolism

    A rare condition that can lead to sudden cardiac collapse with high mortality risk.

    Signup and view all the flashcards

    Indications for amnioinfusion

    Amnioinfusion is indicated in cases of meconium, oligohydramnios, or variable decelerations.

    Signup and view all the flashcards

    Forceps delivery

    Instrumental delivery indicated for prolonged labor or fetal distress, with risks of injuries.

    Signup and view all the flashcards

    NPO

    Nothing by mouth; patients should not eat or drink initially.

    Signup and view all the flashcards

    Chronic Hypertension

    High blood pressure existing before pregnancy or before 20 weeks gestation.

    Signup and view all the flashcards

    Gestational Hypertension

    High blood pressure developing after 20 weeks of pregnancy with no proteinuria.

    Signup and view all the flashcards

    Preeclampsia

    High blood pressure after 20 weeks gestation with protein in urine.

    Signup and view all the flashcards

    Mild Preeclampsia

    BP between 140/90 and 160/100 with low-grade proteinuria.

    Signup and view all the flashcards

    Severe Preeclampsia

    BP > 160/110 with significant proteinuria and severe symptoms.

    Signup and view all the flashcards

    Eclampsia

    Seizures occurring in a patient with preeclampsia.

    Signup and view all the flashcards

    Preeclampsia Triad

    The classic symptoms: proteinuria, rising BP, and dependent edema.

    Signup and view all the flashcards

    Dependent Edema

    Swelling in body parts influenced by gravity, like legs or arms.

    Signup and view all the flashcards

    Physical Exam for Preeclampsia

    Includes 24-hour urine collection, blood tests, and BP monitoring.

    Signup and view all the flashcards

    Study Notes

    Nursing Management of Pregnancy at Risk

    • High-risk pregnancy involves factors jeopardizing the baby, mother, or both. Four categories include biophysical (e.g., genetic conditions, multiples, chronic HTN, diabetes, abnormal placenta), psychosocial (e.g., smoking, substance use, domestic violence, poor support system), sociodemographic (e.g., poverty, teenage pregnancy, advanced maternal age, low education), and environmental (e.g., infections, pollutants, radiation).

    Types of Miscarriages

    • Missed: No vaginal bleeding, closed cervical os, no fetal cardiac activity or empty sac.
    • Threatened: Vaginal bleeding, closed cervical os, fetal cardiac activity present.
    • Inevitable: Vaginal bleeding, dilated cervical os, products of conception may be seen or felt at or above the cervical os.
    • Incomplete: Vaginal bleeding, dilated cervical os, some products of conception expelled, some remain.
    • Complete: Vaginal bleeding, closed cervical os, complete expulsion of products of conception.
    • Habitual abortion: 2 or more spontaneous abortions.

    Spontaneous Abortion Assessment

    • Threatened: Possible mild cramps, spotting to moderate bleeding, closed cervix.
    • Inevitable: Moderate to severe cramps, mild to severe bleeding, dilated cervix.
    • Incomplete: Severe cramps, heavy, profuse bleeding, partial fetal tissue/placenta, dilated cervix.
    • Complete: Mild cramps, minimal bleeding, complete expulsion of tissue, closed cervix.
    • Missed: No bleeding, closed cervix, no fetal tissue.
    • Septic: Varies, varies, usually dilated.
    • Recurrent: Varies, Yes, Usually dilated.

    Cervical Insufficiency

    • Premature dilation of the cervix in the absence of contractions.
    • Often presents before 37 weeks with painless, passive dilation, pelvic pressure, or backache.
    • History of recurrent pregnancy loss, prior cervical disease, or trauma are risk factors
    • Management includes bedrest, pelvic rest, no lifting, and follow-up visits with transvaginal ultrasounds to measure cervical length. Cerclage, which is a suture to reinforce the internal opening, may be performed, but not usually in the first trimester.

    Ectopic Pregnancy

    • Fertilized ovum implants outside the uterine cavity, usually in the fallopian tube.
    • Occurs in approximately 1 in 50 pregnancies.
    • Third most common pregnancy related cause of death in the US.
    • Risk factors include previous pelvic inflammatory disease, previous ectopic pregnancies, and tubal scarring or infection.
    • Medical management with methotrexate may be possible, otherwise management is surgical (salpingectomy or salpingostomy if rupture)

    Placenta Previa

    • Placenta implants below the baby, covering the cervical opening.
    • Types:
      • Marginal: Placenta is near opening, bleeding a possibility.
      • Partial: Placenta partially covering the opening.
      • Complete: Placenta completely covering the opening.
    • Complete previa can cause profuse bleeding.
    • Women with previa cannot deliver vaginally.
    • Diagnosis made by ultrasound.

    Placenta Abruption

    • Detachment of the placenta prior to birth.
    • Characterized by dark red blood, painful contractions, and a rigid abdomen
    • Not to be confused with placenta previa.

    Hyperemesis Gravidarum

    • Persistent projectile vomiting, weight loss greater than 5% of pre-pregnancy weight, and electrolyte imbalance.
    • Extremely severe, can last for long periods (and even throughout the pregnancy)
    • Requires hospitalization, hydration, and medication to control the vomiting.

    Classification of Hypertensive Disorders in Pregnancy

    • Chronic HTN: High blood pressure prior to or within the first 20 weeks of pregnancy.
    • Gestational HTN: High blood pressure that develops after 20 weeks of pregnancy without protein in your urine.
    • Preeclampsia: Higher BP (greater than 140/90) often accompanied by protein in the urine, presence of edema. Can also involve other organ systems.
    • Preeclampsia with severe features: Higher blood pressure (≥160/110) plus other complications (e.g., organ dysfunction, headache).
    • Eclampsia: Seizures resulting from preeclampsia.

    Preeclampsia

    • Preeclampsia is characterized by high blood pressure and signs of damage to another organ system during pregnancy.
    • It usually begins after 20 weeks of pregnancy in women whose blood pressure was previously normal.

    Anemia

    • Defined as hemoglobin levels below 11 for the 1st and 3rd trimesters and below 10.5 for the 2nd trimester.
    • Physiological anemia is a normal response to hemodilution, but pathological anemia requires attention.
    • Increased iron-rich foods, including meat, beans, green leafy vegetables, and fortified grains, supports prevention and treatment of anemia.

    Infections in Pregnancy

    • TORCH infections: Toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex virus, are prenatal screening consideration.
    • Some of these infections can be passed to the baby.

    Prolonged Pregnancy

    • Pregnancy lasting more than 42 weeks gestation.
    • Risk of problems for the baby (e.g., decreased placental perfusion, amniotic fluid decrease)
    • Risk for the mother (e.g., increased risk of C-section, increased pain and risk, uterine rupture).
    • Assessment (e.g., NST, fetal movement counts, cervix check; for prolonged pregnancies)

    Dystocia

    • Abnormal or difficult labor
    • Risks associated include problems with the 5 Ps: Powers, passenger, passageway, psyche, and position
    • May require augmentation (medical procedures) of labor or C/S.

    Precipitous Labor

    • Labor that progresses exceedingly fast, usually less than 3 hours.
    • May result in complications for both the mother and fetus (injury, injury, difficulty).

    Other potential complications

    • Uterine Rupture: A rupture of the uterus during pregnancy or labor.
    • Cord prolapse: The umbilical cord is partially or fully expelled before the baby.
    • Amniotic fluid embolism: A sudden and severe life-threatening complication of pregnancy.

    Types of Cesarean Birth

    • Low transverse incision and vertical incision are the two main types.
    • Low transverse incisions may be ideal for vaginal birth after cesarean
    • Choosing the site and type of uterine incision is individualized.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Week 4 Class 1: Antepartum Complications PDF

    Description

    Test your knowledge on high-risk pregnancy factors, including biophysical, sociodemographic, and environmental influences. This quiz explores conditions such as gestational diabetes and pregestational diabetes, as well as lifestyle factors impacting pregnancy outcomes. Dive into the definition and classifications of high-risk pregnancies.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser