Obstetrics and Gynecology Quiz
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Questions and Answers

What are the signs and symptoms of hyperemesis gravidarum?

  • Frequent urination and back pain
  • Nausea, vomiting, and dehydration (correct)
  • Excessive weight gain
  • High blood pressure and protein in the urine

    • What is the main difference between placenta previa and placental abruption?

  • Placenta previa is a more serious condition than placental abruption
  • Placenta previa is a condition where the placenta is implanted too low in the uterus, while placental abruption is a condition where the placenta detaches from the uterine wall (correct)
  • Placenta previa is a painless bleeding, while placental abruption is often accompanied by pain
  • Placenta previa occurs in the first trimester, while placental abruption occurs in the third trimester

    • Which of the following is NOT a cause of pregnancy bleeding?

  • Preeclampsia (correct)
  • Cervical insufficiency
  • Ectopic pregnancy
  • Miscarriage

    • What is the management for a hydatidiform mole?

    <p>Dilation and curettage (A)</p> Signup and view all the answers

    What is the most appropriate treatment for a cervical insufficiency?

    <p>Cerclage (C)</p> Signup and view all the answers

    What is the best way to manage an ectopic pregnancy?

    <p>Surgical removal (A)</p> Signup and view all the answers

    Which of these is a possible complication of a miscarriage?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the leading cause of maternal death, as mentioned in the provided content?

    <p>Abruptio Placentae (C)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for Placenta Previa?

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

    What is the most common type of hypertensive disorder in pregnancy?

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

    What is a key clinical manifestation of Abruptio Placentae?

    <p>Sudden onset of intense localized uterine pain (A)</p> Signup and view all the answers

    What is the main management approach for Placenta Previa?

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

    Which of the following is a distinguishing characteristic of Preeclampsia?

    <p>Presence of proteinuria (D)</p> Signup and view all the answers

    What is a common symptom of severe preeclampsia?

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

    Which condition is characterized by detachment of the placenta from the implantation site after 20 weeks of gestation?

    <p>Abruptio Placentae (C)</p> Signup and view all the answers

    What is a potential complication associated with Abruptio Placentae?

    <p>DIC (Disseminated Intravascular Coagulation) (A)</p> Signup and view all the answers

    What is the primary pathophysiological mechanism responsible for preeclampsia?

    <p>Vasoconstriction and vasospasm (A)</p> Signup and view all the answers

    What is the main management approach for Abruptio Placentae?

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

    Which of the following conditions is a variant of gestational hypertension and involves hepatic dysfunction?

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

    What is the most concerning sign that indicates a possible progression from preeclampsia to eclampsia?

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

    Which of the following is NOT a common assessment parameter used to evaluate a patient with preeclampsia?

    <p>Electrolyte levels (C)</p> Signup and view all the answers

    What is the primary goal of treatment for preeclampsia and gestational hypertension without severe features?

    <p>Ensure maternal safety and a healthy newborn (A)</p> Signup and view all the answers

    What is the typical timeframe for screening for Gestational Diabetes Mellitus (GDM)?

    <p>24-28 weeks (C)</p> Signup and view all the answers

    Which medication is NOT typically used for Hyperemesis Gravidarum?

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

    What are the major risk factors for developing Gestational Diabetes Mellitus?

    <p>Obesity, Family history of diabetes, Prior history of GDM (C)</p> Signup and view all the answers

    What is the common treatment for Cervical Insufficiency?

    <p>Bed rest, pelvic rest, avoidance of heavy lifting, progesterone supplementation, and cervical cerclage. (A)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for developing Hyperemesis Gravidarum?

    <p>Pregnant with female fetus (C)</p> Signup and view all the answers

    What is the primary concern with treating Pre-existing Diabetes with Insulin in the second half of pregnancy?

    <p>Increased risk of hyperglycemia (B)</p> Signup and view all the answers

    Which of the following is a characteristic of both Pregestational and Gestational Diabetes?

    <p>Increased risk of hypoglycemia after birth (A), Increased risk of polyhydramnios (C), Increased risk of hyperglycemia in the second half of pregnancy (D)</p> Signup and view all the answers

    What is the most critical complication associated with Hyperemesis Gravidarum?

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

    What is the primary reason for inducing labor at 39-40 weeks for women with gestational diabetes?

    <p>To prevent fetal macrosomia and further complications (C)</p> Signup and view all the answers

    A woman who has experienced an ectopic pregnancy is at risk for what complication?

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

    Which of the following is NOT a risk factor for an ectopic pregnancy?

    <p>Use of oral contraceptives (C)</p> Signup and view all the answers

    What is the most common type of gestational trophoblastic disease?

    <p>Hydatidiform mole (A)</p> Signup and view all the answers

    Which of the following is a characteristic symptom of a hydatidiform mole?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary treatment for a hydatidiform mole?

    <p>Suction curettage (C)</p> Signup and view all the answers

    What is a key difference between a miscarriage and an ectopic pregnancy?

    <p>Miscarriages involve a fertilized egg implanting outside the uterus. (C)</p> Signup and view all the answers

    What is a major concern for a woman who has experienced a miscarriage?

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

    Which of the following is a medical intervention used to manage early pregnancy bleeding?

    <p>Dilation and curettage (D&amp;C) (A)</p> Signup and view all the answers

    Which of the following is a symptom of a ruptured ectopic pregnancy?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the role of a transvaginal ultrasound in diagnosing an ectopic pregnancy?

    <p>To detect and locate the implanted egg outside the uterus. (A)</p> Signup and view all the answers

    Study Notes

    Nursing Management of Pregnancy at Risk

    • The presentation covers various high-risk pregnancies, including hyperemesis gravidarum, bleeding complications (miscarriage, ectopic pregnancy, cervical insufficiency, hydatidiform mole, placenta previa, placental abruption), gestational hypertension, preeclampsia, chronic hypertension, and diabetes in pregnancy.
    • Specific learning objectives include understanding management of care for hyperemesis gravidarum, differentiating causes of pregnancy bleeding, various pregnancy complications and their management, and management of pregestational and gestational diabetes, among other conditions.

    Hyperemesis Gravidarum

    • Hyperemesis gravidarum is excessive nausea and vomiting lasting beyond 16 weeks of pregnancy.
    • Risk factors include maternal age under 30, personal or family history of hyperemesis, multiple pregnancies, hyperthyroidism, diabetes, and molar pregnancy.
    • Assessment involves monitoring for excessive vomiting, dehydration/electrolyte imbalance, weight loss, increased heart rate, decreased blood pressure, poor skin turgor, dry mucous membranes, elevated specific gravity in urine, and ketonuria.
    • Management includes IV Lactated Ringers, medications like pyridoxine (B6), doxylamine (Unisom), promethazine (Phenergan), ondansetron (Zofran), and metoclopramide, and, in severe cases, enteral tube feedings or parenteral nutrition.
    • Recommended dietary practices include advancing to clear liquids and bland foods gradually, frequent, small meals, and eating what is palatable.

    Diabetes in Pregnancy

    • Classification: Type 1 (absolute insulin deficiency requiring insulin injections), Type 2 (relative insulin deficiency or resistance), Gestational Diabetes (developed during pregnancy), Pregestational Diabetes (pre-existing type 1 or 2).
    • Pregestational Diabetes (1st Half): Reduced insulin requirement, increased risk of hypoglycemia due to reduced placental function.
    • Pregestational Diabetes (2nd Half): Increased insulin requirement due to placental changes and hormonal shifts; increased risk of hyperglycemia.
    • Gestational Diabetes: Screening typically occurs at 24-28 weeks. Diagnosis utilizes a 1-hour oral glucose screen followed by a 3-hour oral glucose tolerance test (OGTT) if indicated.
    • Nursing Assessment: Includes classic symptoms (3Ps - polyuria, polydipsia, polyphagia), infections (UTIs, yeast infections), polyhydramnios (extra fluid in uterus), and routine urine screening; glucose tolerance tests.
    • Nursing Care and Management: Patient education, blood sugar monitoring, and possible dietary modifications or insulin administration, as needed.

    Cervical Insufficiency

    • Cervical insufficiency is premature dilation of the cervix during pregnancy, resulting in premature labor or pregnancy loss, typically occurring in the second or early third trimester.
    • Risk factors include history of cervical trauma or surgery, history of preterm delivery, and a short cervix.
    • Interventions include bed rest, pelvic rest, avoidance of heavy lifting, progesterone supplementation, or cervical cerclage to maintain pregnancy until term.

    Bleeding and Loss of Pregnancy

    • Early Pregnancy Bleeding (Miscarriage): A pregnancy loss due to natural causes before fetal viability (20 weeks or 500 grams).
    • Assessment involves assessing pregnancy history, vital signs, pain levels, amount and type of bleeding, and related lab values (e.g., HCG, CBC, clotting factors).
    • Potential interventions include monitoring for hemorrhage, infection, and psychological support, as well as possible necessary procedures like IVF, blood products, or D&C.
    • Follow-up care includes rest, avoiding strenuous activities, monitoring for bleeding, foul-smelling discharge or signs of infection, and receiving prescribed antibiotics.

    Ectopic Pregnancy

    • An ectopic pregnancy occurs when a fertilized egg implants outside the uterus (most commonly in the fallopian tubes).
    • Risk factors include sexually transmitted infections (STIs), intrauterine devices (IUDs), previous tubal surgeries, and scar tissue.
    • Clinical manifestations comprise unilateral lower quadrant pain (sharp stabbing, shooting), delayed menses, abnormal vaginal bleeding, palpable unilateral mass, low hCG levels, and/or rigid and tender abdomen.
    • Management includes determining hCG and progesterone levels, transvaginal ultrasound, and possibly methotrexate treatment in early stages, or surgical intervention (salpingostomy or salpingectomy).

    Placenta Previa

    • The placenta is implanted near or over the cervix.
    • Risk factors include previous C-sections, uterine scarring, prior placenta previa, advanced maternal age, multiparity, and smoking.
    • Clinical presentation often involves painless, bright red vaginal bleeding, especially during the second and third trimesters.
    • Outcomes may include delivery via C-section (if full term or excessive bleeding in active labor).

    Placental Abruption

    • The premature separation of the placenta from the uterine wall.
    • Risk factors include maternal hypertension, preeclampsia, cocaine use, smoking, blunt trauma, and history of placental abruption.
    • Symptoms include localized uterine pain, uterine rigidity, dark red vaginal bleeding (concealed or apparent), and rapid onset of maternal shock and fetal distress.
    • Management focuses on immediate delivery (usually C-section), supportive care for maternal hemodynamic stability (blood replacement), lab work, and monitoring for DIC.

    Hypertension Disorders

    • Hypertension disorders in pregnancy include Chronic Hypertension, Gestational Hypertension and Preeclampsia.
    • Preeclampsia includes new onset hypertension and proteinuria after 20 weeks gestation

    HELLP Syndrome

    • HELLP Syndrome is a variant of preeclampsia characterized by Hemolysis, Elevated Liver enzymes (ALT, AST), and Low Platelets (thrombocytopenia).
    • This potentially serious complication presents similarly to preeclampsia but requires immediate medical intervention because of the greater risk of complications (possibly requiring immediate birth, possibly requiring blood transfusions, among other actions).

    Eclampsia

    • Eclampsia is the development of seizure activity or coma in a woman with severe preeclampsia.
    • Assessment involves frequent blood pressure monitoring, dipstick urinalysis for protein, monitoring for edema in hands, face, arms and/or legs.
    • Interventions focus on immediate care(checking airway, and calling for help).

    Magnesium Sulfate

    • Magnesium Sulfate is used to prevent or treat seizures associated with preeclampsia/eclampsia.
    • It involves administration via IV for prevention and treatment.

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    Nursing Management of Pregnancy at Risk PDF

    Description

    Test your knowledge on management and complications of various pregnancy-related conditions including hyperemesis gravidarum, placenta previa, and preeclampsia. Evaluate your understanding of signs, symptoms, and treatment strategies for these critical aspects of obstetrics. This quiz covers crucial concepts for medical professionals and students alike.

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