Obstetrics Complications Overview
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Questions and Answers

Which assessment finding is least indicative of a spontaneous abortion?

  • Dilation of the cervix
  • Positive fetal heart tones (correct)
  • Backache and cramps
  • Bleeding and abdominal tenderness

    • What is considered a defining characteristic of a spontaneous abortion?

  • Pregnancy loss after 37 weeks
  • Loss occurring due to an elective procedure
  • Loss of an intrauterine pregnancy before viability (20 weeks) (correct)
  • Presence of fetal heart activity within the first trimester

    • Which type of spontaneous abortion is characterized by an incomplete loss of pregnancy tissue?

  • Complete abortion
  • Missed abortion
  • Inevitable abortion (correct)
  • Recurrent abortion

    • Which intervention is critical for effective therapeutic communication with a patient experiencing a spontaneous abortion?

    <p>Encourage the expression of feelings and validate grief</p> Signup and view all the answers

    What should a patient report during discharge after a spontaneous abortion?

    <p>Bright red clots in moderate amounts</p> Signup and view all the answers

    What is the primary purpose of cervical cerclage during pregnancy?

    <p>To prevent premature birth due to cervical incompetence</p> Signup and view all the answers

    Which of the following is a key component of monitoring in a patient who has experienced a spontaneous abortion?

    <p>Monitor vital signs and level of consciousness</p> Signup and view all the answers

    Which statement reflects a therapeutic communication approach when responding to a patient’s concerns about a spontaneous abortion?

    <p>“We will be monitoring your bleeding for your safety.”</p> Signup and view all the answers

    When is RhoGAM indicated for a patient experiencing a spontaneous abortion?

    <p>If the patient is Rh negative</p> Signup and view all the answers

    Which of the following does NOT constitute an indication for follow-up care after a spontaneous abortion?

    <p>Bleeding that resolves within a week</p> Signup and view all the answers

    What is an appropriate action during the management of a patient with spontaneous abortion during the procedure?

    <p>Prepare the patient for lab work, diagnostics, and procedures</p> Signup and view all the answers

    Which response would be considered nontherapeutic when addressing a patient’s grief over a miscarriage?

    <p>“You’ll feel better after some time.”</p> Signup and view all the answers

    What is a primary goal during the post-abortion care of a patient?

    <p>Monitor for signs of physical and emotional well-being</p> Signup and view all the answers

    What is a key aspect of patient discharge instructions for someone with an incompetent cervix?

    <p>Monitoring for contractions and bleeding</p> Signup and view all the answers

    Which of the following is a common management technique for cervical insufficiency?

    <p>Encouraging bed rest and reducing physical activity</p> Signup and view all the answers

    During a nursing assessment for a patient with ectopic pregnancy, which symptom is most indicative of a ruptured ectopic pregnancy?

    <p>Sharp pain in the lower abdomen</p> Signup and view all the answers

    What is the purpose of a cervical cerclage procedure?

    <p>To place a suture around the cervix to prevent dilation</p> Signup and view all the answers

    In the context of monitoring and assessment in obstetrics, which of the following is NOT typically monitored for in patients with cervical insufficiency?

    <p>Patient's dietary intake</p> Signup and view all the answers

    What emotional support measure should be included in the follow-up care of a patient with a molar pregnancy?

    <p>Referring to pregnancy loss support groups</p> Signup and view all the answers

    Which sign indicates potential complications during pregnancy related to placenta previa?

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

    Which of the following is a primary nursing intervention for a patient diagnosed with a complete molar pregnancy?

    <p>Suction curettage to evacuate the mole</p> Signup and view all the answers

    What symptom may suggest the presence of conditions associated with ectopic pregnancy?

    <p>Nausea and vomiting due to high hCG levels</p> Signup and view all the answers

    What common risk factor is associated with ectopic pregnancy?

    <p>Pelvic inflammatory disease (PID)</p> Signup and view all the answers

    What is a potential complication of an ectopic pregnancy that requires immediate medical attention?

    <p>Rupture of the ectopic site leading to internal bleeding</p> Signup and view all the answers

    Which should be avoided in a patient with placenta previa during a vaginal examination?

    <p>Digital vaginal exams to check for dilation</p> Signup and view all the answers

    Which nursing intervention is essential during the monitoring phase for a patient with signs of cervical insufficiency?

    <p>Monitoring vaginal discharge and bleeding</p> Signup and view all the answers

    What is an expected change in a patient with hydatidiform mole?

    <p>Vaginal bleeding that is brownish and may be profuse</p> Signup and view all the answers

    Study Notes

    Obstetrics Complications Overview

    • Key complications in obstetrics include hemorrhagic disorders, gestational diabetes mellitus, hyperemesis gravidarum, pregnancy infections, and issues surrounding loss and grief.

    Potential Causes of Hemorrhage

    • Spontaneous abortion types, incompetent cervix, ectopic pregnancy, hydatidiform mole, placenta previa, abruptio placentae, polyhydramnios, and disseminated intravascular coagulation (DIC).

    Loss of Pregnancy Definitions

    • Miscarriage: Loss of intrauterine pregnancy before 20 weeks of viability.
    • Spontaneous abortion: Nonviable intrauterine pregnancy showing signs like an empty gestational sac or lack of fetal heartbeat before 12 weeks.
    • Early pregnancy loss: Pregnancy loss before 10 weeks.
    • Stillbirth: Early (20-27 weeks), late (28-36 weeks), and term (37+ weeks).

    Types of Spontaneous Abortion

    • Classification includes threatened, inevitable, incomplete, complete, missed, septic, recurrent, and habitual.

    Assessment for Spontaneous Abortions

    • Monitor for pain, bleeding, backache, abdominal tenderness, and possible signs of hemorrhage, including vital signs. Emotional status of the patient and family are also crucial.

    Cervical Insufficiency/Incompetent Cervix

    • Definition: Passive, painless dilation of the cervix.
    • Risk factors: History of cervical trauma, short labors, pregnancy losses, DES exposure.
    • Management includes monitoring vaginal discharge, bleeding, and contractions, with the possibility of cervical cerclage to support pregnancy.

    Incompetent Cervix Management

    • Cervical cerclage: Purse-string suture placed around the cervix, usually done between 12-14 weeks, removed around 36-37 weeks.
    • Monitoring vital signs, uterine activity, and providing education on activity restrictions and hygiene.

    Ectopic Pregnancy

    • Occurs when a fertilized ovum implants outside the uterine lining, with sharp abdominal pain and spotting as common symptoms.
    • Risk factors include previous ectopic pregnancies, pelvic inflammatory disease (PID), pelvic surgery, and advanced maternal age.
    • Diagnostics involve transvaginal ultrasound and potential treatment options include methotrexate or surgery.

    Gestational Trophoblastic Disease (GTD)

    • Characterized by abnormal placental development, leading to fluid-filled masses resembling grape-like clusters. Can be associated with choriocarcinoma.

    Hydatidiform Mole (Molar Pregnancy)

    • Abnormal growth of placental tissue without fetal development.
    • Symptoms include vaginal bleeding, enlarged uterus, and signs of preeclampsia.

    Management & Follow-Up for Molar Pregnancy

    • Treat symptoms like hypertension and nausea, perform ultrasound, and proceed with suction curettage for evacuation.
    • Monitor hCG levels post-treatment and provide patient education and emotional support.

    Placenta Previa

    • Characterized by painless vaginal bleeding; avoid digital examinations until confirmed by ultrasound to prevent severe complications.
    • Nursing care focuses on preventing preterm birth and monitoring fetal well-being.

    Spontaneous Abortion Discharge Teaching

    • Educate patients to report specific signs: bright red clots, prolonged bleeding, signs of infection, or severe cramping.

    Clinical Judgment Case Study Insights

    • Acknowledge emotional needs when discussing loss; some responses may be therapeutic, while others could be nontherapeutic. Focus on safety, emotional healing, and support during and after procedures.

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    Related Documents

    Obstetrics Complications PDF

    Description

    Explore key complications in obstetrics, including hemorrhagic disorders and gestational diabetes. Understand the definitions of pregnancy loss types and the causes of hemorrhage in pregnancy. This quiz will deepen your knowledge of critical aspects of maternal health.

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