Podcast
Questions and Answers
Which assessment finding is least indicative of a spontaneous abortion?
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?
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?
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?
Which intervention is critical for effective therapeutic communication with a patient experiencing a spontaneous abortion?
What should a patient report during discharge after a spontaneous abortion?
What should a patient report during discharge after a spontaneous abortion?
What is the primary purpose of cervical cerclage during pregnancy?
What is the primary purpose of cervical cerclage during pregnancy?
Which of the following is a key component of monitoring in a patient who has experienced a spontaneous abortion?
Which of the following is a key component of monitoring in a patient who has experienced a spontaneous abortion?
Which statement reflects a therapeutic communication approach when responding to a patient’s concerns about a spontaneous abortion?
Which statement reflects a therapeutic communication approach when responding to a patient’s concerns about a spontaneous abortion?
When is RhoGAM indicated for a patient experiencing a spontaneous abortion?
When is RhoGAM indicated for a patient experiencing a spontaneous abortion?
Which of the following does NOT constitute an indication for follow-up care after a spontaneous abortion?
Which of the following does NOT constitute an indication for follow-up care after a spontaneous abortion?
What is an appropriate action during the management of a patient with spontaneous abortion during the procedure?
What is an appropriate action during the management of a patient with spontaneous abortion during the procedure?
Which response would be considered nontherapeutic when addressing a patient’s grief over a miscarriage?
Which response would be considered nontherapeutic when addressing a patient’s grief over a miscarriage?
What is a primary goal during the post-abortion care of a patient?
What is a primary goal during the post-abortion care of a patient?
What is a key aspect of patient discharge instructions for someone with an incompetent cervix?
What is a key aspect of patient discharge instructions for someone with an incompetent cervix?
Which of the following is a common management technique for cervical insufficiency?
Which of the following is a common management technique for cervical insufficiency?
During a nursing assessment for a patient with ectopic pregnancy, which symptom is most indicative of a ruptured ectopic pregnancy?
During a nursing assessment for a patient with ectopic pregnancy, which symptom is most indicative of a ruptured ectopic pregnancy?
What is the purpose of a cervical cerclage procedure?
What is the purpose of a cervical cerclage procedure?
In the context of monitoring and assessment in obstetrics, which of the following is NOT typically monitored for in patients with cervical insufficiency?
In the context of monitoring and assessment in obstetrics, which of the following is NOT typically monitored for in patients with cervical insufficiency?
What emotional support measure should be included in the follow-up care of a patient with a molar pregnancy?
What emotional support measure should be included in the follow-up care of a patient with a molar pregnancy?
Which sign indicates potential complications during pregnancy related to placenta previa?
Which sign indicates potential complications during pregnancy related to placenta previa?
Which of the following is a primary nursing intervention for a patient diagnosed with a complete molar pregnancy?
Which of the following is a primary nursing intervention for a patient diagnosed with a complete molar pregnancy?
What symptom may suggest the presence of conditions associated with ectopic pregnancy?
What symptom may suggest the presence of conditions associated with ectopic pregnancy?
What common risk factor is associated with ectopic pregnancy?
What common risk factor is associated with ectopic pregnancy?
What is a potential complication of an ectopic pregnancy that requires immediate medical attention?
What is a potential complication of an ectopic pregnancy that requires immediate medical attention?
Which should be avoided in a patient with placenta previa during a vaginal examination?
Which should be avoided in a patient with placenta previa during a vaginal examination?
Which nursing intervention is essential during the monitoring phase for a patient with signs of cervical insufficiency?
Which nursing intervention is essential during the monitoring phase for a patient with signs of cervical insufficiency?
What is an expected change in a patient with hydatidiform mole?
What is an expected change in a patient with hydatidiform mole?
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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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