High Risk Pregnancy - Learning Objectives PDF

Students should be able to:  Describe sudden complications of pregnancy that place a pregnant woman and her fetus at high risk.  Assess woman who is experiencing a complication of pregnancy.  Formulate nursing diagnosis that address the need of a woman and her family experiencing a complic...

Students should be able to:  Describe sudden complications of pregnancy that place a pregnant woman and her fetus at high risk.  Assess woman who is experiencing a complication of pregnancy.  Formulate nursing diagnosis that address the need of a woman and her family experiencing a complication of pregnancy.  Identify expected outcomes to minimize the risk to a pregnant woman and her fetus when a sudden complication of pregnancy.  Implement nursing care specific to a woman who has developed a sudden complication of pregnancy.  Evaluate expected outcomes for effectiveness of care HIGH RISK PREGNANCY  is one in which a concurrent disorder, pregnancy-related complication, or external factor jeopardizes the health of the woman, the fetus, or both.  external factor: poverty, lack of support people, poor coping mechanism, genetic inheritance and history of pregnancy complications  Age  Presence of chronic or acute medical condition  Maternal obstetric and gynecologic history  Maternal lifestyle and habits  Family culture and ethnicity  Family history  AGE  Pregnant adolescents younger than 15  Gestational hypertension  Iron deficiency Anemia  Cephalo-pelvic disproportion  Low birth weight  and preterm neonates  AGE  Reasons for the high number of early pregnancy: Earlier age of menarche in girls (the average age is 12.4 years; many girls begin menstruating at age 9 and so are ovulating and able to conceive by age 11) Increase in the rate of sexual activity among teenagers Lack of knowledge about (or failure to use) contraceptives or abstinence Desire by young girls to have a child  AGE  Less teenage pregnancies due to pandemic  The University of the Philippines Population Institute (UPPI) released the results of its 2021 Young Adult Fertility and Sexuality Study (YAFS5), which revealed that the proportion of young women 15 to 19 years old who were pregnant sharply declined from 13.7 percent in 2013 to 6.8 percent in 2021 https://www.pna.gov.ph/articles/1188036#:~:text=This%2C%20after %20the%20University%20of,to%206.8%20percent%20in%202021. AGE  Early and consistent prenatal care is essential to their health and the health of their baby. Unfortunately, many adolescents do not seek prenatal care until late in their pregnancies  not seeking prenatal care is a way of protecting the pregnancy—if she doesn’t tell anyone, no one can suggest she terminate the pregnancy  Denial she is pregnant  Lack of knowledge of the importance of prenatal care  Dependence on others for transportation  Feeling awkward in a prenatal setting (an adult setting)  Fear of a first pelvic examination  Difficulty relating to authority figures pregnancy.  Pregnant Woman over age of 40 > Hypertension of pregnancy  are related to the fact that the woman’s circulatory system may not be as competent as when she was younger or her body tissues may not be as elastic as they were once > Preterm and Post-term labor > Candidate for CS delivery  due to cervical inelasticity > having a baby with chromosomal abnormality Maternal Obstetric and Gynecologic History  Multiparity (more than 3)  Pregnancy occurring within 3 months of last delivery  Pelvic inadequacy or misshape  Pelvic inflammatory disease  history with any of the following: - Two or more preterm deliveries or spontaneous abortions - One or more still birth at terms - One or more neonates born with gross anomalies History of the following - Uterine incompetency, position, or structure - placental anomalies - poor weight gain - History of delivery of preterm or post- term neonate History of the following - History precipitous delivery, - cervical or vaginal lacerations due to labor and delivery, - hemorrhage during labor and delivery, retained placenta Exacerbation of a current medical problem 1. Peptic ulcer disease  Gastric reflux due to stomach displacement by the gravid uterus  Cardiac sphincter relaxation and decreased GI motility due to increased progesterone 2. Heart disease  Overtaxing cardiac workload due to increase in blood volume and increased cardiac output  Potential adverse effect on placental perfusion and subsequently fetal nutrition for a woman with severe heart disease, leading to the birth of a low-birth-weight neonate 3.Maternalhypertension leading to an increased risk of abruptio placenta. 4. Diabetes mellitus  Development of insulin resistance, which may require increased amounts of insulin  Fetus typically large due to the overload of maternal glucose, which acts as a stimulator for growth  Possibly cephalopelvic disproportion and dystocia for the mother Maternal Medical History  Abdominal trauma possibly leading to premature rupture of membranes or abruptio placenta.