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NURS 444 Final Exam Guide With Complete Solution
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NURS 444 Final Exam GuideWith Complete Solution
What is an abortion? - ANSWER loss of fetus before viability or capable of
living outside of the uterus
what is considered a nonviable fetus? - ANSWER fetus <20 weeks or <500
grams
what are the different types of abortions? - ANSWER 1. *spontaneous*: loss
of a woman's pregnancy before the 20th week of pregnancy
2. *threatened*: symptoms are present that indicate a miscarriage is possible
3. *inevitable*: vaginal bleeding with progressive dilation of the cervix, but
no expulsion of conception products
4. *incomplete*: partial loss of the products of conception within the first 20
weeks
5. *missed*: unrecognized intrauterine death of an embryo without expulsion
of the products of conception
about __% of spontaneous abortions are related to vaginal bleeding in the
__trimester - ANSWER 50%; 1st
what is the 1st signs of a threatened abortion? - ANSWER vaginal bleeding
what is done to determine if fetus/embryo is present and alive? - ANSWER
US or quantitative beta-hCG test
What device is used to clear the uterus if the natural process is ineffective or
,incomplete in expulsion of uterine contents? - ANSWER vacuum curettage
if the pregnancy is more advanced or if bleeding is excessive, a ____ and ____
may be needed - ANSWER dilation and curettage (D&C)
what interventions are needed for an incomplete abortion? - ANSWER
-stabilizing woman's CV state
-Fluid replacement & drug administration of Pitocin
-Dilation & evacuation
what is a recurrent spontaneous abortion? - ANSWER 3 or more consecutive
spontaneous abortions
thought to be genetic/chromosomal anomalies, such as incompetent uterus
or bicornuate uterus (has 2 horns)
What is an ectopic pregnancy? - ANSWER Tubal pregnancy, when a fertilized
egg develops outside the uterus *(usually in the fallopian tube)*. High risk
for rupture/hemorrhage and death.
what causes ectopic pregnancies - ANSWER 1. pelvic
infection/inflammation/surgery
2.delayed or premature ovulation
3.Multiple induced abortions
What are clinical manifestations of ectopic pregnancies? - ANSWER 1. missed
menstrual period
2. positive pregnancy test
3. UNILATERAL Abdominal pain
,4. vaginal "spotting"
T or F. If the implantation of an ectopic pregnancy occurs in the proximal end
of the tube, rupture of the tube may occur w/in 2-3 weeks of the missed
period. - ANSWER true
T or F If the implantation occurs in the distal end of the fallopian tube, the
woman will not exhibit any usual signs of early pregnancy. - ANSWER false;
she will exhibit signs of pregnancy but will notice intermittent abdominal
pain/vaginal spotting
how is an ectopic pregnancy diagnosed - ANSWER 1. transvaginal US
(determine presence of gestational sac)
2. beta-hCG test (present but @ lower levels)
what is the therapeutic management of an ectopic pregnancy? - ANSWER
*depends on if tube is intact or ruptured*
-Methotrexate administration (if tube is unruptured) to stop fetal growth in
tube
-Surgery (linear salpingostomy or salpingectomy)
What is the difference between a linear salpingostomy and salpingectomy? -
ANSWER ostomy: removal of ectopic pregnancy with effort to salvage the
tube
ectomy: removal of the tube
nursing considerations for ectopic pregnancies - ANSWER -monitor for sxs of
tubal rupture/bleeding (pelvic, shoulder, or neck pain; increased vag
bleeding)
, -administer RhoGAM for Rh - woman
-Remind woman that any fluids from her are toxic if on methotrexate &
teach s/e of medications
-Provide psychological support (possible tube removal)
what is another term used for gestational trophoblastic disease? - ANSWER
molar pregnancy
What is a gestational trophoblastic disease (molar pregnancy)? - ANSWER
-When trophoblasts develop abnormally and create a hydatidiform mole
-Causes the placenta to not develop normally and death to the fetus
What characterizes gestational trophoblastic disease (molar pregnancies)? -
ANSWER proliferation & edema within the chorionic villi
2 types of molar pregnancies? - ANSWER 1. complete: no fetus, only placenta
develops
2. partial: fetus is present, but has varying degrees of development (usually a
partial fetus)
What is the incidence and etiology of molar pregnancies? - ANSWER
-Common in Asian populations (1 in 120)
-Common in younger maternal age or advanced age (>35 yrs)
-Previous molar pregnancies increases risk by 4-5x
what are clinical manifestations of molar pregnancies? - ANSWER -Higher
levels of beta-hCG than expected
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