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NURS 306 Quiz 5
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Exam of 15 pages for the course 388 Midterm review at 388 Midterm review (NURS 306 Quiz 5)
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NURS 306 Quiz 5Causes of bleeding in the first trimester - ANS-spontaneous abortion and ectopic
pregnancy
Causes of bleeding in the second trimester - ANS-gestational trophoblastic disease
Causes of bleeding in the third trimester - ANS-placenta previa, abruptio placentae,
preterm labor, vasa previa
Risk factors for spontaneous abortion - ANS-● Chromosomal abnormalities (account for
50%)
● Maternal illness, such as type 1 diabetes mellitus
● Advancing maternal age
● Premature cervical dilation
● Chronic maternal infections
● Maternal malnutrition
● Trauma or injury
● Anomalies in the fetus or placenta
● Substance use
● Antiphospholipid syndrome
Symptoms of spontaneous abortion - ANS-abdominal cramping or pain, rupture of
membranes, dilation of cervix, fever, manifestations of hemorrhage
symptoms of a Threatened abortion - ANS-possible mild cramps, slight spotting, no
tissue passed, cervical opening is closed
dilation and curettage (D&C) - ANS-to dilate and scrape the uterine walls to remove
uterine contents for inevitable and incomplete abortions
dilation and evacuation (D&E) - ANS-used to dilate and evacuate uterine contents after
16 weeks gestation. Used for gestational trophoblastic disease
nursing care for a spontaneous abortion - ANS-- perform a pregnancy test
-observe color and amount of bleeding (count pads)
- Maintain client of bed rest and inform of the risk of falls if sedative medications are
prescribed
- avoid vaginal exams
, - assist with ultrasound
- save passed tissue for examination
- refer to pregnancy loss support groups
Patient education for spontaneous abortion - ANS-- notify the provider of heavy
bleeding, fever, or foul-smelling discharge
- a small amount of discharge is normal for 1-2 weeks
-take prescribed antibiotics
-do not take tub baths, have sex, or place anything in the vagina for 2 weeks
- discuss grief and loss before attempting another pregnancy
Where does an ectopic pregnancy usually occur? - ANS-fallopian tubes
risk factors for ectopic pregnancy - ANS-STIS, assistive reproductive technologies, tubal
surgery, IUDs, smoking, PID, increased age, endometriosis, and previous ectopic
pregnancies
symptoms of ectopic pregnancy - ANS--unilateral sharp and stabbing pain in the lower
abdomen
-a late period, a light period, or an irregular period
-spotting 6-8 weeks after the last period
- bright red bleeding if rupture has occurred
-referred shoulder pain from blood in the peritoneal cavity
- findings of hemorrhage and shock if a large amount of bleeding has occurred
Methotrexate - ANS-given to dissolve an ectopic pregnancy. The woman cannot take
vitamins with folic acid or a toxic reaction could occur
salpingostomy - ANS-creation of an opening in the fallopian tube to open a blockage
done to salvage the fallopian tube if not ruptured during ectopic pregnancy
Laparoscopic salpingectomy - ANS-Removal of the tube if ruptured
gestational trophoblastic disease - ANS-Swollen, fluid-filled grape like clusters in the
placenta. Associated with choriocarcinoma which is a rapidly metastasizing malignancy
complete molar pregnancy - ANS-No fetal tissue or amniotic sac present. Paternally
derived. Hemorrhage into the uterine cavity occurs, and vaginal bleeding results. More
likely to cause choriocarcinoma
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