Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEPARTMENT Polangui, Albay STUDENT STUDY GUIDE 10 Nursing Care of a Family Experiencing a Sudden Pregnancy Complication Name: ______________________________ Block: ______ LEARNING ACTIVITIES I. MATCHING TYPE _J__ Imminent (inevitable) miscarriage A. is an infection of the placenta and the amniotic fluid. __F_ Ectopic pregnancy B. a surgical operation that was performed after loss of child because of premature cervical dilatation. _I__ Gestational trophoblastic disease C. associated with hypertension, placenta separates from the uterus before birth of fetus. _E__ Premature cervical dilatation D. a condition of pregnancy in which the placenta is implanted abnormally in the lower part of the uterus, and the most common cause of painless bleeding in the third trimester pregnancy. _D__ Placenta Previa E. _B__ Cervical cerclage term. _H__ Preterm labor F. implantation of zygote at site other than in uterus, associated with tubal constrictures _G__ complete miscarriage __C_ premature separation of the placenta _A__ Chorioamnionitis II. cervix that dilates prematurely and therefore cannot retain a fetus until G. The entire products of conception are expelled spontaneously without assistance H. a labor that occurs before the end of week 37 of gestation. I. abnormal proliferation and then degeneration of the trophoblastic villi. J. Possibly poor placental attachment FILL IN THE BLANKS 1. Vaginal bleeding during pregnancy is always ____SERIOUS____ until ruled otherwise because it has the potential to diminish the _____BLOOD SUPPLY______ of both the mother and fetus. 2. Preterm rupture of the membranes is __________TEARING OF THE FETAL MEMBRANE___________ with loss of __AMNIOTIC FLUID________ before the pregnancy is at term. Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEPARTMENT Polangui, Albay 3. A woman is said to be in preterm labor when she has had uterine contractions every ___ minutes for __1__ hour and _____CERVICAL DILATATION_______ begins. 4. Gestational trophoblastic disease is abnormal overgrowth of ______TROPHOBLAST CELLS_______. If not discovered by an ultrasound early in pregnancy, __BLEEDING_____ and ____EXPULSION___ of the abnormal growth occur at about the 16th week of pregnancy. 5. Premature separation of the placenta, placental separation from the uterus before the fetus is__BORN__, usually occurs ______LATE IN PREGNANCY________. 6. Symptoms of a threatened miscarriage begin as vaginal bleeding, initially only scant and usually ____BRIGHT RED________. 7. The organism responsible for infection after miscarriage is usually ______ESCHERICHIA COLI________. 8. One of the most severe complications of pregnancy is _____FETAL DEATH_________. 9. If a seizure from PIH occurs, a woman has eclampsia, but any status above gestational hypertension and below a point of seizures is ____PREECLAMPSIA_______.. 10. Women who have symptoms of placenta previa should not have _________VAGINAL EXAMINATION________ done to prevent disruption of the _______LOW IMPLNATED PLACENTA_______________. III. MULTIPLE CHOICE Encircle the correct answers. 1. A condition that occurs when too much amniotic fluid builds up during pregnancy. a. Oligohydramnios b. Hydramnios c. d. Pseudocyesis Pre- eclampsia 2. It is the most common cause of painless bleeding in the third trimester of pregnancy. a. Abruptio placenta b. Placenta accreta c. Placenta previa d. Placenta increta 3. A part of the conceptus (usually the fetus) is expelled, but the membrane or placenta is retained in the uterus. a. miscarriage b. Septic abortion c. imminent d. Incomplete miscarriage 4. A variation of PIH named for the common symptoms that occur: hemolysis , elevated liver enzymes, and low platelets. a. HELLP syndrome b. Hyperemesis gravidarum c. gestational diabetes d. pre-eclampsia 5. The amount of the amniotic fluid in Hydramnios Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEPARTMENT Polangui, Albay a. more than 2000 ml b. 1000 ml c. 550 ml d. 900 ml 6. The amniotic fluid index og Hydramnios a. 23 cm b. 20 cm c. 22 cm d. above 24 cm 7. Oligohydramnios is a condition caused by? a. high blood sugar b. low amniotic fluid c. low heart rate d. weight gain 8. Normal range of amniotic fluid of a pregnant mother a. 500 ml to - 1000 ml b. 900 ml - 1100 ml c . 1000 ml - 5000 ml d. 800 ml - 900 ml 9. Also known as “ False Pregnancy” where enlargement of the abdomen occurs in either a nonpregnant woman or man. a. Pseudocyesis b. Post term pregnancy c. Abdominal pregnancy d. Gestational Trophoblastic Disease 10. One of the most severe complications of pregnancy a. miscarriage b. fetal death c. HELLP syndrome d. preterm labor IV. MODIFIED TRUE OR FALSE 1. Maternal antibodies form and destroy fetal red blood cells, leading to anemia, edema, and jaundice in the newborn. 2. Hydramnios is a possibility when a woman who is Rh negative is sensitized and carries a fetus who is Rh positive. 3. Ectopic pregnancies are classified as threatened, imminent, complete, incomplete, missed, or recurrent pregnancy loss. 4. Placenta previa is low implantation of the placenta so that it crosses the cervical os. If this is not discovered before labor, cervical dilatation may cause the placenta to tear, causing severe blood loss. 5. Disseminated intravascular coagulation is a blood disorder that may occur with any trauma, so it can accompany such conditions as premature separation of the placenta and pregnancy-induced hypertension. 6. Recurrent pregnancy loss is used to describe this miscarriage pattern, and a thorough investigation is done to discover the cause of the loss and help ensure the outcome of a future pregnancy. Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEPARTMENT Polangui, Albay 7. Pre-eclampsia is a condition in which vasospasm occurs during pregnancy in both small and large arteries. 8. Oligohydramnios refers to a pregnancy with less than the average amount of amniotic fluid. 9. A tocolytic agent, an agent to halt labor, such as terbutaline may be prescribed. 10. Magnesium sulfate is used to stop the local coagulation and free up clotting factors for systemic use. V. ENUMERATION A. List down the complications of miscarriage. 1. ________________ Hemorrhage _________________ 2. _________________ Infection. ________________ 3. ________________ Septic Abortion _________________ 4. ________________ Isoimmunization _________________ 5. __________________ Powerlessness or Anxiety. _______________ Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEP Polangui, Albay ARTMENT B. Give at least four nursing interventions that you can provide to a woman with mild PIH. 1. ____________ Monitor Antiplatelet Therapy ______________________ 2. ______________ Promote Bed Rest. ____________________ 3. _________________ Promote Good Nutrition _________________ 4. _______________ Provide Emotional Support. ___________________ C. Give five nursing interventions that you can provide to a woman with severe PIH. 1. _____________ Support Bed Rest. _____________________ 2. ______________ Monitor Maternal Well-being. ____________________ 3. ______________ Monitor Fetal Well-being. ____________________ 4. _______________ Support a Nutritious Diet ___________________ 5. ________ Administer Medications to Prevent Eclampsia _________________ VI. Label the sites at which an ectopic pregnancy may occur. (INTESTINE,FALLOPIAN TUBE, OVARY, CERVIX) Republic of the Philippines Bicol University POLANGUI CAMPUS NURSING AND HEALTH SCIENCES DEP Polangui, Albay VII. IDENTIFICATION 1. ______hydramnios________ This can lead to premature rupture of the membranes and can cause fetal malpresentation. 2. ______ misoprostol (Cytotec) ________ It is applied to the cervix to initiate ripening or stripping of membranes followed by oxytocin infusion. 3. ______ hemolytic disease of the newborn or erythroblastosis fetalis ________ A condition wherein the fetus can become so deficient in red blood cells that sufficient oxygen transport to body cells cannot be maintained. 4. _______ Intrauterine Transfusion _______ This is done through injecting red blood cells, by amniocentesis technique, directly into a vessel in the fetal cord. ARTMENT 5. ________Fetal Death______ The causes are chromosomal abnormalities, congenital, Hep B, immunologic, complications of maternal disease. 6. _______ Disseminated Intravascular Coagulation _______ An acquired disorder of blood clotting in which the fibrinogen level falls to below effective limits. 7. _______ Betamethasone _______ A corticosteroid that acts as an anti-inflammatory and immunosuppressive agent. It is given to pregnant women 12 to 24 hours before birth to hasten fetal lung maturity if a fetus is less than 34 weeks’ gestation. 8. _______ Premature cervical dilatation _______ Previously termed an incompetent cervix, refers to a cervix that dilates prematurely and therefore cannot hold a fetus until term. 9. ________ cervical cerclage______ A surgical operation performed to prevent premature cervical dilatation from happening in a second pregnancy. 10. _______ Septic Miscarriage_______ An abortion that is complicated by infection, more frequently it occurs in women who have tried to self-abort or were aborted illegally using a non sterile instrument.
