IX. PREGNANCY AT RISK
OBJECTIVES
At the end of this class the student will be able to:
1. Describe any disorders which may cause bleeding in the first and second
trimesters.
2. Explain alterations of the placenta which may cause bleeding in the second and
third trimesters of pregnancy.
3. Discuss the risks and interventions used for patients with hyperemesis
gravidarum.
4. Describe the pathophysiology, interventions, and risks of the hypertensive
disorders of pregnancy.
5. Identify the risks to the fetus and neonate of Rh and ABO incompatibilities.
6. Compare and contrast risks to the fetus and woman with gestational diabetes and
preexisting diabetes mellitus.
7. Describe the potential risks to the pregnancy for a woman with preexisting
cardiac disease
8. Compare and contrast potential risks to the fetus and pregnant woman who has
various types of anemias.
9. Discuss maternal, fetal, and neonatal effects of selected common infections that
may occur during pregnancy.
10. Describe the effect of psychosocial problems on the pregnancy, including
psychiatric illnesses, physical and emotional abuse, and substance abuse.
11. Discuss the screening process used to identify abused pregnant women.
12. List three key components of abuse interventions
13. Prepare a care plan for a high risk pregnancy patient
OUTLINE
I.
Pregnant Woman Experiencing Addiction
A. Alcohol abuse
B. Substance abuse
II.
Diabetes mellitus
A. Classifications
B. Pathophysiology
C. Risk factors
D. Nursing process
III.
Anemias
A. Iron deficiency anemia
B. Folic acid deficiency anemia
C. Sickle cell anemia
D. Thalassemia
IV.
AIDS/HIV
V.
Preexisting cardiac disease
A. Classifications
B. Nursing process
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VI.
Disorders Causing Bleeding in Early Pregnancy
A. Spontaneous/elective abortion
B. Ectopic pregnancy
C. Gestational Trophoblastic Disease
D. Hydatidiform Mole
VII. Disorders Causing Bleeding in Later Pregnancy
A. Placenta Previa
B. Abruptio Placenta
C. Nursing process for patients experiencing bleeding
VIII. Hyperemesis gravidarum
A. Risk factors
B. Priority nursing care
IX.
Premature Rupture of the Membranes - PROM
X. Hypertensive disorders of pregnancy
A. Classification/ assessment
B. Risk factors
C. Pathophysiology
D. Helip syndrome
E. Nursing process
F. Pharmacology and related nursing interventions
XI.
Maternal-fetal blood incompatibilities
A. Rh incompatibility
B. ABO incompatibility
XII. Surgical Procedure
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XIII. Trauma
XIV. Maternal infections
A. Classifications/types
B. Risk factors
C. Fetal risks
D. Nursing process
CRITICAL THINKING EXERCISES
1. A patient is assessed during a prenatal visit. Her blood pressure is 140/90. What
other specific data should the nurse collect at this time?
2. A patient calls into the advice nurse center stating that she is bleeding. What other
priority information does the nurse need to know before giving advice?
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XI.
COMPLICATIONS OF THE PUERPERIUM(Postpartum period)
OBJECTIVES
At the end of this class the student will be able to:
1. Describe postpartum hemorrhage in terms of risk factors, assessment and
priority nursing interventions.
2. Identify complications of postpartum hemorrhage.
3. Explain associated factors, assessment and priority nursing interventions for
subinvolution.
4. Compare and contrast thromboembolic disorders in term of predisposing
factors, assessment and priority interventions.
5. Discuss puerperal infection in terms of location, risk factors, and priority
interventions.
6. Describe major postpartal psychiatric disorders.
7. Apply the nursing process to a patient experiencing complications and
alterations in homeostasis during the postpartum period.
OUTLINE
I.
Postpartum hemorrhage
A. Associated risk factors
B. Early vs. late
C. Complications
D. Nursing care, including pharmacology
II.
Subinvolution of the uterus
A. Risk factors
B. Priority nursing interventions
III.
Infections
A. Classifications
B. Risk factors
IV.
Thromboembolic disorders
A. Classifications
B. Interventions
C. Potential complications
V.
Psychiatric disorders
A. Postpartum depression
B. Postpartum psychosis
C. Risk factors referrals
D. Referrals
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VI.
Nursing Process
A. History
B. Assessment
C. Diagnosis
D. Interventions
E. Patient teaching
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