Learning Guide RNSG
Complications of Pregnancy
Gestational Onset
Bleeding Disorders:
1. Compare and contrast the classifications of abortions including etiology, signs
and symptoms, and interventions, and nursing care:
a. Threatened
b. Inevitable / Imminent
c. Complete
d. Incomplete
e. Missed
f. Habitual
i. What causes a cervix to be “incompetent”?
ii. What is the nursing care and teaching following a cerclage
procedure?
iii. What are the woman’s options regarding delivery? Explain.
2. What is an ectopic pregnancy? Where are the various implantation sites?
3. What predisposes a woman to an ectopic pregnancy? How is it diagnosed?
4. Explain the treatment options for an ectopic pregnancy. Give rationale.
a. Laparoscopy and Laparotomy
b. Linear salpingostomy
c. Methotrexate
5. What goes wrong in the development of a hydatiform molar pregnancy?
6. What are the signs and symptoms of a hydatiform mole and how is it
diagnosed? Explain about the HCG levels.
7. Treatment may be with a hysterotomy – what is this? Why is it important
for the woman to be followed closely for one year following removal? What
is included in the one year extensive follow-up therapy?
8. Compare and contrast placenta previa with abruptio placenta including:
a. signs and symptoms – be able to explain rationale for each.
b. treatment and nursing care
c. what are the signs of concealed hemorrhage in abruption placenta?
d. what is a complication of abruption placenta.
9. What is Disseminated intravascular coagulation?
a. what are obstetric triggering factosr that stimulates DIC?
b. Explain the pathophysiological process of DIC.
c. How is it diagnosed? Study the lab work comparing normal levels with
abnormal.
d. what is the treatment and nursing care?
e. Heparin is sometimes used in the treatment of DIC? Explain rationale.
Hyperemesis Gravidarum:
10. What is the cause of hyperemesis?
How is it treated?
11. Can antiemetic medications be used in treatment? Explain
12. What are the complications?
Pregnancy Induced Hypertension:
13. Define pre-eclampsia and eclampsia.
14. Analyze the predisposing factors of Pregnancy Induced Hypertension.
15. Explain the etiology and pathophysiology / Risk Factors related to PIH.
16. Compare the signs and symptoms of mild pre-eclampsia with severe preeclampsia.
17. How is PIH diagnosed? What diagnostic tests are used in diagnosing
including: purpose, nursing care, normal values, and interpretation of
abnormal values.
 Urine Testing
o Dipstick for protein
o Urinalysis for Creatitine, Creatitine clearance, BUN
 Blood Tests
o Liver enzymes
o Hemoglobin and Hematocrit
o BUN
o Platelets
18. Explain the treatment and nursing care of PIH including:
a. Drug therapy:
o
Magnesium sulfate
o Phenobarbital
o Hydralazine (Apresoline); Aldomet
b. Diet Therapy
o Low sodium
o High Protein
c. Other Nursing Interventions
19. Explain HELLP syndrome including pathophysiology, diagnosis and
interventions.


o Magnesium sulfate
o Phenobarbital
o Hydralazine (Apresoline); Aldomet
Diet Therapy
o Low sodium
o High Protein
Other Nursing Interventions
Perinatal Infections:
20. Explain the Etiology / Pathophysiology, Risk Factors, signs and
symptoms related to the following TORCHA infections:
 T= Toxoplasmosis
 O= Other – gonorrhea, chlamydia, syphilis, hepatitis, group B strep
 R= Rubella
 C= Cytomegalovirus
 H= Herpes Type 2
 A=Aids
21. Explain the following diagnostic tests including purpose, nursing care,
normal values, and interpretation of abnormal values.
 TORCH blood screen
 Elisa / western blot/ viral load / CD4 count
 Cultures
22. What is the treatment regime related to antiretroviral (ARV) therapy?
23. What is the patient teaching related to the TORCHA infections?
Fetal Demise:
24. Compare fetal demise with abortion considering etiology,
pathophysiology, signs and symptoms.
25. What is the treatment and nursing care for fetal demise? Explain use of:
a. Prostaglandins
b. Pitocin
c. Psychological support