1 / 106

MODULE 4 PREGNANCY, CHILDBIRTH, AND POSTPARTUM AT RISK

PREGNANCY AT RISKPREGESTATIONALGESTATIONALCHILDBIRTH AT RISKPRE?LABOR COMPLICATIONSLABOR?RELATED COMPLICATIONSPOSTPARTUM AT RISK . MODULE 4 PART 1A PREGESTATIONAL RISKS SUBSTANCE ABUSE . . SUBSTANCE ABUSE DURING PREGNANCY . ALCOHOLCNS DEPRESSANTINCIDENCE OF ABUSE HIGHEST IN MOTHERS 20-

ida
Download Presentation

MODULE 4 PREGNANCY, CHILDBIRTH, AND POSTPARTUM AT RISK

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. MODULE 4 PREGNANCY, CHILDBIRTH, AND POSTPARTUM AT RISK

    2. PREGNANCY AT RISK PREGESTATIONAL GESTATIONAL CHILDBIRTH AT RISK PRE—LABOR COMPLICATIONS LABOR—RELATED COMPLICATIONS POSTPARTUM AT RISK

    3. MODULE 4 PART 1A PREGESTATIONAL RISKS SUBSTANCE ABUSE

    4. SUBSTANCE ABUSE DURING PREGNANCY ALCOHOL CNS DEPRESSANT INCIDENCE OF ABUSE HIGHEST IN MOTHERS 20-40 YEARS OF AGE PREGNANT WOMEN SHOULD AVOID ALCOHOL COMPLETELY DURING PREGNANCY—WHY? ADVERSE MATERNAL EFFECTS ADVERSE FETUS/NEONATAL EFFECTS

    5. Fetal Alcohol Syndrome

    6. SUBSTANCE ABUSE DURING PREGNANCY COCAINE AND CRACK PREVENTS REUPTAKE OF DOPAMINE, NOREPINEPHRINE—LEADS TO VASOCONSTRICITION, TACHYCARDIA, HYPERTENSION ADVERSE MATERNAL EFFECTS ADVERSE FETAL/NEONATAL EFFECTS

    7. SUBSTANCE ABUSE DURING PREGNANCY MARIJUANA NO STRONG RESEARCH INDICATING TERATOGENIC EFFECTS SOCIAL FACTORS HEROIN/METHADONE ADVERSE MATERNAL EFFECTS ADVERSE FETAL/NEONATAL EFFECTS

    8. SUBSTANCE ABUSE DURING PREGNANCY BARBITURATES STIMULANTS CAFFEINE NICOTINE PSYCHOTROPICS METH

    10. MODULE 4 PART 1B PREGESTATIONAL RISKS: DIABETES

    11. DIABETES MELLITUS IN PREGNANCY PATHOPHYSIOLOGY INSULIN PRODUCTION DECREASE BY PANCREAS WITHOUT ADEQUATE INSULIN, GLUCOSE DOES NOT ENTER CELLS, WHICH BECOME ENERGY DEPLETED BLOOD GLUCOSE LEVELS INCREASE CELLS BREAK DOWN PROTEIN AND FAT STORES FOR ENERGY

    12. DIABETES MELLITUS IN PREGNANCY EARLY PREGNANCY ESTROGEN, PROGESTERONE, OTHER HORMONES RISE TO STIMULATE INCREASED INSULIN PRODUCTION AND INCREASED TISSUE RESPONSE TO INSULIN STORAGE OF GLYCOGEN IN LIVER PRODUCES ANABOLIC STATE DURING IST HALF OF PREGNANCY

    13. DIABETES MELLITUS IN PREGNANCY 2ND HALF OF PREGNANCY PRESENTS WITH INCREASED RESISTANCE TO INSULIN AND DECREASED GLUSOSE TOLERANCE DUE TO: SECRETION OF Hpl (INSULIN ANTAGONIST) PROLACTIN, INCREASED CORTISOL AND GLYCOGEN LEVELS RESULTS IN CATABOLIC STATE DIABETOGENIC EFFECT

    14. DIABETES IN PREGNANCY CLASSIFICATIONS ETIOLOGIC TYPE I TYPE II TYPE III TYPE IV BASED ON CAUSE WHITE’S CLASS A-T DESCRIBES EXTENT OF DISEASE

    17. GESTATIONAL DIABETES GESTATIONAL DIABETES WHY DOES THIS OCCUR? -- WHEN DOES THIS OCCUR? WHAT IS THE INCIDENCE OF THIS OCCURING DURING PRGNANCY? HOW IS IT DIAGNOSED?

    18. COMPARISON OF DIABETES MELLITUS AND GESTATIONAL DIABETES

    19. DIABETES MELLITUS IN PREGNANCY INTRAPARTAL MANAGEMENT WHEN TO DELIVER LABOR MANAGEMENT, INSULIN REQUIREMENTS POSTPARTAL MANAGEMENT INSULIN REQUIREMENTS BREAST FEEDING

    20. DIABETES IN PREGNANCY CHALLENGES, INFLUENCES MATERNAL RISKS FETAL, NEWBORN RISKS

    21. DIABETES MELLITUS IN PREGNANCY CLINICAL TREATMENT GTT CRITERIA LAB ASSESSMENT ANTEPARTAL MANAGEMENT DIET GLUCOSE MONITORING INSULIN REQUIREMENTS FETAL EVALUATION

    22. MODULE 4 PART 1C PREGESTATIONAL RISKS INFECTIONS

    23. HIV IN PREGNANCY RISKS TO MOTHER RISKS TO FETUS/NEONATE ANTEPARTUM, INTRAPARTUM, POSTPARTUM TREATMENT & CARE

    24. TORCH TOXOPLAMOSIS OTHER GBS RUBELLA CYTOMEGALIVIRUS HERPES

    26. TORCH MATERNAL RISKS FETAL RISKS ANTEPARTUM, INTRAPARTUM, POSTPARTUM TREATMENT AND CARE

    27. GROUP B STREPTOCOCCUS INCIDENCE TESTING TREATMENT NURSING INTERVENTIONS

    28. GESTATIONAL PREGNANCY RISKS BLEEDING DISORDERS HYPERTENSIVE DISORDER Rh ALLOIMMUNIZATION ABO INCOMPATIBILITY DOMESTIC VIOLENCE SURGERY, TRAUMA

    29. MODULE 4 PART 2A GESTATIONAL ONSET COMPLICATIONS: BLEEDING DISORDERS

    30. BLEEDING DISORDERS ECTOPIC PREGNANCY TREATMENT, RISKS GESTATIONAL TROPHOBLASTIC DISEASE HYDATIFORM MOLE CHORIOADENOMA DESTRUENS CHORIOCARCINOMA TREATMENT, RISKS

    34. GESTATIONAL RISKS INCOMPETENT CERVIX CERCLAGE HYPEREMESIS GRAVIDARUM FLUID & ELECTROLYTE ISSUES DEHYDRATION RISKS TO FETUS NURSING CARE

    35. Cerclage

    36. GESTATIONAL RISKS PREMATURE RUPTURE OF MEMBRANES PROM PPROM NST, BPP RISKS NURSING CARE

    37. Positive Fern Test

    38. MODULE 4 PART 2B GESTATIONAL COMPLICATIONS AND RISKS: PREGNANCY REDUCED HYPERTENSION

    39. PREGNANCY INDUCED HYPERTENSION--PIH PREECLAMPSIA/ECLAMPSIA CHRONIC HYPERTENSION CHRONIC HYPERTENSION WITH SUPERIMPOSED PREECLAMPSIA OR ECLAMPSIA TRANSIENT HYPERTENSION

    40. PREECLAMPSIA DISEASE OF THEORIES MOST COMMON HYPERTENSIVE DISORDER IN PREGNANCY PATHOPHYSIOLOGY CAUSE UNKNOWN 5-7% OF ALL PREGNANCIES GENERALIZED VASOSPASM, DECREASE IN CIRCULATING BLOOD VOLUME

    41. Preeclampsia

    42. PREECLAMPSIA PRENATAL FACTORS INCREASING RISK OF PIH PRIMIGRAVIDA ESSENTIAL HYPERTENSION AGE EXTREMES (UNDER 17 OR OVER 35 YEARS OLD) UNDERWEIGHT OR OVERWEIGHT FAMILY HISTORY OF HYPERTENSION DIAGNOSIS OF PIH IN PREVIOUS PREGNANCY DIABETES MELLITUS

    43. PREECLAMPSIA CHARACTERIZED BY: DEVELOPMENT OF HYPERTENSION 30MM HG INCREASE IN SYSTOLIC AND 15 MM HG DIASTOLIC OVER BASELINE ON AT LEAST 2 OCCASIONS 6 OR MORE HOURS APART PROTEINURIA EDEMA MATERNAL RISKS FETAL/NEONATAL RISKS

    44. PREECLAMPSIA CLINICAL MANAGEMENT/CARE ANTEPARTAL MANAGEMENT MILD PREECLAMPSIA SEVERE PREECLAMPSIA INTRAPARTAL MANAGEMENT POSTPARTAL MANAGEMENT HELLP SYNDROME ECLAMPSIA

    45. H E L L P Syndrome H – hemolysis- distortion and rupture of RBCs E – elevated L – liver enzymes- fibrin deposits obstruct blood flow L – low P – platelet count

    49. MODULE 4 PART 2C GESTATIONAL RISKS & COMPLICATIONS: Rh ISOIMMUNIZATION

    50. Rh SENSITIZATION ANTIGEN-ANTIBODY RESPONSE IF AN Rh-NEGATIVE WOMAN IS EXPOSED TO Rh POSITIVE BLOOD, EITHER THROUGH TRANSFUSION OR A PRIOR PREGNANCY, SHE PRODUCES IMMUNOGLOBULIN (Ig)G ANTIBODY (ANTIRhD) INDIRECT COOMBS TEST DIRECT COOMBS TEST

    54. Rh SENSITIZATION RhoGAM PROVIDES PASSIVE ANTIBODY PROTECTION AGAINST Rh ANTIGENS ERYTHROBLASTOSIS FETALIS HYDROPS FETALIS KERNICTERUS

    55. MODULE 4 PART 2C BLEEDING COMPLICATIONS

    56. PRE-LABOR COMPLICATIONS PREMATURE RUPTURE OF MEMBRANES PRETERM LABOR BLEEDING MULTIPLE GESTATION AMNIOTIC FLUID ALTERATIONS

    57. ABRUPTIO PLACENTAE ABRUPTIO PLACENTAE: PREMATURE SEPARATION OF PLACENTA FROM UTERINE WALL THREE TYPES: MARGINAL CENTRAL COMPLETE CLINICAL MANAGEMENT

    61. PLACENTA PREVIA PLACENTA PREVIA: IMPLANTATION OF PLACENTA IN LOWER UTERINE SEGMENT THREE CLASSIFICATIONS: LOW PLACENTAL IMPLANTATION PARTIAL PLACENTA PREVIA TOTAL PLACENTA PREVIA CLINICAL MANAGEMENT

    66. MODULE 4 PART 2D SURGERY TRAUMA INFECTION DOMESTIC VIOLENCE

    67. SURGERY TRAUMA FROM AN ACCIDENT INFECTION AFFECTING THE FETUS MATERNAL RISKS FETAL RISKS

    68. DOMESTIC VIOLENCE IN PREGNANCY INCIDENCE RESEARCH STATISITICS SIGNS AND SYMPTOMS

    69. DOMESTIC VIOLENCE IN PREGNANCY HOW DO WE ASSESS? WHEN DO WE ASSESS? WHAT DO WE DO IF THE WOMAN DISCLOSES ABUSE? MATERNAL RISKS FETAL RISKS

    72. MODULE 4 PART 3A PRE-LABOR COMPLICATIONS AMNIOTIC FLUID ALTERATIONS

    73. OLIGOHYDRAMNIOS SEVERELY REDUCED AMOUNT OF AMNIOTIC FLUID OCCURS IN: POSTMATURITY IUGR FETAL RENAL MALFORMATION SOMETIMES IDIOPATHIC

    74. OLIGOHYDRAMNIOS FETAL RISKS CLINICAL MANAGEMENT CRITICAL THINKING WHAT TYPE OF DECELERATION MIGHT YOU EXPECT TO SEE ON THE FETAL MONITOR OF A WOMAN WITH OLIGOHYDRAMNIOS? WHY?

    76. HYDRAMNIOS HYDRAMNIOS: > 2000ML AMNIOTIC FLUID CAUSE UNKNOWN 20% ASSOCIATED WITH CONGENITAL ANOMALIES TWO TYPES: CHRONIC ACUTE RISKS CLINICAL MANAGEMENT

    77. True knot

    78. MODULE 4 PART 3B PRE-LABOR COMPLICATIONS: PRETERM LABOR LABOR RELATED COMPLICATIONS

    79. PRETERM LABOR NONRECURRENT SCREENING FACTORS CORRELATED WITH PRETERM LABOR

    80. PRETERM LABOR PRETERM RISK FACTORS LABOR THAT OCCURS BETWEEN 20-37 WEEKS PREVELANCE RESEARCH RECURRENT

    81. PRETERM LABOR TREATMENT/CARE HOME UTERINE ACTIVITY MONITORING TOCOLYSIS B-ADRENERGIC AGONISTS (B-MIMETICS) MGSO4 NEPHEDIPINE PROSTAGLANDIN SYNTHESIS INHIBITORS BETAMETHASONE (FETUS)

    82. LABOR RELATED COMPLICATIONS DYSTOCIA POSTTERM PREGNANCY FETAL MALPOSITION, MALPRESENTATION MACROSOMIA FETAL DISTRESS

    83. LABOR RELATED COMPLICATIONS HYPERTONIC LABOR HYPOTONIC LABOR LABOR MANAGEMENT MATERNAL RISKS FETAL/NEONATAL RISKS PRECIPITOUS LABOR LABOR LESS THAN 3 HOURS

    84. LABOR RELATED COMPLICATIONS PROLAPSED UMBILICAL CORD AMNIOTIC FLUID EMBOLISM CEPHALOPELVIC DISPROPORTION COMPLICATION OF THIRD OR FOURTH STAGE OF LABOR

    85. Uterine Tachysystole

    86. LABOR RELATED COMPLICATIONS MACROSOMIA NEWBORN WEIGHT > 4000 GMS OFTEN SEEN IN: DIABETIC MOTHERS GRAND MULTIPARITY POSTTERM GESTATION LARGE PARENTS MATERNAL RISKS FETAL / NEONATAL RISKS

    87. MODULE 4 PART 3C LABOR RELATED COMPLICATIONS

    88. POSTTERM PREGNANCY, MALPOSITION POSTTERM PREGNANCY PREGNANCY 42 WEEKS PAST 1ST DAY OF LAST MENSTRUAL PERIOD MATERNAL RISKS FETAL/NEONATAL RISKS MALPOSITION OCCIPUT POSTERIOR PERSISTENT OCCIPUT POSTERIOR LABOR MANAGEMENT MATERNAL RISKS

    89. PROLAPSED UMBILICAL CORD PROLAPSED CORD: WHEN CORD PRECEDES FETAL PRESENTING PART DECREASED BLOOD FLOW IN CORD LEADS TO FETAL DISTRESS MAY RESULT WITH RUPTURE OF MEMBRANES CLINICAL MANAGEMENT

    91. Nurse and Prolapsed cord

    92. AMNIOTIC FLUID EMBOLISM CLINICAL PRESENTATION CHEST PAIN DYSPNEA CYANOSIS HYPOTENSION TACHYCARDIA MASSIVE HEMORRHAGE CLINICAL MANAGEMENT

    93. AMNIOTIC FLUID EMBOLISM AMNIOTIC FLUID EMBOLISM: AMNIOTIC FLUID MAY LEAK INTO CHORIONIC PLATE AND MATERNAL CIRCULATORY SYSTEM THROUGH: TEAR IN AMNION OR CHORION PLACENTAL SEPARATION CERVICAL TEAR

    94. CEPHALOPELVIC DISPROPORTION (CPD) FETUS LARGER THAN PELVIC DIAMETERS PELVIC MEASUREMENTS PROLONGED LABOR CLINICAL MANAGEMENT

    95. MALPRESENTATION MALPRESENTATION BROW FACE BREECH SHOULDER TRANSVERSE LIE COMPOUND PRESENTATION

    96. MULTIPLE GESTATION INCREASED INCIDENCE OF MULTIPLE BIRTHS INCREASED INCIDENCE OF PRETERM LABOR FETAL AND MATERNAL IMPLICATIONS AND CARE

    98. bbbbbbbbbbbbbbbbbbbb

    99. FETAL DISTRESS FETAL DISTRESS CONTIBUTING FACTORS: CORD COMPRESSION UTERO-PLACENTAL INSUFFCIENCY PREEXISTING MATERNAL OR FETAL DISEASE FETAL DISTRESS WARNING SIGNS MECONIUM STAINED AMNIOTIC FLUID

    100. FETAL DISTRESS OMINOUS FHR PATTERNS PERSISTENT LATE DECELERATIONS PERSISTENT SEVERE VARIABLE DECELERATIONS PROLONGED DECELERATIONS DECREASED VARIABILITY

    102. FETAL DEATH INTRAUTERINE FETAL DEATH POSSIBLE CAUSES: PREECLAMPSIA ABRUPTIO PLACENTAE PLACENTA PREVIA DIABETES CONGENITAL ANOMALIES INFECTION

    103. FETAL DEATH ISOIMMUNE DISEASE NUCAL CORD UNKNOWN CAUSES PROLONGED RETENTION OF FETUS MAY LEAD TO: DESSEMINATED INTRAVASCULAR COAGULATION (DIC)

    105. COMPLICATIONS OF THE THIRD & FOURTH STAGE OF LABOR LACERATIONS 1ST DEGREE 2ND DEGREE 3RD DEGREE 4TH DEGREE SULCUS TEAR URETHRAL TEAR

    106. COMPLICATIONS OF THE THIRD AND FOURTH STAGE OF LABOR PLACENTA ACCRETA: ATTACHMENT OF PLACENTA DIRECTLY TO THE UTERINE WALL WITHOUT INTEVENING DECIDUA BASALIS UTERINE RUPTURE RETAINED PLACENTA UTERINE ATONY HEMMORHAGE

More Related