Laura Shared "501 EXAM 2" - 30 Picmonics

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501 EXAM 2

Gestational Diabetes
Signs and Symptoms
Usually Asymptomatic
Fetal Macrosomia
Polyhydramnios
Diagnosis
Glucose Intolerance After 24 Weeks Gestation
3-hr 100g Glucose Tolerance Test
Treatment
Diet and Exercise
Close Glucose Monitoring
Insulin
Ultrasound (or Nonstress Test (NST))
Delivery
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2 mins
Gestational Hypertension
New-Onset Hypertension
> 20 Weeks Gestation
Risk Factors
Nulliparity
Obesity
African American Females
> 35 years Old
Multiple Gestations
Family History of Gestational HTN (or Preeclampsia)
Complications
IUGR
Prematurity
Abruptio Placentae
Management
Fetal Monitoring
Alpha-Methyldopa
Beta-Blockers (Labetalol)
Calcium Channel Blockers
Hydralazine
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4 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
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2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
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1 min
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
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2 mins
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
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3 mins
Incompetent Cervix
Mechanism
Premature Cervical Dilation
Assessment
Recurring Miscarriage
Short Cervix
Considerations
Cervical Cerclage
Rest
Labor
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1 min
Chorioamnionitis
Fever
Maternal or fetal tachycardia
Leukocytosis
Foul Odor to Amniotic Fluid
Treatment: Antibiotics
Monitor uterine tenderness, contractions and fetal activity
Monitor maternal vital signs & FHR
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2 mins
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
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2 mins
Spontaneous Abortion Overview
Assessment
Bleeding < 20 weeks Gestation
Interventions
Identify Type
Bed Rest
Monitor for Hemorrhage
Save Pads and Linens
RhoGAM
Dilation and Curettage (DandC)
Cerclage
Emotional Support
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2 mins
Spontaneous Abortion Types
Missed Abortion
No Fetal Heartbeat, No Cervical Dilation, No Bleeding
Threatened Abortion
No Cervical Dilation and Minimal Bleeding
Inevitable Abortion
Bleeding and Cervical Dilation with No Loss of Products of Conception
Incomplete Abortion
Bleeding and Cervical Dilation with Loss of Some Products of Conception
Complete Abortion
Bleeding with No Cervical Dilation, with Loss of All Products of Conception
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2 mins
Hydatidiform Mole (Molar Pregnancy)
Cause/Mechanism
Abnormal Fertilization
Assessment
Symptoms of Pregnancy
Elevated hCG
Vaginal Bleeding
Inappropriate Uterine Growth
No Fetal Heart Rate (FHR)
Interventions
Dilation and Curettage (D&C)
Emotional Support
Considerations
No Pregnancy 1 Year
Hysterectomy
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3 mins
Polyhydramnios
Pathophysiology
Increased Amniotic Fluid
Causes
Duodenal Atresia (or Gastrointestinal Atresias)
Maternal Diabetes
Multiple Gestations
Anencephaly
Hydrops Fetalis
Diagnosis
Ultrasound
Amniotic Fluid Index (AFI) > 25 cm
Treatment
Weekly Nonstress Test (NST) and Biophysical Profile (BPP)
Amnioreduction
Indomethacin
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3 mins
Oligohydramnios
Decreased Amniotic Fluid
Etiologies
Renal Agenesis (Fetal Urinary Tract Abnormalities)
Uteroplacental Insufficiency
Premature Rupture of Membranes (PROM)
Diagnosis
Ultrasound
Amniotic Fluid Index (AFI) < 5 cm
Complications
Spontaneous Abortion
Pulmonary Hypoplasia
Musculoskeletal Abnormalities
Intrauterine Growth Restriction (IUGR)
Treatment
Treat Underlying Cause
Delivery (When Viable)
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2 mins
Intrauterine Growth Restriction (IUGR)
Pathophysiology
Slowed Fetal Growth
Symmetric Type
Factors Early in Pregnancy
Genetic (Chromosomal) Abnormalities
Congenital Infections
Asymmetric Type
Preserved Head Circumference
Factors Late in Pregnancy (2nd / 3rd trimester)
Placental Insufficiency
Diagnosis
Ultrasound
< 10th Percentile (for SGA)
Decreased Fundal Height
Complications
Increased Perinatal (Fetal) Morbidity and Mortality
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2 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
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1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
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2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
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1 min
Placental Implantation Abnormalities
Mechanism
Placenta adheres directly to myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by scar tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section delivery
Artery ligation or embolization
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2 mins
Placenta Previa
Mechanism
Placenta Covers Cervical Os
Assessment
Painless
Bright Red Vaginal Bleeding
Interventions
Stable Fetus
Bed Rest
Observation
Unstable Fetus
C-section Delivery
Considerations
Risk for Shock
Magnesium Sulfate
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2 mins

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