Steven Shared "2015 NCLEX Obstetrics 2" - 12 Picmonics

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2015 NCLEX Obstetrics 2

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
Abruptio Placentae
Mechanism
Premature Separation of Placenta
Assessment
Tearing Pain
Bleeding (Often Concealed)
Rigid Uterus
Contractions
Interventions
Prepare for Vaginal Delivery
Considerations
Increased Risks for Neonate
Rh (Rhesus) Incompatibilities
Increased Risk for Shock
Monitor Fetal Heart Rate
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2 mins
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
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
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
Ectopic Pregnancy
Signs and Symptoms
Lower Abdominal Pain
Delayed Menses
Abnormal Vaginal Bleeding
Shock
Referred Shoulder Pain
Cullen Sign
Considerations
Methotrexate
Surgery
RhoGAM
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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
Prolapsed Umbilical Cord
Mechanism
Cord Prolapses
Signs and Symptoms
Visualization of Cord
Prolonged or Variable Decelerations
Considerations
Hips Elevated
Insert 2 fingers in Vagina
Saline Towel on Cord
Oxygen
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2 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

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