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Pathology | Nurse Practitioner (NP) School Study Aid
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
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
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
2 mins
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
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
3 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
2 mins
Hyperemesis Gravidarum
- Signs and Symptoms
- Excessive Vomiting
- Significant Weight Loss
- Dehydration
- Hypotension
- Electrolyte Imbalance
- Interventions
- Antiemetics
- Frequent Small Meals
- IV Therapy
2 mins
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
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
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
2 mins
Fetal Macrosomia
- Pathophysiology
- Increased Birth Weight
- > 4500 g
- Causes
- Maternal Obesity
- Gestational Diabetes
- Diagnosis
- Weigh Newborn at Birth
- Ultrasound
- Hadlock's Formula
- Complications
- Birth Canal Trauma
- Neonatal Hypoglycemia
- Shoulder Dystocia
- Treatment
- Planned Cesarean Section
2 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
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)
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
2 mins
Premature Rupture of Membranes (PROM)
- Pathophysiology
- Rupture > 1 Hour Before Labor
- Risk Factors
- Infection
- PROM History
- Incompetent Cervix
- Diagnosis
- Fern Test
- Nitrazine Paper Test
- Ultrasound
- Treatment
- Consider Tocolytics
- Consider Antibiotics
- < 34 Weeks Gestation
- Corticosteroids
- > 34 Weeks Gestation
- Induction of Labor
2 mins
Cesarean Section - Indications
- Maternal Indications
- Active Genital Herpes Infection
- Cervical Cancer
- Eclampsia (Preeclampsia)
- History of Uterine Surgery
- History of C-section (Vertical)
- Fetal Indications
- Malpresentation
- Fetal Distress
- Cord Compression/Prolapse
- Other Indications
- Failed Vaginal Delivery
- Cephalopelvic Disproportion
- Abruptio Placentae or Placenta Previa
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
2 mins
Uterine Atony
- Pathophysiology
- Most Common Cause of Postpartum Hemorrhage
- Uterine Overdistention
- Exhausted Myometrium
- Uterine Infection
- Presentation
- "Boggy" Uterus
- Treatment
- Resuscitation with IV Fluids and Transfusions
- Bimanual Uterine Massage
- Oxytocin
- Methergine
- Prostaglandins
2 mins
Incompetent Cervix
- Mechanism
- Premature Cervical Dilation
- Assessment
- Recurring Miscarriage
- Short Cervix
- Considerations
- Cervical Cerclage
- Rest
- Labor
1 min
Postpartum Infection
- Diagnosis
- Fever > 100.4F After 24 Hours (38 C)
- Risk Factors
- Multiple Vaginal Examinations
- Vaginal Trauma
- Prolonged Rupture of Membranes
- Cesarean Birth
- Anemia of Pregnancy
- Retained Placental Fragments
- Poor Health Status
3 mins
Postpartum Hemorrhage
- Mechanism
- Uterine Atony
- Lacerations
- Retained Placenta
- Signs and Symptoms
- Bleeding
- Hypotension
- Boggy Uterus
- Considerations
- Oxytocin
- Bimanual Compression of Uterus
- Surgery
- Blood Transfusion
2 mins
Sheehan's Syndrome
- Postpartum Pituitary Gland Necrosis
- Agalactorrhea
- Amenorrhea
- Secondary Hypothyroidism with Cold Intolerance
1 min
Uterine Leiomyoma (Fibroids) Characteristics and Presentation
- Most Common Gynecologic Tumor
- Benign Smooth Muscle Tumor
- Risk Factors
- Early Menarche
- Hormone Sensitive
- African Americans
- Presentation
- Abnormal Menses
- Infertility
- Urinary Symptoms
- Irregularly Enlarged Uterus
3 mins
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