Spontaneous Abortion Overview
- Bleeding < 20 weeks Gestation
- Identify Type
- Bed Rest
- Monitor for Hemorrhage
- Save Pads and Linens
- RhoGAM
- Dilation and Curettage (DandC)
- Cerclage
- Emotional Support
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
Diabetes Assessment
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Adult Onset
- Insulin Resistance
- Obesity
- Onset During Pregnancy
- Glucose Intolerance
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
Disseminated Intravascular Coagulation (DIC) Assessment
- Improper Initiation of Clotting Cascade
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
Disseminated Intravascular Coagulation (DIC) Interventions
- Risk for Shock
- Renal Failure
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
Abruptio Placentae
- Premature Separation of Placenta
- Tearing Pain
- Bleeding (Often Concealed)
- Rigid Uterus
- Contractions
- Corticosteroids as Needed
- Emergent Delivery
- Increased Risks for Neonate
- Rh (Rhesus) Incompatibilities
- Increased Risk for Shock
- Monitor Fetal Heart Rate
Ectopic Pregnancy
- Lower Abdominal Pain
- Delayed Menses
- Abnormal Vaginal Bleeding
- Shock
- Referred Shoulder Pain
- Cullen Sign
- Methotrexate
- Surgery
- RhoGAM
Endometriosis
- Endometrial Tissue Outside Uterus
- Retrograde Menstrual Flow
- Dysmenorrhea
- Cyclic Pelvic Pain
- Irregular Vaginal Bleeding
- Pain with Defecation
- Dyspareunia
- Medications to Decrease Ovulation
- NSAIDs
- Surgery
Placental Implantation Abnormalities
- Placenta Adheres Directly to Myometrium
- Placenta Accreta
- Placenta Increta
- Placenta Percreta
- Caused by Scar Tissue
- Hemorrhage
- Ultrasound is First-line, then MRI
- C-section Delivery
- Artery Ligation or Embolization
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
HIV CD4+ 100
- Aspergillus fumigatus
- Cryptococcus neoformans
- Candida albicans (Esophagitis)
- Mycobacterium avium complex (MAC)
- Cytomegalovirus (CMV)
- Epstein-Barr virus (EBV) B-cell lymphoma
- Toxoplasma gondii
- Cryptosporidium
- Bartonella henselae
HIV CD4+ 200
- Herpes Simplex Virus (HSV)
- JC Virus
- Progressive Multifocal Leukoencephalopathy (PML)
- Pneumocystis Pneumonia
- (HIV) Dementia
- Histoplasmosis
HIV CD4+ 500
- Candida albicans (Oral Thrush)
- Kaposi's Sarcoma (HHV-8)
- Human Papillomavirus (HPV)
- Epstein-Barr Virus (Oral Hairy Leukoplakia)
Human Immunodeficiency Virus (HIV) Stages
- Primary Infection
- Within 3 Weeks
- Flu-like Symptoms
- Asymptomatic Stage
- Years
- Symptomatic Stage
- CD4+ < 500
- AIDS
- Opportunistic Infections
- CD4+ < 200
Human Immunodeficiency Virus (HIV) Interventions
- Adequate Nutrition
- Small Frequent Meals
- IV Hydration
- Emotional Support
- HAART
- Transmission Education
- Strict Asepsis for Invasive Procedures
- Treat Opportunistic Infections
Hydatidiform Mole (Molar Pregnancy)
- Abnormal Fertilization
- Symptoms of Pregnancy
- Elevated hCG
- Vaginal Bleeding
- Inappropriate Uterine Growth
- No Fetal Heart Rate (FHR)
- Dilation and Curettage (D&C)
- Emotional Support
- No Pregnancy 1 Year
- Hysterectomy
Preeclampsia Assessment
- After 20 Weeks of Pregnancy
- Hypertension > 140/90
- Proteinuria or End-Organ Dysfunction
- Hypertension > 160/110
- Progressive Renal Insufficiency
- Vision Changes
- HELLP Syndrome
- Pulmonary Edema
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
Severe Preeclampsia
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Hypertension
- Proteinuria or End-Organ Dysfunction
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
Eclampsia
- Increased Central Nervous System Irritability
- Hyperreflexia
- Positive Ankle Clonus
- Headaches
- Visual Disturbances
- Epigastric or RUQ Pain
- Seizures
- Coma
- Don't Leave Bedside
- Magnesium Sulfate
Magnesium Sulfate
- Muscle Relaxant
- Preterm Labor Contractions
- Preeclampsia
- Warm Feeling
- Hypotension
- Decreased Deep Tendon Reflexes (DTRS)
- Decreased Respiratory Rate
- Decreased Urine Output
- Paralytic Ileus
- Calcium Gluconate
Incompetent Cervix
- Premature Cervical Dilation
- Recurring Miscarriage
- Short Cervix
- Cervical Cerclage
- Rest
- Labor
TORCHeS Screening
- Toxoplasmosis
- Other
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus (HSV)
- Syphilis
- Diagnostic Testing
Syphilis TORCH
- Nonspecific TORCH Symptoms
- Often Results in Stillbirth
- Hydrops Fetalis
- Saber Shins
- Notched Teeth
- Saddle Nose
- Blindness
- Deafness
- Hepatitis
Rubella TORCH
- Nonspecific TORCH Symptoms
- Patent Ductus Arteriosus
- Pulmonary Artery Hypoplasia
- Cataracts
- Deafness
- Blueberry Muffin Rash
- Glaucoma
Cytomegalovirus (CMV) TORCH
- Nonspecific TORCH symptoms
- Intrauterine Growth Restriction (Retardation)
- Deafness
- Microcephaly
- Seizures
- Periventricular Calcifications
- Petechial Rash
- Blueberry Muffin Rash
- Chorioretinitis
- Urine Viral Culture or PCR
Toxoplasma gondii TORCH
- Congenital TORCH Infection
- Mom Usually Asymptomatic
- Rarely Lymphadenopathy
- Nonspecific TORCH Signs
- Intrauterine Growth Retardation
- Hepatosplenomegaly
- Deafness
- Chorioretinitis
- Hydrocephalus
- Calcifications
Pyelonephritis Assessment
- Ascending Urethral Bacteria
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Urosepsis
Chlamydia
- Chlamydia trachomatis
- May Be Asymptomatic
- Dysuria
- Epididymitis
- Discharge
- Dyspareunia
- Doxycycline
- Azithromycin
- No Intercourse for 1 Week
- Treat Partners
Syphilis
- Treponema pallidum
- Painless Chancre
- Rash on Palms and Soles
- (Generalized) Lymphadenopathy
- Condylomata Lata
- Asymptomatic
- Aortitis
- Neurosyphilis
- Gummas
- Penicillin
- Jarisch-Herxheimer Rash
Gonorrhea
- Neisseria gonorrhoeae
- Dysuria
- Yellowish-Green Discharge
- Increased Urinary Frequency
- Women Often Asymptomatic
- Ceftriaxone (IM)
- Doxycycline
- Azithromycin
- Treat Partners
Human Papillomavirus (HPV)
- Non-enveloped
- Circular
- Double Stranded DNA
- Warts 1, 2, 6, 11
- Condyloma acuminata
- Type 16, 18
- Cervical Carcinoma
- Penile Carcinoma
- AIDS/Immunocompromised
- Worsened by Smoking
- Koilocytic change in squamous epithelium
- Pyknotic Nuclei Surrounded by Clear Halo
- Vaccine Available
Tuberculosis Assessment
- Airborne Droplet
- 3 Week Productive Cough
- Night Sweats
- Chest Pain
- Fever
- Weight Loss
- Fatigue
- Chest X-Ray
- Blood Tests
- Mantoux Skin Test
- 3 Positive Sputum Tests
Tuberculosis Intervention
- Airborne Isolation
- Combination Drug Therapy (RIPE)
- 6-12 Months
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control