Hemorrhagic Disorders of Pregnancy Practice Flashcards

Comprehensive vocabulary flashcards covering hemorrhagic disorders of pregnancy including spontaneous abortion, molar pregnancy, cervical insufficiency, ectopic pregnancy, placenta previa, and placental abruption based on ATI Engage materials.

Hemorrhagic Disorders Learning Objectives

Examine anatomy, physiology, and pathophysiology of hemorrhagic disorders during pregnancy and explore the role of the nurse.

Uterine Cavity

The space surrounded by the uterine wall where the embryo develops.

Internal Orifice of the Cervix

The opening located at the bottom of the uterine cavity.

External Orifice of the Cervix

The opening of the cervix that leads directly to the vagina.

Menstrual Cycle Days $1$ to $5$

The phase characterized by endometrium breakdown and shedding.

Menstrual Cycle Days $6$ to $10$

The phase characterized by endometrium repair and growth.

Menstrual Cycle Days $11$ to $18$

The phase during which the endometrium continues its growth.

Menstrual Cycle Days $19$ to $28$

The phase during which the endometrium continues to thicken in preparation for pregnancy.

Implantation Timing

The event that may occur around day $23$ of the menstrual cycle involving a blastocyst.

Spontaneous Abortion

Commonly known as a miscarriage, involving pregnancy loss before viability.

Threatened Abortion

A type of spontaneous abortion where vaginal bleeding occurs but the pregnancy may continue.

Inevitable Abortion

A type of spontaneous abortion where the cervix dilates and the pregnancy cannot be saved.

Incomplete Abortion

A spontaneous abortion where some, but not all, products of conception are expelled.

Complete Abortion

A spontaneous abortion where all products of conception are expelled from the uterus.

Septic Abortion

A spontaneous abortion that is complicated by a uterine infection.

Missed Abortion

A spontaneous abortion where the fetus has died but the products of conception are retained in the uterus.

Medical Management of Miscarriage

May require dilating the cervix to remove the products of conception.

Spontaneous Abortion: Psychosocial Impact

Involves considerations of grief and loss and the maternal client’s emotional needs.

Role of the Nurse: Spontaneous Abortion

Involves monitoring the client, administration of care, and providing emotional support and teaching.

Expectant Management

Monitoring a client without immediate medical or surgical intervention to see if the body completes the process naturally.

Alloimmunization

The development of antibodies against foreign red blood cell antigens, which must be addressed after a spontaneous abortion.

Complete Mole Pathophysiology

An ovum without maternal genetic material is fertilized by a single sperm, resulting in $46XX$ chromosomes.

Partial Mole Pathophysiology

An ovum containing maternal genetic material is fertilized by two sperm, resulting in $69XXY$ chromosomes.

Molar Pregnancy Clinical Presentation

Includes hydropic vesicle changes of the trophoblast that have a typical grape-like appearance.

Gestational Trophoblastic Neoplasia (GTN)

A condition following a molar pregnancy that may require chemotherapy or surgical treatment.

Treatment for molar pregnancy

Options include uterine evacuation, hysterectomy, or chemotherapy.

Cervical Insufficiency

Painless cervical dilation that leads to a second-trimester pregnancy loss.

Cervical Insufficiency Medical Management

Treatment involving the administration of progesterone.

Cerclage Placement

A surgical management procedure for cervical insufficiency involving stitching the cervix shut.

Normal Cervix Anatomy

A cervix that is closed and contains a mucus plug during pregnancy.

Insufficient Cervix Anatomy

A cervix that lacks a mucus plug and dilates prematurely.

Ectopic Pregnancy

A pregnancy where the fertilized egg implants outside the uterine cavity, most commonly in the fallopian tubes.

Common Manifestations of Ectopic Pregnancy

Abdominal pain and vaginal bleeding.

Methotrexate

An antimetabolite medication ordered for nonsurgical management of an ectopic pregnancy.

Methotrexate Mechanism of Action

Works by interfering with DNA synthesis and cell multiplication to stop the growth of the pregnancy.

Anterior Placenta

A placenta positioned at the front of the pregnant person's uterus.

Posterior Placenta

A placenta positioned toward the top back of the uterus.

Placenta Previa

The implantation of the placenta over or near the internal os of the cervix.

Marginal Placenta Previa

The placenta is attached to the uterine wall near but not covering the cervix.

Partial Placenta Previa

The placenta is attached to the uterine wall with a small amount covering the cervix.

Complete Placenta Previa

The placenta is positioned entirely over the cervix.

Magnesium Sulfate

An anticonvulsant medication that may be ordered during pregnancy complications.

Betamethasone

A glucocorticoid administered to promote fetal lung maturity during complications.

Placental Abruption

The premature separation of the placenta from the uterine wall.

Acute Placental Abruption

A sudden onset separation of the placenta.

Chronic Placental Abruption

A gradual or long-term separation of the placenta over time.

Concealed Hemorrhage

A placental abruption where the bleeding is contained under the placenta with no blood flow to the vagina.

External Hemorrhage (Abruption)

A placental abruption where blood leads from the site to the cervix and outside the vagina.

Clotting factor: VII

A protein in the blood involved in the coagulation process.

Clotting factor: VIII

An essential blood-clotting protein known as antihemophilic factor.

Clotting factor: X

An enzyme involved in the coagulation cascade that converts prothrombin to thrombin.

Fibrinogen

A soluble protein found in blood plasma that is converted to fibrin during blood clot formation.

Protein X

Recognized in the transcript as a clotting mediator involved in coagulation regulation.

Plasmin

A clotting mediator responsible for the degradation of many blood plasma proteins, including fibrin clots.

Platelets

Cell fragments in the blood that are essential for normal blood clotting.

Inherited Thrombophilia

A genetic disorder that increases the risk of developing blood clots during pregnancy.

Gestational Thrombocytopenia

A lower-than-normal platelet count during pregnancy.

SA Care: Recognize Cues

The assessment phase of the nursing process when caring for a client with spontaneous abortion.

SA Care: Analyze Cues

The analysis phase where the nurse interprets assessment findings regarding spontaneous abortion.

SA Care: Prioritize Hypothesis

The analysis phase where the nurse identifies the most critical needs for an SA client.

SA Care: Generate Solutions

The planning phase where the nurse develops goals for a client experiencing spontaneous abortion.

SA Care: Take Action

The implementation phase where nursing interventions are performed for an SA client.

SA Care: Evaluate Outcomes

The evaluation phase where the nurse measures the success of interventions for an SA client.

Molar Pregnancy: Recognize Cues

Monitoring for clinical presentation signs like grape-like vesicles and high hCG levels.

Molar Pregnancy: Take Action

Performing uterine evacuation as part of medical management.

Cervical Insufficiency: Analyze Cues

Recognizing the potential for second-trimester loss due to painless dilation.

Cervical Insufficiency: Take Action

Assisting with cerclage placement or education on progesterone.

Ectopic Pregnancy: Recognize Cues

Assessing for abdominal pain and vaginal bleeding signs.

Ectopic Pregnancy: Take Action

Administering methotrexate as ordered and providing teaching.

Placenta Previa: Recognize Cues

Assessing placenta location via ultrasound and monitoring for bleeding.

Placenta Previa: Take Action

Implementing activity restrictions and teaching risks to the client.

Placental Abruption: Analyze Cues

Distinguishing between acute and chronic presentations and determining hemorrhage type.

Placental Abruption: Generate Solutions

Planning for emergency delivery or monitoring based on maternal/fetal stability.

Clotting Disorders: Analyze Cues

Reviewing factor levels like VIII, X, and Fibrinogen against reference ranges.

Clotting Disorders: Take Action

Anticipating and administering prescribed anticoagulation or factor replacement.

Clotting Mediator Reference Range

The expected physiological levels of Protein X and Plasmin.

Epidemiology of Hemorrhagic Disorders

The study of the distribution and determinants of pregnancy-related bleeding conditions.

Etiology

The study of the cause or origin of hemorrhagic disorders in pregnancy.

Maternal Genetic Material in Complete Mole

The maternal DNA is lost during the formation of a complete mole.

Fertilization of a Partial Mole

Occurs when one ovum with maternal DNA is fertilized by two sperm.

Hydropic Vesicles

The grape-like structures formed from the trophoblast in a molar pregnancy.

Preterm Labor vs. Preterm Birth

Preterm labor is the process of heading toward birth; preterm birth is the actual delivery before term.

Nurse's Role in Preterm Delivery

Preparing for delivery and managing risks for both the mother and the infant.

Expectant Management of Ectopic Pregnancy

Monitoring the ectopic pregnancy without medical or surgical intervention if stable.

Expectant Management of Spontaneous Abortion

Allowing the body to expel the products of conception without medical or surgical aid.

Invasive Mole

A form of gestational trophoblastic disease where the mole invades the uterine wall.

Uterine Evacuation

The procedural management of removing the contents of the uterus, typically for molar pregnancy or SA.

Chemotherapy in GTN

Used as a treatment for Gestational Trophoblastic Neoplasia.

Methotrexate Client Education

Instruction regarding side effects, monitoring, and necessity of follow-up for ectopic pregnancy management.

Magnesium Sulfate Classification

Categorized as an anticonvulsant in the context of pregnancy complications.

Betamethasone Classification

Categorized as a glucocorticoid for fetal maturation.

Activity Restrictions in Placenta Previa

Teaching provided by the nurse to minimize bleeding risks.

Maternal Vessels in Abruption

The source of blood flow that provides for the tissues of the uterus and placenta.

External Hemorrhage Visualization

Blood flows through the cervix and is visible outside the vagina during abruption.

Concealed Hemorrhage Visualization

Blood remains trapped under the placenta and is not visible externally.

Inherited Thrombophilia Goal of Treatment

The primary goal is the prevention of thromboembolic events throughout pregnancy and postpartum.

Medication Administration for Clotting Disorders

Includes specific protocols for each stage of pregnancy, labor, and delivery.

Grief and Loss in Ectopic Pregnancy

A psychosocial consideration due to nature of the pregnancy loss.

Grief and Loss in Molar Pregnancy

Psychosocial concern regarding the lack of a viable fetus and the diagnosis of a mole.

Progesterone for Cervical Insufficiency

Medical management used to maintain pregnancy length.