| Reason for teenage pregnancies: 1: | Earlier age of menarche in girls (the average age is
12.4 years; many girls begin menstruating at age 10
and so are ovulating and able to conceive by age 11) |
| Reason for teenage pregnancies: 1:
Earlier age of menarche in girls, the average age is? | 12.4 years; many girls begin menstruating at age 10
and so are ovulating and able to conceive by age 11) |
| Reason for teenage pregnancies: 2: | Increase in the rate of sexual activity among teenagers |
| Reason for teenage pregnancies: 3: | Lack of knowledge about ( or failure to use) contraceptives or abstinence |
| Reason for teenage pregnancies: 4: | Desire of young girls to have a child |
| The fourfolds of an adolescent’s developmental tasks; | To establish a sense of self-worth or a
value system
To emancipate from parents
To adjust to a new body image
To choose a vocation |
| Mature minor
A person capable of making health care decisions
May sign permission for her own care | Emancipated minor |
| Prenatal Assessment: High-risk clients: 5
HIPHH | High incidence of pregnancy-induced hypertension
Iron-deficiency anemia
Premature labor
Higher incidence of low-birth-weight infants
High rate of intimate partner abuse |
| Prenatal Assessment: The factors contributing to the lack of prenatal care include: 6
DLDFFD | Denial she is pregnant
Lack of knowledge of the importance of prenatal care
Dependence on others for transportation
Feeling awkward in a prenatal setting (an adult setting)
Fear of a first pelvic examination
Difficulty relating to authority figures |
| Prenatal Assessment: | Conflicting development crises
High risk for hypertension
High risk for cephalopelvic disproportion
High risk for hemorrhoidsd
dHigh risk for iron deficiency anemia |
| Prenatal Assessment: Adolescent: Health history: | Family profile
Day history |
| Prenatal Assessment: Adolescent: Physical Examination: | Baseline blood pressure at first prenatal visit
Doppler technique to obtain fetal heart
Record fundal height every visit
Monitor weight |
| Prenatal Assessment: Adolescent: Pregnancy Education: | Adolescent girls may respond to health teaching that is
directed to their own health more than to that of a fetus inside
them.
Instructions about possible discomforts and changes
associated with pregnancy, and measures to relieve them.
Hemorrhoids is normal in pregnancy
Assure adolescents that abdominal striae (stretch marks) are
normal due to skin elasticity.
Chloasma (excess pigment on face and neck) is normal.
Suggesting a cover makeup and offering reassurance the
pigmentation will fade after pregnancy can help. |
| Prenatal Assessment: Adolescent: Nutrition:
preterm birth and low-birth-weight newborns.
The younger the mother the more susceptible
Need to gain more weight | Lack of Good nutrition |
| Prenatal Assessment: Adolescent: Nutrition: Lack of Good Nutrition symptoms and indications: | preterm birth and low-birth-weight newborns.
The younger the mother the more susceptible
Need to gain more weight |
| Prenatal Assessment: Adolescent: Nutrition:
macrosomia in fetus
Should not restrict nutrients during pregnancy
May be deficient in protein and vitamins due to obesity | Overweight or obese |
| Prenatal Assessment: Adolescent: Nutrition: Overweight or Obese: Symptoms or indications: | macrosomnia in fetus
Should not restrict nutrients during pregnancy
May be deficient in protein and vitamins due to obesity |
| Prenatal Assessment: Adolescent: Activity and Rest: | Assess a girl’s participation in sports and determine which ones (if any) may have to be discontinued during pregnancy (e.g., diving, gymnastics,
touch football)
Suggest alternative activities |
| Prenatal Assessment: Adolescent: Physiologic Changes Childbirth Preparation Birth Decisions: | Pelvic measurements should be taken early because of the possibility of cephalopelvic disproportion due to incomplete pelvic growth.
May lead to cesarean birth and the information should be shared with the parents |
| Prenatal Assessment: Adolescent: Plans for baby: | Adolescents may need additional time at prenatal visits to talk to a good listener about how they feel about being pregnant and becoming a mother
Encourage them to breastfeed
They know all options available
Keeping the baby
Placing the baby in a temporary foster home or adoption |
| Complications of Adolescent Pregnancy: Pregnancy-Induced Hypertension Management: | Bed rest in a 'side-lying position'
Low-dose aspirin therapy may be prescribed to help reduce symptoms of hypertension of pregnancy
They need activities to keep them busy
If hypertension continues, a girl should be admitted to the
hospital and labor or a cesarean birth may be induced if
fetus is already mature. |
| Complications of Adolescent Pregnancy: Iron Deficiency Anemia: Many adolescent girls are deficient in iron because? | their low protein intake cannot balance the amount of iron lost with menstrual flows.
A pregnancy compounds iron-deficiency anemia because a girl must now supply enough iron for fetal growth and her increasing blood volume.
All pregnant women should take an iron and folic acid supplement (folic acid is important for red blood cell growth and prevention of neural tube defects) and these are especially important for the adolescent.
As soon as the body has iron, it will begin forming immature red blood cells (reticulocytes) rapidly.
If the reticulocyte count is not elevated by 2 weeks, it implies a girl did not take the supplement. |
| Complications of Adolescent Pregnancy: Iron Deficiency Anemia: | A pregnancy compounds iron-deficiency anemia because a girl must now supply enough iron for fetal growth and her increasing blood volume.
All pregnant women should take an iron and folic acid supplement (folic acid is important for red blood cell growth and prevention of neural tube defects) and these are especially important for the adolescent.
As soon as the body has iron, it will begin forming immature red blood cells (reticulocytes) rapidly.
If the reticulocyte count is not elevated by 2 weeks, it implies a girl did not take the supplement. |
| Complications of Adolescent Pregnancy: Preterm Labor:
Adolescents are at high risk for preterm labor because?
Signs of preterm labor... | their uteruses are not fully grown.
... must be reviewed during the third month of
pregnancy.
Labor contractions
Vaginal bleeding |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: It is a lack of engagement at the beginning of labor, prolonged first stage of labor, and poor fetal descent.
Baby's head too large to pass through the mother's pelvis. | Cephalopelvic Disproportion |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: is a good way to detect labor that is becoming abnormal. | Graphing Labor progress |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: Postpartum hemorrhage:
1.) More prone than average woman because?
2.) Adolescents may also have more frequent or deeper perineal
and cervical lacerations than older women because? | 1.) their uterus becomes overdistended by pregnancy.
An overdistended uterus does not contract as readily as a
normal distended uterus in the postpartum period = bleeding
2.) of the size of the infant. |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: Inability to Adapt Postpartally:
Urge her to talk about labor and birth to make the happening real to her; otherwise, 'what' is more apt to occur? | They may “block out” the hours of labor as if they did not happen.
If the adolescent is frightened by labor, she may received a narcotic, so her memory of labor hours may not be clear.
...postpartum depression |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: lack of Knowledge About Infant Care: | They can be overwhelmed in the postpartum period to
realize that when the baby is their own, child care is not
as simple as it once seemed. |
| Complications of Adolescent Labor, Birth, and the Postpartum Period: lack of Knowledge About Infant Care: Management: | Spend time with a girl observing how she handles her
infant.
Demonstrate bathing and changing the baby as
appropriate.
Model good parenting behaviors whenever possible by
being aware of how you hold and care for the child.
Educate adolescents for breastfeeding and provide other
feeding method |
| Complications of Pregnancy for a Woman Over Age 40: Pregnancy-Induced Hypertension:
They have a higher incidence of pregnancy-induced hypertension due to?
To reduce symptoms: | blood vessel inelasticity or because of hypertension tends to occur more frequently in nulliparas than in multiparas.
Allow rest each day by planning activities she can accomplish on bed rest (e.g. reworking a school course outline, restructuring her office filing system, or working at a hobby she has wanted to pursue but never had time for before.) |
| Complications of Labor, Birth, and the Postpartum Period for a Woman Over Age 40: Failure to progress in labor:
Labor may be prolonged because | cervical dilatation may not occur as spontaneously as in a younger woman. Thus, they may need a cesarean birth if labor is overly prolonged. |
| Complications of Labor, Birth, and the Postpartum Period for a Woman Over Age 40:
Women over age 40 may begin to have second thoughts about
childbearing this late in life as the reality of a new baby registers with
them during the intrapartal and postpartum periods.
Review plans for child care and postpartum rest, with an emphasis on
helping women learn to balance their lives, especially if they are
planning on returning to work soon after the birth. | Difficulty Accepting the Event |
| Complications of Labor, Birth, and the Postpartum Period for a Woman Over Age 40: Postpartum Hemorrhage: becuase: | The uterus may not contract as readily in the postpartum period
because of inelasticity.
More prone to perineal-anal tears because her perineum is less subtle.
Assess the amount of lochial flow to detect complication. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Area: Transportation: What is the Assessment and Planning Guidelines: | Ask if a woman has transportation for prenatal care and for emergencies. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Area: Pregnancy counseling: What is the assessment and planning guidelines: | Assess the special modifications of care that will need to be made depending on a woman's special challenge. Use additional visual or auditory aids to make your teaching points clear. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Area: Support person: What is the assessment and planning guideline/s: | Determine who is the woman's support person. In some instances, a woman's condition requires so much assistance during pregnancy that one support person will not be enough if necessary, contact community agencies to lend additional support with her consent. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Area: health: What is the asseessment and planning guidelines: | Do not lose track of a woman's primary health problem. For example, a woman with cerebral palsy may need to continue an active muscle exercise program during pregnancy for her primary illness. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Area: Work: What is the assessment or planning guidelines: | Assess whether a woman works outside her home and, if work is discontinued during pregnancy, what she could substitute for a social contact activity. Women with physical or cognitive challenges may be lonely because they do not have a wide range of friends or social contacts. |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Recreation: What is the assessment and planning guidelines: | Assess whether her level of activity is adequate and make concrete suggestions within her limitations for increasing it. Many women with a physically challenging condition lead a rather sedentary life (partly because they do not have many social contracts). |
| Areas of Planning with Pregnant Woman Who Is Physically or
Cognitively Challenged during pregnancy: Self-esteem: What is the assessment and planning guidelines: | Assess a woman's level of self-esteem it may be low because of repeated failures in her life. Give praise at prenatal visits and help her make pregnancy a growth experience. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Rights (Ethical and Legal Considerations): 4: | Physically disabled persons must have freedom of access to public buildings by means of ramps or handrails.
A hospital cannot deny care to a person with a disability even though the disabling condition complicates treatment considerably, possibly requiring extra personnel and time.
A woman with a disability has full rights to her child, so the baby cannot be taken from her at birth without her full consent.
She cannot be forced to terminate a pregnancy or undergo sterilization unless that is her informed decision. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Safety Measures: Emergency contacts: | Evaluate client's ability to contact someone in case of pregnancy-related emergency |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Safety Measures: Transportation: | Assess a client’s ability to come for prenatal care.
Women with cognitive or vision challenges, for example, may not qualify for a driver’s license and so may need someone, such as a family member or friend, to drive.
Women with spinal cord injury may have difficulty transferring into the specially equipped, hand-controlled car they usually drive as pregnancy progresses. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Safety Measures: Mobility: | All women who use wheelchairs are taught to press with their hands against the armrests and lift their buttocks up off the wheelchair seat for 5 seconds every hour to prevent formation of pressure ulcers on the buttocks and posterior thighs.
For at least 1 hour every morning and afternoon, encourage women who ambulate by wheelchair to decrease the sharp bend at their knees that results from sitting in the chair, to promote venous return and help prevent varicosities and thrombi formation. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Safety Measures: Elimination: | Encourage a high fluid intake and frequent voiding, however, to prevent urinary tract infections.
Women with indwelling catheter may be at risk for urinary tract infection. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Safety Measures: Autonomic Responses: | Observe for autonomic dysreflexia in a woman who has a high spinal cord injury (cervical or high thoracic)
Elevate a woman’s head to reduce cerebral pressure and locate the irritating stimulus (usually a distended bladder or bowel). |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Modifications for Labor and Birth: Women who are physically or cognitively challenged will need adaptations in preparation for labor and birth, what are the helpful suggestions of the following: A woman with a spinal cord injury: | may not be able to feel uterine contractions.
Late in pregnancy, she will need to palpate her abdomen periodically for tightening or the presence of contractions so she is aware of beginning labor. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Modifications for Labor and Birth: Women who are physically or cognitively challenged will need adaptations in preparation for labor and birth, what are the helpful suggestions of the following: Women with muscle spasticity (or spinal cord injury): | may not be able to push effectively for the second stage of labor and so may need cesarean or forceps birth. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Modifications for Labor and Birth: Women who are physically or cognitively challenged will need adaptations in preparation for labor and birth, what are the helpful suggestions of the following: Visually challenged persons: | Braille watches used by visually challenged persons may not have second hands.
They may need to time the length of contractions by counting rather than timing them by a watch.
Be certain to identify the usual sounds of birthing rooms ( the beeping of a monitor, the swish of a central supply routing system, and so forth) for the visually challenged woman. hearing sounds and not being able to identify them can be frightening. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Modifications for Labor and Birth: Women who are physically or cognitively challenged will need adaptations in preparation for labor and birth, what are the helpful suggestions of the following: hearing-challenged woman: | During labor, cannot hear information on how she is progressing if you are not directly facing her. If she needs to communicate with her support person in sign language, act as an advocate to keep her hands unencumbered by equipment such as intravenous lines.
Remember she cannot hear her infant cry at birth. Hand the infant to her as soon as possible after birth so she can see and feel the baby is crying and breathing well. |
| Pregnant Woman Who Is Physically or Cognitively Challenged: Modifications for Postpartum Care: After birth, be sure to assess and teach: | Whether a woman desires contraceptive information.
Whether she needs additional support to be successful at breastfeeding.
Whether she has a return appointment for both herself and her infant for follow-up care and that the
arrangements are within her capabilities, transportation, and understanding. |
| A Woman Who Is Substance Dependent: Is the inability to meet major role obligations, an increase in legal problems or risk-taking behavior, or exposure to hazardous situations because of an addicting substance. | Substance abuse |
| A Woman Who Is Substance Dependent: When he or she has withdrawal symptoms following discontinuation of the substance, combined with abandonment of important activities, spending increased time in activities related to substance use, using substances for a longer time than planned, or continued use despite worsening problems because of substance use. | Substance dependent |
| A Woman Who Is Substance Dependent: Illicit drugs tend to be of small molecular weight, so they readily cross the placenta. As a result: | a fetus of an addicted mother has a drug concentration
of about 50%.
Fetal abnormalities
Preterm birth
Hepatitis B
HIV |
| Common Substances Abused During Pregnancy: Cocaine: is derived from? | Erythroxylum coca, a plant grown almost exclusively in South America. |
| Common Substances Abused During Pregnancy: Cocaine: It can be detected by? | urine analysis or urinalysis |
| Common Substances Abused During Pregnancy: Cocaine: It is absorbed? | across the mucous membranes to affect the central nervous system. Thus, vasoconstriction occurs which will result to respiratory and cardiac rates and increase blood pressure of worse, death from cardiac failure. |
| Common Substances Abused During Pregnancy: Cocaine: Infant symptoms: | Intracranial hemorrhage
Tremulousness
Irritability
Muscle rigidity |
| Common Substances Abused During Pregnancy: Cocaine: It is exceptionally harmful during pregnancy because? | the extreme vasoconstriction can severely compromise placental circulation = premature separation of placenta = preterm labor or fetal death. |
| Common Substances Abused During Pregnancy:
-Derived from Erythroxylum coca, a plant grown almost exclusively in South America.
-Can be detected by urine analysis
-Absorbed across the mucous membranes to affect the central nervous system. Thus, vasoconstriction occurs which will result to respiratory and cardiac rates and increase blood pressure or worse, death from cardiac failure
-exceptionally harmful during pregnancy because the extreme vasoconstriction can severely compromise placental circulation = premature separation of placenta = preterm labor or fetal death. | Cocaine |
| Common Substances Abused During Pregnancy:
Methamphetamine (speed) has a pharmacologic effect similar to cocaine.
It is easy and cheaply manufactured.
Ice, a rock type that is smoked, can produce high concentrations of drug in the maternal circulation.
Infant symptoms:
- Jitterines
- Poor feeding
- Growth restricted | Amphetamines |
| Common Substances Abused During Pregnancy: Amphetamines: Infant symptoms: | jitterines
Poor feeding
Growth restricted |
| Common Substances Abused During Pregnancy:
Both are obtained from the hemp plant, cannabis. It is associated with short-term memory and respiratory infection.
When smoked, they produce tachycardia and a sense of well-being.
Some women use marijuana to counteract nausea in early pregnancy.
Frequently part of polydrug abuse, so their effects on fetal development are not well documented.
A frequent user may not be able to breastfeed because of reduced milk production and the risk to the newborn from
excretion of the drug in the milk. | Marijuana and Hashish |
| Common Substances Abused During Pregnancy: Marijuana and Hashish: Both are obtained from? | the hemp plant, cannabis.
It is associated with short-term memory and respiratory infection. |
| Common Substances Abused During Pregnancy: Marijuana and Hashish: When smoked, they produce: | tachycardia and a sense of well-being. |
| Common Substances Abused During Pregnancy: Marijuana and Hashish: Some women use marijuana to? | counteract nausea in early pregnancy |
| Common Substances Abused During Pregnancy: Marijuana and Hashish: A frequent user may not be able to breastfeed because? | of reduced milk production and the risk to the newborn from excretion of the drug in the milk. |
| Common Substances Abused During Pregnancy:
An animal tranquilizer that is frequently used street drug in polydrug abuse.
Causes increased cardiac output and a sense of euphoria (sense of elation and extreme happiness) and long-term hallucinations.
These drugs tend to leave the maternal circulation and concentrate in fetal cells = injurious to a fetus. | Phencyclidine |
| Common Substances Abused During Pregnancy: Phencyclidine: causes: | increased cardiac output and a sense of euphoria (sense of elation and extreme happiness) and long-term hallucinations. |
| Common Substances Abused During Pregnancy: Phencyclidine: These drugs tend to leave to the? | maternal circulation and concentrate in fetal cells = injurious to a fetus. |
| Common Substances Abused During Pregnancy:
Used for the treatment of pain, cough suppression, analgesic, and euphoric effect.
It can be administered in 3 ways.
-snorting (inhalation)
-skin popping (intradermal)
-Shooting (intravenous)
Infant symptoms:
-small for gestational age
-increased fetal distress
-meconium aspiration
-mature liver | narcotic agents |
| Common Substances Abused During Pregnancy: narcotic agents: used for: | the treatment of pain, cough suppression, analgesic and euphoric effect. |
| Common Substances Abused During Pregnancy: narcotic agents: A raw opiate, is the main opiate used recreationally to the point of dependence, and its use is increasing in incidence in young adults. | herion |
| Common Substances Abused During Pregnancy: narcotic agents: What ways can it be administered? | skin popping (intradermal)
Snorting (inhalation)
Shooting (intravenous) |
| Common Substances Abused During Pregnancy: narcotic agents: Infant symptoms: | -small for gestational age
- increased fetal distress
- meconium aspiration
- mature liver |
| Common Substances Abused During Pregnancy: Inhalants:
Most of these substances contain ??? as a propellant and can lead to severe respiratory and cardiac irregularities. | freon |
| Common Substances Abused During Pregnancy: Inhalants:
They have the same effect with what during pregnancy? | alcohol abuse |
| Common Substances Abused During Pregnancy:
Refers to the “sniffing” or “huffing” of aerosol drugs (e.g. airplane glue, cooking sprays, and computer keyboard cleaner)
Most of these substances contain freon as a propellant and can lead to severe respiratory and cardiac irregularities.
They have the same effect with alcohol abuse during pregnancy.
Respiratory depression they cause can result to limit the fetal oxygen supply to a serious level. | Inhalants |
| Common Substances Abused During Pregnancy:
Excessive use tends to occur in women with impulsive personalities.
Can cause fetal alcohol syndrome (FAS)
- Facial deformities
- Possible cognitive challenges
- Memory deficits | alcohol |
| Trauma and Pregnancy: Physiologic Changes in Pregnancy That Affect Trauma Care: primary rule after traumatic injury: | A woman's body will maintain her own homeostasis at the expense of the fetus. |
| Trauma and Pregnancy: Physiologic Changes in Pregnancy That Affect Trauma Care: Assessment: | -Vital signs
-Doppler to assess fetal heart tones
-External monitoring of fetal heart rate
-Support person/s |
| Initial Assessments After Trauma During Pregnancy: Respiratory system: | Quality of respirations - labored or even?
Rate of respirations
Sounds of obstruction - Wheezing, retractions, coughing?
Color - cyanotic?
Oxygen hunger - inability to lie flat, nasal flaring? |
| Initial Assessments After Trauma During Pregnancy: Cardiovascular system: | color - pallor from hemorrhage?
Gross bleeding
Pulse rate - increases with hemorrhage
Blood pressure - decreases with hemorrhage
Feeling of apprehension from altered vascular pressure? |
| Initial Assessments After Trauma During Pregnancy: nervous system: | level of consciousness (woman answers questions coherently?)
Pupils - equal and reacting to light?
Bruises or bump on head or spinal column
Loss of motion or sensory function in a body part |
| Initial Assessments After Trauma During Pregnancy: Renal system: | Bruising on anterior abdominal wall over bladder or on back over kidneys
Blood in urine |
| Initial Assessments After Trauma During Pregnancy: uterine-fetal system: | Bradycardia, tachycardia, or absence of fetal heart tones or loss of variability on fetal monitor.
Vaginal bleeding
Clear (amniotic) fluid leaking from vagina
Bruising on abdomen over uterus |
| Physical Examination: Woman who experienced blow to their abdomen: Should? | evaluate premature separation of placenta |
| Physical Examination: Woman with multiple trauma: should? | perform nasogastric tubing to empty the stomach
Insert foley catheter to assess urine output and to rule out ruptured bladder. |
| Trauma and Pregnancy Therapeutic Management: Open Wounds:
Jagged cut
May involve only the skin layer or may penetrate deeper subcutaneous tissue or tendons
bleed profusely | Lacerations |
| Trauma and Pregnancy Therapeutic Management: Open Wounds: Lacerations:
Management: | Sutured through each layer of tissue with the use of local anesthetic such as lidocaine (Xylocaine) and it is safe during pregnancy.
1. Put pressure on the edges of the laceration |
| Trauma and Pregnancy Therapeutic Management: Open Wounds:
results from penetration of a sharp object such as a nail,
splinter, nail file, or knife
Bleed little | Puncture wounds |
| Trauma and Pregnancy Therapeutic Management: Open Wounds: Puncture wounds:
Not usually sutured because: | suturing would create a sealed, unoxygenated cavity below the sutures with a space where tetanus bacilli could grow. |
| Trauma and Pregnancy Therapeutic Management: Open Wounds: Puncture wounds:
Cause deep penetration and are often directed into the abdomen
They may easily reach the depth of the uterus, possibly directly cutting the fetus. | Knife |
| Trauma and Pregnancy Therapeutic Management: Open Wounds: Puncture wounds:
may be done to determine the depth and extent of a wound: | fistulogram (thin catheter inserted into the wound with radiopaque solution) |
| Trauma and Pregnancy Therapeutic Management: Open Wounds: Animal or Snake bites management: | Animal bites produce a form of puncture wound, so if the rabies immunization status of the dog is known, the wound is washed and treated as a puncture wound. If the dog cannot be located or is proved to be rabid after 48 hours of observation, a woman must be administered rabies immune globulin and vaccine.
Pregnancy is not a contraindication to rabies immunization because contracting the disease would be fatal.
The same is true of anti-venom serum for snake bites (Olson, 2009). |
| Trauma and Pregnancy Therapeutic Management:
occurs generally from automobile accidents, when a woman’s abdomen strikes the steering wheel or dashboard, or from someone kicking or
punching her abdomen.
No visible break is present in the skin.
Underlying tissue becomes edematous, broken underlying blood vessels ooze and form ecchymoses or a hematoma at the site.
Peritoneal lavage may be performed to assess abdominal bleeding | blunt trauma |
| Trauma and Pregnancy Therapeutic Management: Blunt trauma:
may be performed to assess abdominal bleeding | Peritoneal lavage |
| Trauma and Pregnancy Therapeutic Management: Gunshot wounds:
Assessment of the wound includes: | inspection for the point where the bullet entered the body and the point where it exited (the entry wound is small but the exit wound is large because as a bullet slows, it begins to tumble, enlarging the
space it occupies). |
| Trauma and Pregnancy Therapeutic Management: Gunshot wounds:
The uterine wall is so thick during pregnancy that it may trap a bullet, so? | there may be no exit point from a woman's body if the uterus was punctured. |
| Trauma and Pregnancy Therapeutic Management: Gunshot wounds:
If the bullet entered high in the abdomen: what will happen and why? | the intestines will surely be injured because so many loops of these are compressed above the uterus |
| Trauma and Pregnancy Therapeutic Management: Gunshot wounds: Management: | Gunshot wounds are surgically cleaned and debrided and is treated with high-dose antibiotic (Ampicillin - safe for pregnancy) |
| Trauma and Pregnancy Therapeutic Management: Poisoning:
Pregnant women are not apt to swallow a poison, although this can occur accidentally, especially if? | a woman wakes at night and attempts to take medicine in the dark |
| Trauma and Pregnancy Therapeutic Management: Poisoning:
In an emergency department, what is the drug of choice to neutralize stomach poison? | activated charcoal |
| Trauma and Pregnancy Therapeutic Management: Poisoning: How is poisoning in the pregnant are managed? | Poisoning in the pregnant woman is managed the same as in any other person |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Standing Position: Plan and Principle: 1: | Plan: Stand behind the woman and encircle her chest with your arms
Principle: Proper positioning ensures proper placement of chest pressure and prevents inadvertent injury to underlying body structures |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Standing Position: Plan and Principle: 2: | Plan: Place the thumb side of your fist on the middle of the woman's sternum.
Principle: Placement of fist against the chest ensures a solid structure for compression. |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Standing Position: Plan and Principle: 3: | Plan: Grab the fist with the other hand and perform backward thrust until the foreign body is expelled.
Principle: Pressure on the chest compresses the ribs, increasing chest and lung pressure. This increased pressure forces an object lodged in the airway to move upward. |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Standing Position: Plan and Principle: 1,2,3 | Congrats, Heimlich maneuver lang |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Supine Position: Plan and Principle: 1: | Plan: place the woman in the same position as for external heart compressions (heel of the hand on the lower sternum)
Principle: Loss of consciousness interferes with the woman's ability to maintain an upright position. |
| Trauma and Pregnancy Therapeutic Management: Choking: Chest Thrusts for the Pregnant Woman: To relieve tracheal aspiration: For conscious Victim in Supine Position: Plan and Principle: 2: | Plan: Follow Steps 2 and 3 as with standing victim (proper placing sa thumb, palm, and heel and then exert force or push)
Principle: Compression of the chest forces the object lodged in the airway to move upward. Chest compression can be as effective in the supine position as in the standing position. |
| Trauma and Pregnancy Therapeutic Management: Orthopedic injuries occur Because? | Because a woman has poor balance late in pregnancy, it is easy for her to trip; when she falls, she automatically reaches out a hand to cushion the fall and to prevent landing on her abdomen. |
| Trauma and Pregnancy Therapeutic Management: Orthopedic injuries: Falls can cause serious wrist injury, a 'what' fracture or otherwise called?
If you may, explain also why it does happen. | A colles fracture
it does happen because as a body's response or reflex, the arm-hand-wrist, is what's instinctively used to cushion the body especially the baby |
| Trauma and Pregnancy Therapeutic Management: Orthopedic injuries: Management: | Apply ice to the area to decrease swelling as first-aid measure
Radiograph to determine whether a fracture is present
Provide calcium food sources to promote bone growth if she has fracture. |
| Trauma and Pregnancy Therapeutic Management: Burns: Dangerous in the pregnant woman not only because of the thermal injury that occurs but because of? | inhalation of carbon monoxide gases from the fire, which could lead to extreme fetal hypoxia as carbon monoxide crosses the
placenta in place of oxygen. |
| Trauma and Pregnancy Therapeutic Management: Burns: Because fluid and electrolyte losses can be great with burns, What can occur? | Because fluid and electrolyte losses can be great with
burns, hypotension from hypovolemia or an electrolyte
imbalance can occur. |
| Trauma and Pregnancy Therapeutic Management: Burns: Can cause preterm labor due to? | released of prostaglandins. |
| Trauma and Pregnancy Therapeutic Management: Burns: Interestingly, burn tissue heals more quickly than normal during pregnancy due to? | increased metabolism and possibly to the increased corticosteroid serum level that prevents inflammation and damage tissue from the
pressure of edema. |
| If a pregnant woman does not survive serious trauma, it
may still be possible for her child to be born safely by a?
No consent is necessary for this procedure
Classic cesarean incision is used
Personnel should be available to resuscitate the newborn immediately. | Postmortem Cesarean birth |
| Postmortem Cesarean Birth is usually attempted if? | the fetus is past 24 weeks and less than 20 minutes has passed since the mother died. |
| Postmortem Cesarean Birth: Infant survival is best in these circumstances if? | no more than 5 minutes has passed |
