Question

Q5:Discuss the types of molar pregnancy, signs and treatment. (medical, surgical and nursing) ?

Q6:Discuss the changes and management during menopause ?

Q7:Discuss the nursing management of a patient with bleeding and placenta previa ?

Q8:Briefly discuss the role of progesterone in pregnancy ?

Answer 1

QUES-5

MOLAR PREGNANCY

-It is also known as hydatidiform mole,the word hydatidiform mole came from Latin word HYDATID,means ' drop  of water' and MOLE means' spot'

-It is defined as an abnormal pregnancy charactrized by the the presence of non-viable fertilized egg may implant   in the uterus and pregnancy may be pathogenic

TYPES OF MOLAR PREGNANCY

Molar pregnancy is classified into two

1-COMPLETE HYDATIDIFORM MOLE

-there isan absence of embryo

-uterus size is more than gestational age

-charactrized by severe anemia,lower abdominal pain and high level of human chorionic gonadotrophin

-there is a presence of grape like vesicles

2-PARTIAL HYDATIDIFORM MOLE

-there is an embryo

-uterine size is less than the expected date of gestation

-charactrized by frequent abortions

SIGNS

    -Pallor

-headache

-proteinuria

-lower abdominal pain

-nausea or vomiting

-blurred vision

-reduced urine output

-hyperemesis gravidarum

-fatigue or weakness

-soft or firm uterus

-cannot palpate fetus

-absence of fetal heart rates and fetal heart sounds

-grape like vesicles in the lower perineal region

MANAGEMENT

MEDICAL MANAGEMENT-it includes

-treat severe anemia

-treat hyperemesis gravidaruum

-administarion of antibiotics to prevent infections

-administration of intravenous fluids

-treat the underlying diseases

-administration of analgesics and anti-inflammatory drugs

SURGICAL MANAGEMENT-it includes

-Surgical correction by suction curettage

it is the process of cleaning or drain out the moles by administering oxytocin

-Hystrectomy

it is defined as the surgical excision of the entire uterus through abdominally or birth canal

NURSING MANAGEMENT

-monitor patients regularly

-assess for early signs of pre-eclampsia

-correction of dehydration

-maintain standard precautions

-intravenous administration of fluids

-maintain blood levels

-assess for the earlysigns of infection

-provide family planning methods

-provide counselling

QUE-6

MENOPAUSE

- Literally means the permanent cessation of menstruation

- peak ages between 45-55 years of age

CHANGES

-The classical changes are as follows;

-NIGHT SWEAT

-HOT FLUSH

-SLEEP PATTERN DISTURBANCES

Other changes are;

-sexual dysfunction

-dryness of the birth canal

-urinary problems like dysuria ,incresed risk of urinary tact infections

-skin colur changes

-impaired hormonal functions

-thinning of hair

risk for cardio-vascular diseases

-risk for musculo-skeletal disorders

-risk for bone fractures

-neurological disturbances like lack of concentatration and motivation

-extreme stress and anxiety

-weakness

-weight gain and decreased physical activity

-dryness of the skin

-risk for psychitaric disorders like dementia

MANAGEMENT

The choice of treatment is HORMONAL THERAPY

Hormonal therapy is a treatment used to reduce the hot flushes and dryness birth canal

-It includes OESTROGEN therapy

-improve physical activity

-maintain nutritional status

-stop smoking

-treat underlying causes and diseases

-improve sleep and provide relaxation techniques

-supplementation of calcium and phosphorous

-prevent hot flush by taking cool drinks

QUESTION-7

NURSING MANAGEMENT OF BLEEDING AND PLACENTA PREVIA

Objectives are;

-to maintain hydration status

-to prevent shock

-to prevent further complications

-to maintain standard precautions

-to administer intravenous fluids

- Placenta previa is nothing but placenta is situated near the internal os

NURSING MANAGEMENTS

-assess the condition of the patients

-assess the featl heart rates and fetal sounds

-physical condition of the mother and the fetus

-provide emergency care if needed

-administration of intravenous fluid

-maintain positions

-provide calm and quite enviornments

-assess the general condition of the mother

-blood transfusion if necessary

-assess for the indication of cessarean section

-complete bed rest

-assess the fetal maturity by using ultrasonography

-administer oxygen if needed

-maintain universal precautions

-assess fetal well being

-treat anemia and shock

-assess for coplications like mal presentations,premature rupture of membrane

NURSING DIAGNOSIS

-ACUTE PAIN

-IMPAIRED HYDRATION STATUS

-IMBALANCED NUTRITIONAL STATUS

-ACTIVITY INTOLERANCE

-HIGH RISK FOR INFECTION

QUESTION-8

ROLE OF PROGESTERONE IN PREGNANCY

PROGESTERONE

It is a steroid hormones produced by the corpus luteum

ROLES ARE AS FOLLWS;

-help for the development of placents

-stimulates the functions of the blood vessels in the uterus

-prevent uterine contractions

-strengthening the pelvic floor muscles ,thus help for easy labour process

-prepare uterus for fertilized ovum

-help for bodily changes

-maintain fetal growth

-development of the breast

-endometrial changes for implantation

-maintain uterine secretery functions

-relaxation of smooth muscles

-inhibit lactation during pregnancy

-regulates blood pressure