Signs of Complications (Nursing)

00:00 We talked about 1 complication that may be experienced during the antepartum period, let's talk about another one. Let's talk about preterm labor and all the symptoms that may indicate that someone is experiencing this particular complication. They may present with bleeding. It might be a lot, it might be spotting, but any amount of bleeding in pregnancy deserves followup. They may complain of mild cramping, not particularly severe, but it might be bothering them enough that they call. The client may also be experiencing full-fledged contractions where the uterus is tightening and getting stronger and coming regularly. So any of those symptoms prior to 38 weeks is going to be a sign of preterm labor that needs to be investigated. They may present with back pain that just sort of comes and goes. So, it is a good idea if a patient comes in and says I'm having back pain for the nurse to ask more questions to decide whether it's back pain just from the strenuousness of being pregnant or whether it's actually a contraction and in disguise. So, asking questions like "Does the back pain come and go?" may help you to differentiate that. The other complication that may show up during the antepartum period that we get some clues because of symptoms is preeclampsia.

01:14 So we ask questions like "Have you experienced any headaches that don't go away with Tylenol or some other pain reliever?" "Have you had any swelling that goes beyond sort of typical swelling?" Now, pregnancy and swelling kind of go together like peanut butter and jelly for people who actually like that. But if you have swelling that really doesn't go away when you get up in the morning or the swelling is not in your feet, but it's in your face around your eyes or in your hands, then we need to explore that a little bit more and make sure that the blood pressure is normal. We may find that a client who has never had morning sickness or the morning sickness or nausea and vomiting has gone away after the first trimester, shows up with that complaint in the third trimester. So remember the third trimester is after 28 weeks. If that happens, we always need to suspect preeclampsia until proven otherwise.

02:06 There may be changes in vision. There may be decreased fetal movement. So, if we have an issue with preeclampsia, it's going to imbibe hypertension. And when we have hypertension and constriction of vessels, then the blood flow to the baby is not going to be optimal and one of the ways we know that the blood flow is not optimal is that the baby doesn't move very much. So asking questions about decreased fetal movement will let us know about that.

02:30 We're also going to look for signs of infection. So remember when we got the CBC, we were looking for white blood cell count to make that determination, but what other indications are there for infection? Fever, nausea and vomiting, bleeding might indicate a sexually transmitted infection, or back pain. So think about a renal infection, a kidney infection, and that may present as back pain.