NCLEX-PN

Z.​ Cardiopulmonary maternal collapse is a serious and life-threatening complication that can occur during pregnancy, posing risks to both the mother and fetus. Various risk factors are associated with this condition, including hemorrhage, heart disease, genitourinary tract infections, major trauma, eclampsia, thromboembolism, ruptured ectopic pregnancy, and amniotic fluid embolism. ●​ The signs and symptoms of cardiopulmonary maternal collapse involve increased levels of pulmonary capillary wedge pressure, systemic vascular resistance, clotting factors, tidal volume, erythrocytes volume, sequestration of blood to the uterus, plasma volume by 40-50%, cardiac rate by 15-20 beats per minute, cardiac output by 40%, oxygen consumption by 20%, arterial blood pressure by 10-15 mm Hg, and functional residual capacity by 25%. ●​ Prompt interventions are crucial, including cardiopulmonary resuscitation and advanced cardiac life support . In some cases, an immediate cesarean section might be required to ensure the safety of both the mother and the baby, while a post-mortem cesarean section could be performed to save the baby if the mother has passed away. AA.​Disseminated Intravascular Coagulation (DIC) is an acquired clotting factor abnormality that can develop during pregnancy, particularly in conjunction with other disorders such as amniotic fluid embolism, eclampsia, incomplete abortion, retained dead fetus, or placental retention. Signs and symptoms of DIC encompass both signs of blood clotting and bleeding. Additional indicators may include decreased consciousness, cyanosis, hypotension, hypothermia, tachycardia, and behavioral and mood changes. If left untreated, DIC can lead to serious consequences, including death. BB.​Ectopic pregnancy occurs when a fertilized egg implants somewhere other than the uterus, most commonly in the fallopian tube. Signs and symptoms of ectopic pregnancy can include unilateral pain, nausea, vomiting, brown vaginal discharge, and faintness. CC.​Substance use and abuse , whether legal or illicit, can significantly impact pregnancy. Legal substances like alcohol, prescription drugs, over-the-counter drugs, and tobacco products can pose risks. For instance, tobacco use can lead to placental abruption, spontaneous abortions, low birth weight, and sudden infant death syndrome. Alcohol use and abuse can result in fetal alcohol syndrome, impaired growth, mental retardation, and cardiac anomalies. Illicit substances can also have severe effects on the fetus and pregnant woman. Various complications can arise due to substance use, such as intrauterine growth restriction, neonatal withdrawal, developmental and behavioral abnormalities, impaired respiratory function, tremors, convulsions, irritability, and more. Medications are categorized by risk levels , with categories A and B being considered safer for pregnant women, while categories C, D, and X are associated with greater risks. In 2015, the Food and Drug Administration introduced the Pregnancy and Lactation Labeling Rule (PLLR) to replace the previous pregnancy risk categories, aiming to create a more informative system that helps doctors and clients make evidence-based decisions. Yet, despite this update, many physicians still rely on the older, established medication categories as seen below.

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