Question

20. Describe the complications of having more than one fetus during pregnancy 21. Define: neuromalignant syndrome (NMS). What drugs might cause this condition? 22. What are the nursing considerations/ interventions for NMS? 23. Define: adrenoleukodystrophy. 24. What are Braxton-Hicks contractions? What are their cause? 25. Describe ballottement.

Answer 1

ANSWER

20. Complication of more than one fetus during pregnancy.

         * Presence of more than one fetus result in both maternal

           and fetal complications.

         * Maternal complications include

                 * Anemia.

                 * Preeclampsia.(Superabundant chorionic villi in the case of more

                    than one fetus lead to High blood pressure during pregnancy.)

                 * Hydramnios (Excess amniotic fluid due to increased urine output and

                    renal perfusion).

                 * Antepartum hemorrhage.

                 * Malpresentation of fetus.

                 * Preterm labor.

                 * Mechanical distress.

                 * Early rupture of membranes and prolapse of code.

                 * Prolonged labor.

                 * Bleeding.

                 * Postpartum hemorrhage.

                 * Postnatal infections due to increased operation time.

                 * Lactation failure.

        * Fetal complications include

               * Increased rate of prematurity.

               * Increased rate of miscarriage.

               * Intrauterine death of fetus.

               * Fetal anomalies.

               * Asphyxia.

               * Stillbirth.

21. Neuromalignant syndrome (NMS)

                It is defind as the idiosyncratic reaction to antipsychotic drugs which

                result in fever,muscle rigidity,autonomic dysfunction and changes

                in mental health status.

             * Drugs which cause neuromalignant syndrome include

                           * Atypical antipsychotics

                                    * Clozapine.

                                    * Olanzapine.

                                    * Cariprazine.

                         * Typical antipsychotics.

                                    * Chlorpromazine.

                                    * Haloperidol.

                                    * Thiothixene.

                         * Dopaminergic drugs.

                                    * Levodopa.

                           * Antiemetics

                                    * Metachlopromide (induce NMS)

22. Nursing interventions for NMS.

              * Instruct the patient to stop the usage of particular antipsychotic drug

                 which cause NMS.

              * Hyperthermia management with the help of ice packs and cooling blankets.

              * Provide ventillatory support or oxygen therapy if required to maintain the

                 normal breathing pattern of patient.

              * Administration of muscle relaxants to reduce muscle rigidity as per physicians

                order.

              * Administer intravenous fluids and diuretics to eliminate excess myoglobin produced

                 because of muscle damage.

              * Provide psychological support to reduce the anxiety level of patient.

              * Provide a peaceful therapeutic environment to enhance recovery process of the patient.

23. Adrenoleukodystrophy.

              * It is a X linked genetic disease which result in loss or breakdown of

                myelin which coverthe surrounding nerve cell in the brain along with

                progressive dysfunction of adrenal gland.

24.Braxton -Hicks contractions.

            * This are contractions occur in the uterine muscle which leads to

               tightening of the muscles and which aid in pregnant women body in

               preparation for birth.

            * Causes include.

                    * A full bladder can cause braxton hicks contractions.

                    * Dehydration trigger this type of contractions.

                    * It can develop after sexual intercourse.

                    * It can occur when the mother and baby are active.

                    * Touching on mothers belly can trigger this type of contractions.

25. Ballottement.

            * It is a diagnostic method in which a upward push against the uterine

               wall with the help of a finger inserted into the female genital tract for

   diagnosing pregnancy through feel a opposite impact of the displaced

               fetus.

     * This diagnostic procedure also used for detecting a floating kidney.

             * Ballotement technique also used as a indicator of increased fluid in

                the suprapatellar pouch of patella at the knee joint.

             * In the case of knee joint diagnosis through applying downward pressure

                towards the foot with one hand and along with pushing the patella backwards

                against the femur with one finger of the opposite hand.

             * If feeling of sponginess occur around the joint indicate test positive for ballottement.