NCLEX Review Guide: COVID-19 in Pregnancy

COVID-19 Effects on Pregnancy

• Pregnant women are at increased risk for severe COVID-19 illness due to physiological changes including decreased lung capacity, altered immune response, and increased cardiac output.
• COVID-19 increases risk of preterm birth, preeclampsia, and thromboembolic events during pregnancy.
• Vertical transmission from mother to fetus is possible but rare, occurring in less than 5% of cases.

Signs and Symptoms

• Common symptoms include fever, cough, shortness of breath, fatigue, and loss of taste/smell, similar to non-pregnant individuals.
• Monitor for signs of respiratory distress, as pregnant women can deteriorate rapidly due to decreased functional residual capacity.

Priority Nursing Actions

1. Implement isolation precautions with N95 mask, gown, gloves, and eye protection
2. Monitor maternal vital signs and oxygen saturation continuously
3. Assess fetal well-being through continuous fetal monitoring if indicated
4. Monitor for signs of preterm labor and preeclampsia
5. Administer prescribed medications (remdesivir, corticosteroids if indicated)

Delivery Management

• COVID-19 is not an indication for cesarean delivery unless maternal or fetal compromise occurs.
• Delayed cord clamping and skin-to-skin contact are still recommended with appropriate precautions.
• Epidural anesthesia is preferred to avoid general anesthesia and reduce aerosol-generating procedures.

Postpartum Management

• Breastfeeding is encouraged as benefits outweigh risks, with proper hand hygiene and mask wearing.
• Mother and baby can room together if mother is well enough to care for infant with precautions.
• If separation is necessary, expressed breast milk can be given to infant by healthy caregiver.

NCLEX Success Strategies

• Remember: Pregnancy increases COVID-19 severity risk
• Focus on respiratory assessment and fetal monitoring priorities
• Know that breastfeeding is still recommended with precautions