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EMT > Chapter 33 > Flashcards

Chapter 33 Flashcards

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1
Q

the ovaries:
two glands, one on each side of the uterus
each ovary contains thousands of …, and each of these contains an …
… occurs approximately 2 weeks prior to menstruation

A

follicles; egg; ovulation

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2
Q

the fallopian tubes:
extend out laterally from the uterus
fertilization usually occurs when a … meets the … inside the fallopian tube
the fertilized egg continues to the uterus where it develops into an …

A

sperm; egg; embryo

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3
Q

the uterus:
muscular organ that encloses and protects the developing fetus
produces … during labor
helps to push the fetus through the birth canal
birth canal is made up of the … and the lower third of the uterus, called the …

A

contractions; vagina; cervix

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4
Q

the … is the outermost cavity of the reproductive system
forms the lower part of the birth canal
completes the passageway from the uterus to the outside world

A

vagina

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5
Q

the breasts produce milk that is carried through … to the nipple to provide nourishment to the newborn once it is born

A

small ducts

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6
Q

the placenta attaches to the … and provides nourishment to the fetus

A

uterine wall

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7
Q

placenta keeps the … of the woman and fetus separate but allows substances to pass between them. anything ingested by a pregnant woman has the potential to affect the fetus

A

circulation

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8
Q

the … connects the woman and fetus through the placenta
the … carries oxygenated blood from the placenta to the fetus
the … carry deoxygenated blood from the fetus to the placenta

A

umbilical cord; umbilical vein; umbilical arteries

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9
Q

the fetus develops inside a fluid-filled, baglike membrane called the ….–> contains about 500 to 1000 mL of amniotic fluid, which helps … and protect the fetus

A

amniotic sac; insulate

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10
Q

hormone levels increase to support fetal development and prepare the body for childbirth. pregnant women are at an increased risk for complications from …, …, and some med conditions
uterus is shifted from its normal position

A

trauma; bleeding;

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11
Q

rapid uterine growth occurs during the …–> as the uterus grows, it pushes up on the … and displaces it
respiratory capacity changes, with … respiratory rates and … minute volumes
blood …. and speed of … increase
… is increased

A

second trimester; diaphragm; increased; decreased; volume; clotting; cardiac output

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12
Q

in the third trimester, there is an increased risk of … and potential … following trauma
changes in the cardiovascular system and the increased demands of supporting the fetus increase the … of the heart

A

vomiting; aspiration; workload

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13
Q

weight gain during pregnancy is normal: challenges the heart and impacts the musculoskeletal system
the joints become … or ….
changes in the body’s … increases the risk of slips and falls

A

“looser”; less stable; center of gravity

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14
Q

… can develop during pregnancy in many women who have not had diabetes previously. usually resolves after delivery. treatment is the same as for any other patient with diabetes

A

gestational diabetes

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15
Q

… is a common complication:

  • pregnancy-induced hypertension
  • can develop after the 20th week of gestation
  • signs and symptoms include severe hypertension, severe or persistent …, … abnormalities, swelling in the hands and feet, and …
A

preeclampsia; headache; visual; anxiety

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16
Q

…is characterized by seizures that occur as a result of hypertension.
To treat seizures:
Lie the patient on her …side.
Maintain a patent airway.
Administer supplemental oxygen if necessary.
If vomiting occurs, suction the airway.
Provide rapid transport and call for ALS.

A

Eclampsia; left

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17
Q

Transporting the patient on her left side can also prevent supine hypotensive syndrome:
Caused by compression of the …and the …by the pregnant uterus when the patient lies supine

A

descending aorta; inferior vena cava

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18
Q

…:

An embryo develops outside the uterus, most often in a fallopian tubes

A

Ectopic pregnancy

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19
Q

The leading cause of maternal death in the first trimester is …. following rupture of an ectopic pregnancy.
Consider the possibility in a woman who has missed a menstrual cycle and complains of sudden, severe pain in the lower abdomen.

A

internal hemorrhage;

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20
Q

Hemorrhage from the vagina that occurs before labor begins may be very serious.
May be a sign of …, or miscarriage.
…: the placenta separates prematurely from the wall of the uterus
…: the placenta develops over and covers the cervix

A

spontaneous abortion; Abruptio placenta; Placenta previa

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21
Q

abortion:
Passage of the fetus and placenta before …
May be spontaneous or induced
Most serious complications are …and …Treat for shock and transport promptly.

A

20 weeks; bleeding; infection

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22
Q 
Pregnant women have an increased chance of being victims of domestic violence and abuse.
Abuse increases the chance of:
…
…
...
A

spontaneous abortion
premature delivery
low birth weight

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23
Q

abuse contd:
The woman is at risk from …., …., and ….
Pay attention to the environment for any signs of abuse.
Talk to the patient in a private area, away from the potential abuser if possible.

A

bleeding; infection; uterine rupture

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24
Q

Effects of addiction on the fetus include:
…
Low …
Severe …. distress
….
….describes the condition of infants born to women who have abused alcohol.
in cases of substance abuse, newborn will probably need immediate resuscitation

A 
prematurity
birth weight
respiratory
death
fetal alcohol syndrome
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25
Q

Pregnant women have an increased amount of overall total blood volume and a 20% increase in ….
May experience a significant amount of blood loss before you will see signs of …Uterus is vulnerable to penetrating trauma and blunt injuries.

A

heart rate; shock

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26
Q

In a motor vehicle crash, severe hemorrhage may occur from injuries to the pregnant uterus.
Trauma is one of the leading causes of ….
Common symptoms include vaginal bleeding and severe abdominal pain.

A

abruptio placenta

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27
Q

Improper positioning of the … can result in injury to a pregnant woman and the fetus.
Cardiac arrest
Focus is the same as with other patients.
Perform CPR and provide transport.
Compressions may need to be applied …on the sternum.

A

seat belt; higher

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28
Q

Scene safety
Take standard precautions.
… and … and … protection are a minimum if delivery is already begun or is complete.
If time allows, a … should also be used.
Consider calling for additional resources.

A

gloves; eye; face; gown

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29
Q

Mechanism of injury/nature of illness

  • You will encounter pregnant patients who are not …, so it is important to determine the MOI or NOI.
  • Do not develop tunnel vision during a call.

Form a general impression:

  • Whether the patient is in active labor or whether you have time to assess and address other possible life threats
  • Perform a …
A

in labor; rapid examination.

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30
Q

Transport decision
If delivery is …, prepare to deliver at the scene.
If delivery is not …, prepare the patient for transport.

A

imminent; imminent

31
Q 
Transport decision (cont’d)
Provide rapid transport for pregnant patients who:
Have significant ...and pain
Are ... 
Are having a ... 
Have an...
A

bleeding
hypertensive
seizure
altered mental status

32
Q 
Obtain a thorough obstetric history:
Her expected … 
Any … that she is aware of
If she has been receiving … care
A complete medical history
A

due date
complications
prenatal

33
Q

Obtain a SAMPLE history.
Determine the due date, frequency of …, a history of previous pregnancies and deliveries, the possibility of …, and if she has taken any drugs or medications.
If her water has broken, ask whether the fluid was … (due to meconium).

A

contractions; multiples; green

34
Q

Secondary Assessment- Physical examinations
Assess the major body systems as needed.
Emphasis on the chief complaint
If the patient is in labor, focus on … and possible delivery.
If you suspect that delivery is imminent, check for …

A

contractions; crowning

35
Q

stages of labor:

  1. Dilation of the …
  2. Delivery of the ..
  3. Delivery of the …
A

cervix
fetus
placenta

36
Q

first stage:
Begins with the onset of …and ends when the cervix is fully …
Usually the longest stage, lasting an average of … hours
Frequency and intensity of contractions increase

A

contractions; dilated; 16;

37
Q

Labor is generally longer in a … than in a … .
A woman may experience preterm or false labor, or …
Some women experience a premature rupture of the …

A

primigravida; multigravida; Braxton-Hicks contractions; amniotic sac

38
Q

Second Stage:
Begins when the fetus begins to encounter the …
Ends when the newborn is born
Uterine contractions are usually … together and last longer.
The … will bulge significantly, and the top of the fetus’s head will appear at the vaginal opening (…).

A

birth canal; closer; perineum; crowning

39
Q

Third Stage:
Begins with the birth of the newborn and ends with the delivery of the … The placenta must completely separate from the …
This may take up to …minutes.

A

placenta; uterine wall; 30;

40
Q 
To determine if delivery is imminent, ask the patient:
How ...have you been pregnant?
When are you due?
Is this your ...baby?
Are you having ...?
How far apart?
How ...do they last?
A

long
first
contractions
long

41
Q

To determine if delivery is imminent, ask the patient (cont’d):
Have you had …or …?
Has your …?
Do you feel as though you need to have a ….?
Do you feel the need to push?

A

spotting; bleeding
water broken
bowel movement

42
Q

To determine potential complications, ask:
Were any of your previous deliveries by …?
Have you had problems in this or any previous pregnancies?
Do you use drugs, drink alcohol, or take any medications?
Is there a chance of …?
Does your physician expect complications?

A

cesarean section; multiple deliveries

43
Q

once labor has begun, don’t let the woman …

A

go to the bathroom

44
Q

Patient position
Preserve the patient’s privacy.
Place the patient on a …surface that is padded with blankets, sheets, and towels.
Support the …, …, and …
Have her keep her legs and hips flexed, with her feet flat and her knees spread apart.
place … or … on the floor around the delivery area
open OB kit carefully
use sterile sheets and drapes from OB kit to make a sterile delivery field

A

firm; head; neck; upper back; towels; sheets

45
Q

Your partner should be at the patient’s head to comfort, soothe, and reassure.
Continually check for …
Some patients experience …labor and birth.
Position yourself so that you can see the …area at all times.
…the contractions.

A

crowning; precipitous ; perineal; Time

46
Q

Delivering the head
Observe the head as it exits the vagina.
Support the head with your gloved hand as it ….
Do not poke your fingers into the newborn’s eyes or fontanelles.

A

rotates

47
Q

Unruptured amniotic sac
If the amniotic sac does not rupture by the time the head is crowning, it will appear as a fluid-filled sac emerging from the vagina.
It will …the fetus if not removed.
You may puncture the sac with a .. or tear it by twisting it between your …
Clear the newborn’s mouth and nose immediately.

A

suffocate; clamp; fingers

48
Q

Umbilical cord around the neck
As soon as the head is delivered, use one finger to feel whether the umbilical cord is .. (…cord).
Usually, you can slip the cord gently over the delivered head.
If not, you must cut it.

A

wrapped around the neck; nuchal

49
Q

Delivering the body
Once the head is born, the body usually delivers easily.
Support the … and … as the shoulders deliver.
Do not pull the fetus from the birth canal.
The newborn will be slippery and covered in …

A

head; upper body; vernix caseosa

50
Q

If the mother is able and willing, place the newborn on her abdomen so … contact can begin immediately.
Dry off the newborn and wrap him or her in a blanket or towel.
Place the newborn on one side, with the head slightly …than the rest of the body.

A

skin-to-skin; lower

51
Q

postdelivery care:
… and … the cord.
Obtain the 1-minute….
Delivery of the placenta
The placenta delivers itself, usually within a few minutes of the birth.
You can help to slow bleeding by gently …the woman’s abdomen with a firm, circular, “kneading” motion.

A

clamp; cut
Apgar score
massaging

52
Q

Record the time of birth in your patient care report.
The following are emergency situations:
More than …minutes elapse and the placenta has not delivered
There is more than …mL of bleeding before delivery of the placenta.
There is significant …after the delivery of the placenta.

A

30; 500; bleeding

53
Q

Follow standard precautions.
Always put on gloves before handling a newborn.
Newborn will usually begin breathing spontaneously within …to …seconds after birth.
Heart rate will be …beats/min or higher.
If you do not observe these responses:
Gently tap or flick the … or ….
Many newborns require some form of stimulation, including:
Positioning the airway, drying, warming, suctioning, or tactile stimulation

A

15; 30; 120

soles of feet; rub the back

54
Q

Neonatal assessment and resuscitation:
Position the newborn on his or her …with the head … and the neck slightly ….
If necessary, suction the mouth and then the nose.

A

back; down; extended

55
Q

Observe the newborn for spontaneous …, skin …, and movement of the ….
Evaluate the heart rate at the base of the …or the … or listening to the newborn’s chest with a stethoscope.

A

respirations; color; extremities

umbilical cord; brachial artery

56
Q

If chest compressions are required, use the … technique for two-person resuscitation.
Perform BVM ventilation during a pause after every third compression, using a ratio of…

A

hand-encircling; 3:1.

57
Q

If you see …in the amniotic fluid and the newborn is not breathing adequately, quickly suction the newborn’s mouth and then nose before providing rescue ventilations.

A

meconium

58
Q 
Apgar score: 
Standard scoring system used to assess the status of a newborn
Assigns a number value to five areas:
…
… 
...or ... 
… or … 
… 
calculate the apgar score at 1 minute and 5 minutes after birth
A 
appearance
pulse
grimace; irritability
activity; muscle tone
respirations
59
Q

Assessing a newborn
Calculate the Apgar score.
Stimulation should result in an immediate increase in ….
If the newborn is breathing well, assess the …
Assess oxygenation via … and observe for ….

A

respirations; pulse; pulse oximetry; central cyanosis

60
Q

Apgar score:
Request a …if the newborn is in distress and will require resuscitation.
In situations where assisted ventilation is required, use a newborn BVM.
If the newborn does not begin breathing on or does not have an adequate heart rate, continue CPR and rapidly transport.

A

second unit ;

61
Q

Most infants are born headfirst.
Occasionally, the buttocks are delivered first.
Called a…
Breech deliveries usually take longer, so you will often have time to transport the pregnant woman to the hospital.
If the buttocks have passed through the vagina, the delivery has ….

A

breech presentation; begun

62
Q

Preparing for a breech delivery is the same as for a normal childbirth.
Allow the buttocks and legs to deliver spontaneously, supporting them with your hand.
The head is almost always …and should be allowed to deliver spontaneously.
Make a “V” with your gloved fingers and position them in the vagina to keep the walls from …

A

facedown; compressing the fetus’s airway.

63
Q

On rare occasions, the presenting part of the fetus is a single arm, leg, or foot.
Called a …
A fetus with a limb presentation cannot be delivered in the field.
Transport immediately.
If a limb is protruding, cover it with a …
Never try to push it in or pull on it.

A

limb presentation; sterile towel

64
Q

..of the umbilical cord must be treated in the hospital.
The umbilical cord comes out of the vagina before the fetus.
Do not push the cord back into the vagina.
Keep the fetus’s head from …the cord.
Insert your gloved hand into the vagina and push the fetus’s head away from the umbilical cord.
Transport rapidly.

A

Prolapse; compressing

65
Q

….: Developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae
Cover the open area of the spinal cord with a …. dressing.
Maintenance of .. is important when applying moist dressings.

A

spina bifida; sterile, moist; body temperature

66
Q

multiple gestation:
Twins occur once in every …births.
Twins are … than single fetuses, and delivery is typically not difficult.
After …minutes after the first birth, contractions will begin again, and the birth process will repeat itself.
The procedure is the same as that for a single fetus.
Record the time of birth of each twin separately.
Twins may be so small that they look premature.

A

30; smaller; 10

67
Q

premature birth:
Any newborn who delivers before ….(36 weeks) or weighs less than … at birth is considered premature.
A premature newborn is smaller and thinner, and the head is proportionately ….

A

8 months; 5 lb; larger

68
Q

postterm pregnancy:
Pregnancies lasting longer than … weeks
Fetuses can be larger, sometimes weighing …or more.
Can lead to problems with the woman and fetus:
A more difficult labor and delivery

A

42; 10 lb

69
Q 
postterm pregnancy contd: 
Problems (cont’d):
Increased chance of injury to the fetus
Increased likelihood of ...
Woman is at risk for ... and ....
Postterm newborns have increased risks of ..., ..., and being ....
A

cesarean section;
perineal tears; infection
meconium aspirations; infection; stillborn

70
Q

fetal demise:
Onset of labor may be premature, but labor will progress normally in most cases.
If an intrauterine infection caused the demise, you may note a foul odor.
Do not attempt to resuscitate an obviously dead neonate.

A

foul odor

71
Q

delivery without sterile supplies:
You should always have eye protection, gloves, and a mask with you.
Carry out the delivery as if sterile supplies were available.
Use ….

A

freshly laundered sheets and towels

72
Q

delivery without sterile supplies contd:
Carry out the delivery (cont’d)
Wipe the inside of the newborn’s …with your finger.
Do not cut or clamp the umbilical cord.
As soon as the placenta delivers, wrap it in a … and transport.
Keep the placenta and the newborn at the…, and keep the newborn ….

A

mouth
clean towel
same level; warm

73
Q

postpartum complications:
If bleeding continues after delivery of the placenta:
Continue to ..the uterus.
Check your technique and hand placement if bleeding continues.
Cover the vagina with a …
Administer oxygen, monitor vital signs, and transport the patient immediately.

A

massage; sterile pad

74
Q

Postpartum patients are at an increased risk of an ….
Most commonly, a pulmonary embolism
Results from a clot that travels through the bloodstream and becomes lodged in the …
Consider when a woman complains of sudden difficulty breathing or shortness of breath following delivery

A

embolism; pulmonary circulation

EMT (45 decks)

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