Chapter Obstetrics and Neonatal Care Flashcards
Abruptio placenta:
When the placenta prematurely separates from the uterine wall
Cephalic presentation:
Head first presentation
Eclampsia:
Seizures caused by pregnancy induced hypertension
Ectopic pregnancy:
When the embryo develops outside of the uterus
Footling breech presentation:
Limb first presentation
(frank) Breech Presentation:
Buttocks first presentation
Fundus:
The top of the uterus
Meconium:
Fetal stool
Miscarriage:
A spontaneous abortion
Placenta previa:
When the placenta blocks the cervix
Preeclampsia:
Hypertension caused by pregnancy
Primigravida:
First pregnancy
Prolapsed umbilical cord:
Umbilical cord comes out before the head
What are the five aspects of the APGAR rating? When is the APGAR taken?
Appearance
Pulse
Grimace/ irritability
Activity/ muscle tone
Respirations
Taken 1 minute and 5 minutes after birth
What are the rating possibilities for appearance in APGAR?
2- Entire body is pink
1- Body is pink, hands and feet are blue
0- Entire body is blue
What are the rating possibilities for pulse in APGAR?
2- Pulse above 100 beats per minute
1- Pulse below 100 beats per minute
0- Absent pulse
What are the rating possibilities for grimace/ irritability in APGAR?
2- Crys and tries to withdraw from finger being snapped against sole of foot
1- Weak cry in response to stimulus
0- No response (cry or reaction) to stimulus
What are the rating possibilities for activity/muscle tone in APGAR?
2- Resists straightening of hips or knees
1- Weakly resists straightening
0- Limp with no muscle tone
What are the rating possibilities for respirations in APGAR?
2- Rapid respirations
1- Slow respirations
0- Absent respirations
What position should pregnant patients who are not delivering be possibly transported in?
Reclined on their left side to prevent Supine hypotensive syndrome
What is supine hypotensive syndrome?
The compression of the descending aorta and inferior vena cava by a baby in the womb.
List three signs that indicate the beginning of labor:
Contractions, bloody show (blood-streaked mucus), and bursting of amniotic sac (water breaking)
When determining whether delivery is imminent and whether there are complications, what questions should you ask the patient?
Has your water broken?
Have you had a bloody show?
Have contractions begun?
When is your due date?
Have you sought pre-natal care?
Has your doctor informed you or are you aware of any complications with this pregnancy?
Is this your first pregnancy? (primigravida)
Have you had any complications with previous pregnancies?
Once the baby’s head emerges, what actions could be taken to prevent too rapid a delivery?
An EMT could provide slight resistance with a gloved hand on the baby’s head
Why is it important to avoid pushing on the fontanelles?
The fontanelles are soft areas covering unprotected areas of the brain. Pushing on the fontanelles can cause major problems for the baby.
What are the two situations in which an EMT may insert his or her fingers into a patient’s vagina?
1) To move the baby’s umbilical cord from around its neck to allow for continued delivery
2) In the prolapse of the umbilical cord an EMT makes a “V” with their fingers and hold the baby’s head off of the umbilical cord until the patient reaches the surgery.
What are some of the effects of maternal drug or alcohol addication?
Premature birth, low birth weight, severe respiratory depression in newborns.
What is preeclampsia and what are signs/symptoms associated with it?
It is new-onset hypertension in pregnant mothers that tend to present itself during the second half of pregnancy with other signs and symptoms
Hypertension
Severe and persistent headache
Visual abnormalities
Edema in hands and feet
Upper abdominal and epigastric pain
Dyspnea and or retrosternal chest pain
Anxiety
Altered mental status
What can cause dyspnea in a pregnant woman or up to a six-week postpartum woman? What do you do?
Pulmonary embolism.
High flow oxygen and rapid transport
Perineum:
The space between the vagina and the anus
What physiological changes can pregnancy cause?
Respiratory: difficulty as baby pushes on diaphragm
Cardiovascular: 20% increase in blood volume
Musculo skeletal: weight gain, joints loosen
Hormones: gestational diabetes
What treatment can EMTs provide for eclampsia?
Left lateral recumbent, supplemental oxygen, suction, ALS, rapid transport
What are the signs and symptoms of an ectopic pregnancy?
Light vaginal bleeding and pelvic pain, sudden onset severe abdominal or pelvic pain with vaginal bleeding. Exteme lightheadedness or fainting, shoulder pain,
Rupture leads to internal bleeding leads to shock
What is important to note in pregnant trauma patients?
Increased blood volume delays signs of shock
What are the three stages of labor?
Dilation of cervix to 10 cm (contractions
Delivery of the infant (pushing)
Delivery of placenta (begins with baby’s birth, end with placenta delivery)
What are the difference between Braxton-Hicks Contractions and true labor?
Contractions: B-H: irregular, do not increase intensity or frequency TL: get consistently stronger and closer together
Pain and contractions: B-H: start and stay in lower abdomen TL: start in lower back and “wrap around” to the lower abdomen
Physical activity: B-H may relieve pain and contractions, TL: may intensify contractions
Change in position: B-H may relieve pain and contractions, TL: does not relieve contractions
Bloody show: B-H if present is brownish TL: Red typically w/ mucus
Leakage: B-H: Urine- small and smell like ammonia TL: amniotic sac may have broken smell sweet and will continue to leak
Lightening: And what may happen to the mother?
Baby descends into the pelvis for delivery
The mother may experience easier breathing
What two positions may help shoulder dystocia?
When baby’s shoulders get stuck
McRoberts: Mother pulls knees up to chest
Gaskin Maneuver: all fours
How many hours is the typical first stage of labor in a woman pregnant with her first baby?
16 hours
What should you do for a woman in cardiac arrest?
Manually displace her uterus to the left
Why is it most important to position your partner near the head of a woman in labor?
The mother may become nauseated and vomit
What is a nuchal cord?
When the umbilical cord becomes wrapped around the baby’s neck
What may the presence of meconium in the amniotic fluid indicate?
That the baby’s airway might be obstructed
What could you do when the mother is experiencing a contraction?
Tell her to take quick short breaths
What is indicated if respiratory distress is present in the newborn?
Suctioning prior to cutting the umbilical cord
At what time between contractions should you assess for crowning?
Approximately three minutes apart
