Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paramedic > EMRG 1305 - OB > Flashcards

EMRG 1305 - OB Flashcards

You may prefer our related Brainscape-certified flashcards:
NREMT® EMT flashcards NREMT® Paramedic flashcards
1
Q

How long is a full term of pregnancy?

A

37-42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 stages of pregnancy?

A

Germinal stage 0-2 weeks
Embryonic stage 3-8 weeks
Fetal stage 9-birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is the start of a pregnancy counted from

A

last menstrual cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

child bearing years are considered what years

A

14-50 yrs of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the total weight gain during pregnancy

A

25 to 35 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does an uncomplicated Pregnancy, labour and birth include

A

A healthy pt without medical conditions
Uncomplicated pregnancy
term gestation
singleton pregnancy (single child)
Vertex presentation (crown of baby)
Spontaneous labour (no induction)
Clean Amniotic fluid (fluid in sac)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are normal maternal changes

A

Circulatory system: 10-20bpm increase, need for iron increases
Respiratory: increase in rate, diaphragm moves up into chest, consumption rate increases
Genital Tract: fundal grows a cm per week of pregnancy. 20 weeks, should be at belly button (umbilicus). Bladder has extra weight on it, urinate frequently
GI system: elevated progesterone = vomitting, also relaxation of smooth muscle - decrease gastric mobility = constipation
Metabolism: 10-20 percent increase in BMR (base metabolic rate), insulin resistance, fat deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gravida

A

how many times they’ve been pregnant - includes miscarriage/abortions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Para

A

of pregnancies a woman carried past 20 wks live or dead
20 wks is considered a liable child, it actually gets a death certificate
twins count as 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Amniotic Sac

A

the fluid filled, bag like membrane where the fetus grows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Abortion

A

expulsion of the fetus, from any cause before the 20th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ectopic pregnancy

A

any egg that attaches outside the uterus, usually Fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Primipara

A

the pt has only had one birth/delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Multipara

A

the pt has had 2 or more deliveries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how to time contractions

A

Frequency - time between the start of one contraction and the start of the next
Duration - how long one contraction last

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Braxton Hicks contraction

A

contractions of the uterus that typically are not felt until the second or third trimester of the pregnancy
Painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stage 1 - Labour

A

dilation and effacement of the cervix
longest stage
begin with contractions that gradually increases in frequency, strength and length
fetus descends into pelvis (decrease in fundal height)
cervix softens, shortens, thins and dilates until at 10 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Early Labour

A

you can still walk around fine
bloody show - pink, red or brown discharge
Spontaneous rupture of the membrane (SROM) - water breaks
contractions are mild and irregular
Contractions: F - far apart and irregular, L- short ~20-30 sec, S - mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Active Labour

A

Can’t walk, to strong
SROM may or may not occur
bright red blood show
dilation to 10 cm progresses
vomiting, shaking, overwhelming emotions
Contractions: F - 3 to 4 min, L- 45 to 60 sec, S - moderate to strong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Stage 2

A

Fully dilated to 10cm
Feels the urge to push
ends when baby is born
Contractions: F - 2 min or less, L - 60-90 secs, S- strong
uterus will change shape and rise up
bloody show, stool amniotic fluid drainage
bulging until presenting part Is visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical considerations - When do we look?

A

dangle - umbilical cord
baby’s coming
decrease blood - vaginal bleeding is heavy and the pt is hypotensive or in shock
body parts decreased LOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Imminent birth as per ALS - how is it different between Primips and Multips

A

Primps - presenting par visible during and between contractions, maternal urge to push, contractions are less than two min apart
Multips - contractions 5 min apart of less and any other sings of second stage are present

22
Q

Stage 3

A

Birth of the baby to delivery of the placenta
Occurs 5-30 min after birth
Observation - lengthening of cord, sudden gush or trickle of blood, uterine contractions

23
Q

Placenta delivery

A

placenta will separate from uterine wall
apply gentle controlled cord traction (CCT) and guard the uterus with other hand
encourage delivery, ask mom to push
when delivered - inspect for wholeness, put in bag from OBS kit, label it with maternal patients name and time of delivery
HIGHEST RISK stage because of increase bleeding

24
Q

How to prepare

A

get pt on a firm surface (if they don’t want to move, leave them where they are
prepare a neonatal resus station
open OB kit
dispatch for a second crew

25
Q

Phase of a normal labour and delivery

A

decent
flexion
internal rotation
extension
restitution
external rotation
expulsion

26
Q

Decent

A

Fetus moves down toward the pelvis and becomes engaged (duck waddle)

27
Q

Flexion

A

fetal chin to chest

28
Q

Internal Rotation

A

Fetal occiput turns toward maternal pelvis

29
Q

Extension

A

Birth with head facing down

30
Q

Restitution

A

baby’s head rotates to the side

31
Q

External Rotation

A

Fetus turns to deliver shoulder

32
Q

Expulsion

A

Birth of baby

33
Q

Cord Clamping

A

Clamp and hand width of baby’s abdomen, cut the cord when it stops pulsating up to 2 minute mark ( wait till blood is no longer pumping, plus avoids mother from having anemia)
No crying - cut the cord and CPR
Multiple babies - Cute and deliver other baby

34
Q

Uncomplicated Delivery Care

A

massage uterus to help minimize bleeding- should feel firm and central
Check for bleeding every 5 min for the first 15 min
monitor vitals
encourage voiding to decrease the risk of postpartum hemorrhage
keep newborn warm, skin to skin, breastfeed (if possible)
monitor newborn using APGAR

35
Q

Oxytocin - what does it do?

A

Increases the amplitude a frequency of uterine contractions, delays uterine blood flow and decreases cervical activity causing dilations and thinning of cervix

36
Q

what are all the malpresentation that we can deliver?

A

Occiput anterior (face down)
occiput posterior (sunny side up)
breech
transverse
face
compound
brow

37
Q

what are malpresentation that we CAN’T deliver?

A

Transverse Lie - head and breech can be felt with exam of abdomen
Shoulder presentation - shoulder is presenting part
Oblique Lie - fetus lies diagonal

38
Q

Limb presentation, do we deliver?

A

Not possible to deliver, we discourage pushing, wrap the presenting limb and keep it warm while we transport

39
Q

Brow presentation, how do they present?

A

the face is coming out first, its nose is leading they’re way

40
Q

Frank breech, what is it?

A

Hips flexed and legs extended, the butt is coming out first from the cervix

41
Q

Complete Breech, what is it?

A

both hips and knees are flexed, both butt and feet enter the cervix first

42
Q

Footling breech, what is it?

A

one hip and one knee flexes, the other is presenting out of the cervix.

43
Q

How do you approach a breech presentation?

A

Hands off approach, just have your hands there to catch the baby, let gravity of the work, have mom on the end of the bed.

44
Q

during the hands off approach, how does the timing work?

A

8 min for a full delivery
4 min from when you see the umbilicus
3 min when you see neck, at 1 min left, use the smellie veit maneuver

45
Q

What is the smellie veit maneuver?

A

have a hand on the babies chest and two fingers exerting gentle pressure on the face to increase flexion
place other hand on the baby’s back with two fingers hooked to pivot around the symphysis pubis and allow the fave to be born

46
Q

Cord prolapse, what do you do?

A

L&G, if there is a pulse, put cord gentle back in, ask mom if she wants to do it.
if there is no pulse, put it back in and push the object to make it pulse again, use gravity to your advantage

47
Q

what is the Exaggerated “sims” position?

A

On the side, with the R arm behind and the hips propped up by a pillow to have gravity working with you

48
Q

What is a sing of shoulder dystocia?

A

turtle sign, the head comes out and back in because the shoulders are stuck

49
Q

what does ALARM stand for?

A

Ask for help
Lift legs, hyperflex thighs
Adduct shoulders (apply suprapubic pressure)
Rollover (all fours)
Manual posterior arm (try to grab and torpedo)

do x2 then leave

50
Q

Postpartum Hemorrhage, when does it happen and what happens?

A

occurs either right after <24hrs or up to 12 weeks later
Excessive bleeding is defined as 500 ml or more of blood. Severe PPH is at 1L
Pt will be pale, confused, light headed, diaphoretic, in hypovolemic shock

51
Q

PPH causes are the 4T’s what are they?

A

Tone - exhausted uterus & cannot contract
Tissue - parts of the placenta retained and clotting compromised
Trauma - uterine rupture/lac during delivery
Thrombin - coagulation abnormalities

52
Q

How to treat PPH

A

Fundal massage - one hand on lower abdomen and use smooth circular movement to massage. Do for 10 - 15 min and
Breast feed to help release oxytocin
Bimanual Compression - one hand above symphysis pubis & other on top of fundus and squeeze together - for 5-10 minutes until bleeding stops

53
Q

Meconium, what is it?

A

Newborns first stool/bowel movement

Paramedic (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions