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AP III > OB (1/10) > Flashcards

OB (1/10) Flashcards

1
Q

what are the different hormones involved in changes to mom with pregnancy

A
  1. relaxin
  2. progesterone
  3. cortisone
  4. estrogen
  5. endorphins
  6. prostaglandins
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2
Q

during pregnancy the heart moves _______ and to the _____________

A

up; left

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3
Q

what is normal CO during pregnancy

A

6-12 L/min

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4
Q

during pregnancy CO increases by ___________%

A

50

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5
Q

HR during pregnancy increases by about _____%

A

25

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5
Q

BP during pregnancy may decrease except with _________________

A

htn

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5
Q

SVR is decreased by _________ % during pregnancy

A

20

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6
Q

what hormones are responsible for the decrease in SVR during pregnancy

A
  1. prostacyclines
  2. estrogen
  3. progesterone
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7
Q

during pregnancy what CV parameters increase?

A
  1. CO
  2. HR
  3. contractility
  4. blood volume
  5. SV
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8
Q

T/F: pregnancy causes a high vascular resistance system

A

false; low vascular resistance system

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9
Q

why does SVR decrease during pregnancy

A

due to low vascular resistance system 2/2 vasodilation that gets blood to the utuerus for adequate blood flow.

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10
Q

normal blood volume of 150 lb, non-pregnant pt = ___________

blood volume in this pt who is pregnant at term will ___________ by 1-1.5L

A

4.7; increase

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11
Q

T/F: hgb decreases with increased blood volume in pregnancy

A

false; RBC/hgb increases by 30% but the plasma volume increases by 50% and that why you may see dilutional anemia

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12
Q

CO during pregnancy starts to increase at ____________ weeks

A

5

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13
Q

when is CO the greatest during pregnancy

A

right at delivery, CO increases up to 80%

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14
Q

CO reaches 50% increase mark in the ___________ trimester, and is due to increased _________ stimulated by __________

A

2nd; SV; estrogen

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15
Q

LV mass of the heart increases by ______% between the 1st and 3rd trimesters

A

23

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16
Q

there is a ______________ shift in the oxyhgb dissocation curve with pregnancy

A

right

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17
Q

during labor, CO increases by _____% in the first stage of labor; _____% in the late first stage of labor, and ____% in the second stage of labor

A

10; 25; 40

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18
Q

T/F: giving a pregnant pt an epidural will suppress the SNS stimulation and increase in CO during labor

A

true

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19
Q

during a uterine contraction __________ mL of blood is displaced from the intervillous space of the placenta to maternal central circulation = _______________

A

300-500; autotransfusion

20
Q

a woman is in labor laying in the supine position, you come in and she is c/o N/V & dizziness, she looks pale, diaphoretic, and pallor, & hypotensive what do you think is going on/what is the intervention?

A

aortal/inferior vena caval compression; compression of vessels –> transient decrease in CO from decrease in venous return

fix: left uterine displacement (placing wedge under the right hip)

21
Q

when is a mom particularly sensitive to aortal/inferior vena caval compression when close to labor?

A

after epidural block

22
Q

pregnant mom goes into cardiac arrest while on the OR table; baby is still utero what position change should you do while doing compressions

A

left uterine displacement (wedge under right hip)

23
Q

mom is term and is sitting up in the bed; what vessel is a risk of occlusion

A

femoral

24
Q

if mom is term and sitting up –> s/sx of hypotension, diaphoresis, N/V how do you intervene

A

she is possibly occluded femorally, put head down and do left uterine displacement

25
Q

TV & Mv during pregnancy increases by _______%

A

45

26
Q

what hormone causes an increase in minute ventilation during pregnancy

A

progesterone

27
Q

FRC is _________ by 20% during pregnancy

A

decreased

28
Q

O2 consumption increases by _________% during pregnancy

A

50

29
Q

why do pregnant women drop their O2 saturation so fast during pregnancy?

A

decrease FRC and increased O2 consumption

30
Q

progesterone causes what respiratory changes during pregnancy

A
  1. bronchodilation
  2. increased minute ventilation
31
Q

hypoxic ventilatory response during pregnancy is _______x the normal level

A

2 (this is a protective mechanism in the pregnant pt)

32
Q

what respiratory parameters are increased during pregnancy

A
  1. inspiratory reserve volume
  2. Tidal volume
  3. inspiratory capacity
  4. dead space
  5. minute ventilation
  6. alveolar ventilation
33
Q

what respiratory parameters decrease during pregnancy

A
  1. expiratory reserve volume
  2. residual volume
  3. functional residual capacity
  4. total lung capacity
34
Q

T/F: the pregnant pt in surgery, the EtCO2 is assumed to be about 5 < than PaCO2

A

false; during pregnancy EtCO2 is assumed to = PaCO2

35
Q

what parameter during surgery of the pregnant pt predicts the degree of maternal hyperventilation and an be used to avoid uterine vasoconstriction induced by hypocarbia

A

EtCO2

36
Q

if you have to intubate a pregnant woman at term, what are the risks

A
  1. trauma
  2. bleeding
  3. obstruction
  4. difficult DL (d/t arytenoid and VC edema)
37
Q

T/F: you should avoid nasal airways in the pregnant pt at term

A

true - increased risk of bleeding

38
Q

pregnant women are in a mild state of _________________ (respiratory or metabolic acidosis or alkalosis)

A

respiratory alkalosis (d/t increased Mv –> more CO2 blown off by mom)

39
Q

what hormone drives the change in CO2 in the pregnant pt

A

progesterone

40
Q

changes to Mv in stages of labor:
1st stage = ___________
2nd stage = ____________

A
  1. 1st stage = 70-140% increase Mv
  2. second stage of labor Mv increases 120-200%
41
Q

during labor PaO2 may ___________ by _______ mmHg

A

decrease; 10 - 15

42
Q

in the first stage of labor O2 consumption increases by _____% and increases by _____% in the second stage of labor

A

40; 75

43
Q

T/F: during labor maternal aerobic requirement for Oxygen > oxygen consumption

A

true

44
Q

what helps with the respiratory changes (increased Mv, decreased PaO2, increased O2 consumption) during labor?

A

epidural and adequate pain control

45
Q

FRC ___________ after delivery, but remains ___________ pre-pregnancy level for _______ weeks

A

increases; lower; 1-2

46
Q

O2 consumption, Tv, and Mv remain elevated after birth for ___________ weeks

A

6-8

47
Q

what two factors cause physiologic anemia for pregnancy

A
  1. maternal plasma volume increases 50% by 34 weeks
  2. increase in maternal plasma volume exceeds RBC volume increase
48
Q

plasma volume increases from 49 mL/kg up to __________ mL/kg during pregnancy

A

67

AP III (20 decks)

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