OB Flashcards
Respiratory Changes:
would you anticipate the PaO2 to be higher in the pregnant or non pregnant state
Pregnant
Respiratory Changes:
Would you anticipate the PaCO2 to be higher in the pregnant or non-pregnant state
Non-Pregnant
Respiratory Changes:
the increase in O2 consumption produces a 70% increase in _____ _____ at term
Alveolar ventilation
Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the ____ will increase by 40%
tidal volume
Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the Tidal volume will increase by 40% and the _____ increases by 15%
respiratory rate
Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the Tidal volume will increase by 40% and the respiratory rate increases by 15% relenting the increase in what?
alveolar ventilation
Respiratory Changes:
the increase in alveolar ventilation and decrease in FRC enhance maternal uptake of what?
inhaled anesthestics
Respiratory Changes:
increased AV + decreased FRC = what w/ MAC
Decreased MAC
Changes in lung parameters: increase/ decrease/ NC:
Inspriatory reserve volume (IRV)
increase ( 5%)
Changes in lung parameters: increase/ decrease/ NC:
TV
increase (45%)
Changes in lung parameters: increase/ decrease/ NC:
Expiratory reserve volume (ERV)
decrease (25%)
Changes in lung parameters: increase/ decrease/ NC:
Residual volume (RV)
decrease (15%)
Changes in lung parameters: increase/ decrease/ NC:
Inspiratory capacity (IC)
increase (15%)
IC = IRV + TV
if IRV and TV increase obviously IC must increase
Changes in lung parameters: increase/ decrease/ NC:
FRC
decrease (20%)
FRC = ERV + RV
If ERV an dRV both decrease then obviously FRC must also decrease
Changes in lung parameters: increase/ decrease/ NC:
Vital Capacity (VC)
no change
VC= IRV + ERV + TV
Changes in lung parameters: increase/ decrease/ NC:
TLC
decrease (5%)
Changes in lung parameters: increase/ decrease/ NC:
Closing volume and Capacity
no change
Changes in lung parameters: increase/ decrease/ NC:
Deadspace
increase (45%)
Changes in lung parameters: increase/ decrease/ NC:
respiratory rate
NC to INcrease (15%)
Changes in lung parameters: increase/ decrease/ NC:
Minute ventilation
increase (45%)
Changes in lung parameters: increase/ decrease/ NC:
alveolar ventilation
increase (45%)
Changes in lung parameters: increase/ decrease/ NC:
oxygen consumption
Increase (20%)
Respiratory changes: Anesthestic significance
why is airway management more challenging? (3 things)
- weight and breast engorgement hinder laryngosocpy
- Swollen mucose bleeds easily: avoid intranasal manipulation
- use smaller ETT (swollen airway)
Respiratory changes: Anesthestic significance
what is their response to anesthestics?(4 things)
- MAC decreased
- Decreased FRC results in faster indution
- Increased MV = faster induction
- Rapid overdose with loss of airway reflexes
Respiratory changes: Anesthestic significance
3 reasons the prego is at greater risk for hypoxemia
- Decreased FRC ( less O2 reserve)
- Increased O2 consumption
- Rapid airway obstruction
Respiratory changes: Anesthestic significance
excessive mechanical hyperventilation (ET CO2 < 24 mmHg) may do what to things
decrease maternal CO
decrease uterine blood flow
Respiratory changes: Anesthestic significance
Maternal and fetal hypoxemia are associated with pain-induced hyper-hypoventilation and can be avoided how?
with analgesics
Cardiovascular Changes:
Does BLOOD VOLUME increase/ decrease/ No change?
Increase (35%)
Cardiovascular Changes:
Does PLASMA VOLUME increase/ decrease/ No change?
Increase (45%)
if blood volume increases why is the prego anemic?
b/c plasma volume increases more
Cardiovascular Changes:
Does RBC VOLUME increase/ decrease/ No change?
increases (20%)
Cardiovascular Changes:
Does CO increase/ decrease/ No change?
increases (40%)
Cardiovascular Changes:
Does STROKE VOLUME increase/ decrease/ No change?
Increases (30%)
Cardiovascular Changes:
Does HEART RATE increase/ decrease/ No change?
Increases (15%)
Cardiovascular Changes:
Does MAP increase/ decrease/ No change?
Decrease (15 mmHg)
Cardiovascular Changes:
Does SYSTOLIC BP increase/ decrease/ No change?
Decreses (0-15mmHg)
Cardiovascular Changes:
Does DIASTOLIC BP increase/ decrease/ No change?
Decreases (10-20mmHg)
Cardiovascular Changes:
Does CVP increase/ decrease/ No change?
No change
CV changes: Anesthetic Significance:
venodilation may increase the incidence of accidental what?
epudural vein punture
CV changes: Anesthetic Significance:
a healthy partutient will tolerate upto ____ mLs if blood loss, thus transfusions are rarely needed
1500mL’s
CV changes: Anesthetic Significance:
the drug ___ with a free water IV infusion may lead to fluid overload?
oxytocin
CV changes: Anesthetic Significance:
High hgb level (<14) indicated low volume status caused by what ?
pre-eclampsia
HTN
inapropriate diuretics
CV changes: Anesthetic Significance:
____ reduces cardiac work during labor and may be benificial is some cardiac disease states
Epidural
CV changes: Anesthetic Significance:
maternal SBP of <___ to ____ during regional block should be of concern b/c it may be associated w/ proportional decrease in uterine blood flow
<90-95mmHg
Placenta Previa:
the first episode of bleeding is typically when? and there are NO contractions with bleeding
preterm
Placenta Previa:
onset of bleeding is not related to any particular event. ther is NO abdominal pain, painless vaginal bleeding during the ____ or _____ trimester
2nd or 3rd trimesters
Placenta Previa:
____ lying placenta previa increases the risk of excessive bleeding w/ C-section
anterior
Placenta Previa:
_____ and _____ are the treatment especially if the fetus is less than 37 weeks gestation
bedrest and observation
Placenta Previa:
what confirms diagnosis
US
Placenta Previa:
management is based on what 2 things
amount of vaginal bleeding
maturity if fetus
Placenta Previa:
_______remains the most common cause of neonatal morbidity and motality, especially if bleeding begins before 20 weeks
Prematurity
Placenta Previa:
the incidence of _____ of the fetus is greatest in women with placenta previa
asymetric intrauterine growth restriction
Placenta Previa:/
the urgency for C-section is based on what
Maternal hypotension
Placenta Previa:
can you use either regional or general anesthesia
yes
Placenta Previa:
what type
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Marginal
Placenta Previa:
what type
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partial
Placenta Previa:
what type
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Complete
Placental Abruption
what is it
separation of the placenta from the decisuas basalis before delivery of the fetus
Placental Abruption:
may have acute bleeding from the exposed ______ vessels, this usually accounts for a lot of blood
decidual vessels
Placental Abruption:
_____ results from loss of area for maternal-fetal gas exchange
fetal distress
Placental Abruption:
Fetal distress signals what?
general C-section
Placental Abruption:
what is the classic presentation
painful vaginal bleeding
Placental Abruption:
what is teh definative treatment?
delivery of fetus and placenta
Placental Abruption:
any concerns with ____ or _____ = no epidural
volume
coasgulation studies
Placental Abruption:
agressive volume resuscitation w/___ or ____
colliod or crytalloid
Placental Abruption:
what tyoe is this
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Marginal
Placental Abruption:
What type is this
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partial
Placental Abruption:
what type is this?
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Complete