Brainscape's Knowledge GenomeTM

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


See full index

AP III > OB (4/10) > Flashcards

OB (4/10) Flashcards

1
Q

oxygen uptake in fetus is ________x that of the adult, but decreases significantly with hypoxemia

A

2

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

fetal circulation directs oxygenated blood to the _______________ & ___________ and deoxygenated blood to the ____________ & ________

A

Brain; heart; umbilical circulation; placenta

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

describe the flow of fetal circulation starting at the placenta

A

(oxygenated) placenta –> liver –> portal sinus and ductus sinus –> IVC –> right atrium –> foramen ovale –> L. atrium –> L ventricle –> aorta –> brain and myocardium (ensuring they get the highest concentration of O2 blood)

(deoxygenated blood) coming in from lower extremities and SVC –> R. ventricle –> pulmonary trunk –> ductus arteriosus –> descending Ao –> lower extremities and hypogastric arteries –> returns to placenta via umbilical arteries

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

the fetal oxyhgb dissociation curve is shifted to the ______________ with respect to the adult (non-pregnant) form and the pregnant womans oxyhgb curve lies to the ____________ of the nonpregnant

A

left; right

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

what would you expect to happen to the pregnant mothers oxy-hgb dissociation curve with hyperventilation

A

move left

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

why does fetal blood have higher affinity for O2 than the mothers

A

fetal hgb has no B-chain so has higher affinity

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

what are the 3 major shunts of fetal circulation

A
  1. ductus venosus
  2. foramen ovale
  3. ductus arteriosus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

the fetal circulatory shunt bypasses the liver via the ________________

A

ductus venosus

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

_________________ is the shunt in fetal circulation which bypasses pulmonary circulation

A

ductus arteriosus

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

what is the purpose of oxytocin (“pitocin”)

A
  1. induce or augment labor
  2. induce uterine contractions
  3. maintains uterine tone
  4. given postpartum to increase uterine tone and stop bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

dose of oxytocin when used to augment/induce labor

A

3-40 miliunits/min titrated to achieve normal contraction pattern

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

dose of oxytocin postpartum to decrease hemorrhage

A

10-40 units per IVF bag or 10 units IM

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

common s/e of pitocin

A
  1. uterine hypertonicity
  2. N/V
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

_______________ are what change the size of the cervix

A

contractions

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

what is the black box warning for oxytocin

A

not indicated for elective labor

(but this is what we primarily use it for…)

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

serious side effects of pitocin

A
  1. anaphylaxis
  2. SIADH
  3. HTN
  4. arrhythmias
  5. postpartum hemorrhage
  6. pelvic hematoma
  7. vaginal or cervical laceration
  8. abruption
  9. uterine rupture
  10. uterine tetany
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the laboring dose of oxytocin

A

0.5-1 mU/min

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

what dose of pitocin is equivalent to spontaneous labor

A

6 mU/min

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

what are the different drugs used for uterine atony

A
  1. oxytocin
  2. methylergonovine (methergine)
  3. hemabate
  4. misoprostol (cytotec)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if you have given pitocin for uterine atony after delivery, but the uterus is still boggy what drug should you give

A

methergine

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

dose of methergine

A

0.2 mg IM

can be repeated x1 after 1 hour

22
Q

contraindications to using methergine for uterine atony

A
  1. htn
  2. preeclampsia
  3. CAD
23
Q

________________ is a drug used for uterine atony, has a long duration of action and may be repeated 1x after 1 hour

A

methergine

if pt has htn you would not give methergine you would instead give hemabate

24
Q

s/e of methergine

A
  1. thromboembolic sequelae
  2. severe N/V
  3. arteriolar constriction
25
Q

dose of hemabate

A

250 mcg IM or IU for uterine atony

can be repeated q15min up to 2 mg

26
Q

c/i to using hemabate

A
  1. reactive airway dz
  2. pulmonary htn
  3. hypoxic pts
27
Q

s/e of hemabate

A
  1. bronchoconstriction
  2. shivering
  3. Temp increase
  4. diarrhea
28
Q

dose of misoprostol (cytotec) for uterine atony

A

800-1000 mcg PR

29
Q

s/e of misoprostol (cytotec)

A
  1. shivering
  2. temp increase
  3. N/V/D
30
Q

what is the rule of 3’s to guide pitocin administration

A
  1. 3 units of pitocin given IVP
  2. assesment of uterine tone at 3 minute intervals, redosing if needed with 3 unit boluses up to a total of 3
31
Q

what are the different ways to administer pitocin

A
  1. 200 mU/min for several minutes until uterus remains fimr then 1-2 mL/min until discharge
  2. 20 units in 1 L LR wide open then add 20 U to next IV bag
  3. 30 units in 500 mL of LR wide open
  4. 10 units IVP then 20 units in > 500 mL, add 20 more units per surgeon request
  5. 30 u/500 mL on pump at 333 mL/hr x 1 hour then 42 mL/hr after that til bag is complete
32
Q

what is the third line drug for uterine atony?

A

hemabate

33
Q

_____________ is a synthetic prostaglandin that stimulates uterine contraction

A

hemabate

34
Q

what is the common on label use of misoprostol (cytotec)

A

cervical ripening

35
Q

cytotec is administered via what route for cervical ripening? what route for post partum uterine atony?

A
  1. ripening = oral or vaginally
  2. postpartum atony = rectal
36
Q

_______________ is a synthetic analogue of lysine

A

TXA

37
Q

MOA of TXA

A

prevents fibrin degradation

38
Q

use of TXA

A
  1. postpartum bleeding
  2. trauma
  3. surgery
  4. tooth removal
  5. nose bleeds
  6. being used in prophylaxis for high risk pregnant moms before C-section
39
Q

dose of TXA

A

1000 mg IV over 30 minutes, can be repeated once

40
Q

T/F: if mom has covid 19, you should avoid TXA

A

true - increased risk of clot

41
Q

use of cervidil

A

cervical ripening

42
Q

dose/administration of cervidil

A

10 mg via vaginal suppository - leave in x12 hours

43
Q

under what circumstance would you remove the vaginal suppository cervidil from the pt before 12 hours

A
  1. if pt cervix dilates > 4 cm
  2. rupture of membrane
  3. non reassuring fetal heart tones.
44
Q

after placing cervidil, what positioning instructions should you give the pt

A

must lie flat for 2 hours

45
Q

what are the s/e of cervidil

A

cramping

46
Q

_______________ is a stick poked in the cervix for cervical ripening, mother is sent home and then next morning comes to the hospital for induction of labor

A

dilapan-S

47
Q

______________ initates endogenous prostaglandin release causing collagen degradation –> cervical softening

A

dilapan-S

48
Q

______________ is a catheter with 2 large ballons inserted into cervix, every few hours nurse tugs on catheter, once comes out pt is dilated to _________ cm

A

cook catheter; 4-5 cm

49
Q

______________ is a beta adrenergic agonist that is used a tocolytic

A

terbutaline

50
Q

dose of terbutaline for tocolysis

A

0.25 mg SQ

AP III (25 decks)

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