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CC-P OB > OB Emergencies > Flashcards

OB Emergencies Flashcards

1
Q

Name 4 maternal changes in pregnancy.

A

increased circulating blood by 50%
Decreased TV
BP decreases slightly in the second trimester.
HR increases by 10-20 beats per min.
anemia in pregnancy

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2
Q

Name 5 considerations in OB transport.

A

place in left lateral recumbent or place pillows on the right side to relive supine hypotension.
EKG
O2
Fetal monitoring
IV

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3
Q

The left lateral recumbent position can increase overall circulating volume by?

A

30-40%

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4
Q

On fundal height assessment where is the measurement taking place? and what does that tell you about the age of the fetus?

A

symphysis pubis to the ridge of the uterus.
tells us the gestational age in weeks.
so 20com is 20 weeks old.

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5
Q

Fetal lie indicated the baby’s spine in relation to the mother’s spine. T/F

A

True. Fetal lie/fetal position also referred to as baby’s position in the womb before labor establishes where the baby’s face is – toward the mother’s back or her belly. Fetal presentation actually tells you what part of the baby’s body will lead the way out of the birth canal. With this, one can determine the direction the baby’s head and feet are.

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6
Q

Describe fetal station.

A

-3 is a floating baby and +3 in a crowning baby

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7
Q

what is effacement?

A

Effacement is the thinning and shortening of the cervix. It happens at the end of pregnancy in preparation for childbirth. A pregnant person must be 100% effaced for a vaginal delivery.

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8
Q

What is the first stage of labor?

A

Begins with the onset of contractions and ends with complete dilation of the cervix 10cm

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9
Q

Complete dilation to birth is what stage of labor?

A

second stage of birth

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10
Q

Birth of the placenta is considered ______ stage of labor.

A

the third stage of labor.

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11
Q

what is considered bradycardia in FHR?

A

<120 beats for greater than 5-10 min

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12
Q

Causes of bradycardia include?

A

Cord compression
cord prolapse
Tetanic contraction
Epidural spinal anesthesia
maternal seizures
Vigorous examination

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13
Q

Tachycardia FHR is?
causes are?

A

> 160 for 5-10 min
Fetal hypoxia
Maternal fever
hyper thyroid
Anemia and premature.

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14
Q

what is the FHM strip?

A

Fetal heart rate (FHR) accelerations associated with fetal movements is considered a sign of fetal well-being. baby is just moving and increasing the heart rate for a short time. sometimes with the contractions.

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15
Q

What is the FHM strip?

A

Early deceleration is defined as a symmetrical deceleration that matches the contractions decrease and return of fetal heart rate (FHR) that is associated with a uterine contraction. not harmful, returns to baseline after contraction

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16
Q

Name this FHM strip

A

Variable decelerations are generally irregular variable decelerations“. I remember it because the dips in the fetal heart tones look like V’s. The v’s remind me that this is a “variable deceleration”. Variable decelerations are NOT good! Notice that every time mom has a contraction the baby’s heart rate majorly decreases. Remember a normal fetal heart rate is 110-160 bpms.

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17
Q

What causes variable decelerations

A

Cord compression ( harmful)
premature rupture of membrane
decreased amniotic fluid

18
Q

What is this FRM strip
Causes ?

A

Late decelerations begin at or after the peak of a contraction smooth shallow dip remains down long after the contraction has ended. Very Bad

The causes are fetal hypoxia placenta disfunction

19
Q

What is this FHM strip?

A

Sinusoidal waveform wavy non-reactive to contractions Very Bad c section required

Causes are fetal anemia or hypoxia

20
Q

What is A tetanic contraction?

A

What is a A tetanic contraction is a sustained muscle contraction

21
Q

Pre-mature labor usually occurs between __________ weeks.
Medications for Premature labor include?

A

20-37 weeks.
Corticosteroids to help with lungs and GI tract, Tocolytics to reduce contractions, Magsolfate for seizures, and antibiotics for infection

22
Q

Blurry vision or double vision
Frequent and persistent headaches
Stomach and/or abdominal pain
Rapid weight gain
Nausea and/or vomiting

A

PIH no protein in the urine.

23
Q

Proteinuria may be an indicator of____________

A

Pr eclampsia

24
Q

What three medications are indicated for PIH

A

(IV) labetalol 20mg
hydralazine 5mg
nifedipine 10-30 mg PO

25
Q

What is the BP goal in PIH?

A

DBP=100-105 systolic BP=<160

26
Q

HTN, protein in the urine, and weight gain may be signs of _________in the pregnant mother.

What is the giveaway?

A

Pre-eclampsia
give away is protein in the urine.

27
Q

What three medications can be used for seizures in eclampsia?

A

Mag sulfate 4mg
Valium
Ativan

28
Q

what does H.E.L.L.P stand for

A

(Hemolysis, Elevated Liver enzymes and Low Platelets

29
Q

ALT and AST enzymes are found in the ________and are ________during H.E.L.L.P, in H.E.L.L.P the platelet count will be ______________

A

ALT and AST are found in the liver and are elevated during H.E.L.L.P, In H.E.L,L,P the platelet count will be < 100,000mcl

30
Q

H.E.L.L.P will present with tight upper quadrant pain? T/F

A

True

31
Q

alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) are bi-products of liver damage T/F

A

True If your ALT and AST level is high, it may indicate minor or severe liver injury.

32
Q

Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. Which of the following conditions is suspected?
Abrupto Placenta
STD
Pre mature labor
Planceta Previa

A

Placenta Previa is painless vagianal bleeding

33
Q

Treatment for placenta previa includes.

A

O2, volume replacement, tocolytics to stop contractions, Must have a C-section, no vaginal exams

34
Q

What is placenta previa?

A

Placenta previa is a problem during pregnancy when the placenta completely or partially covers the opening of the uterus (cervix).

35
Q

Premature separation of the placenta from the uterine wall with dark red blood and server pain is___________?

A

Placenta abruption

36
Q

What is the procedure for delivery of a nuchal cord presentation?

What FHM strip will be present?

A

gently unwrap the cord if possible, summersault maneuver if needed, and clamp and cut as last resort.

37
Q

What is prolapse cord and what is the treatment?
Is a c-section required?

A

umbilical cord presents in the birth canal before the baby.
Knee chest maneuver or high Trendelenburg, no encouragement to push gloved fingers in the birth canal to prevent cord compression. C-Section is required because the baby will compress the cord.

38
Q

In a breach presentation, the fetus should not be touched until the umbilicus has been delivered. T/F

A

True

39
Q

In a breech delivery after the umbilicus and shoulders have been delivered, you should rotate the baby so that the back is anterior and apply downward pressure. T/F

A

True the umbilicus and shoulders must be delivered before you can rotate the fetus anterior.

40
Q

Describe Mauriceaus maneuver and when it is used.

A

Mauriceau-Smellie-Veit maneuver is a method of delivering the aftercoming head in cases of breech presentation: the infant’s body rests on the physician’s palm and forearm with the index and middle fingers over the maxilla to flex the head while the other hand is placed on the infant’s shoulders to apply traction. Called also Smellie

41
Q

Post Partum hemorrhage is defined as blood loss ____________in a vaginal delivery and __________ in a C-Section

A

> 500ml in vagina and >1,000 mls in C-section delivery

42
Q

Treatment for postpartum hemorrhage includes?

A

Fluids
external uterine massage
Oxytocin
Methergine ( smooth muscle constrictor)
Bi-manual uterine compression

CC-P OB (1 decks)

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