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Critical Care FP-C 2.0 > OB Emergencies > Flashcards

OB Emergencies Flashcards

1
Q

Anatomical and physiologic changes

A

Joints relax: progesterone
Heart is displaced to the left
-Left axis deviation on EKG
Diaphragm moved up 4cm
-Chest tubes should be inserted one ICS higher

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2
Q

Respirations

A

Minute ventilation increases
Respiratory alkalosis

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3
Q

Cardiac

A

Increases 20-30% by 10 weeks, up to 43% by term
Baseline HR increase by 10 BPM
Approx. 10mmHg decrease in blood pressure

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4
Q

Blood volume

A

-Circulatory volume increases 40-45%
-Pregnant won’t exhibit clinical sings of hypovolemia till late and severe blood loss
-Risk for DVT and PE

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5
Q

Effacement

A

Cervical thinning, measured from 0-100%

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6
Q

Dilation

A

Cervical opening, measured in centimeters 0-10cm

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7
Q

HELLP

A

Hemolytic anemia
Elevated
Liver enzymes
Low
Platelet count

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8
Q

HELLP treatment

A

Blood product administration
Magnesium and antihypertensives
Delivery of fetus and placenta

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9
Q

Preeclampsia

A

Presentation:
Hypertension
Proteinuria
Hyperreflexia
Edema
Abdominal pain

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10
Q

Preeclampsia treatment

A

IV mag bolus 4-6 grams over 20 minutes
IV mag drip 2-4 grams per hour
IV labetalol, hydralazine, or nifedipine
Delivery of fetus and placenta

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11
Q

Magnesium Toxicity

A

Symptoms: loss of DTR, resp depression, AMS
Treatment: calcium gluconate or calcium chloride
Mag exposed baby:
Lethargic
Higher likelihood of need of resuscitation

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12
Q

Placenta previa

A

Presents as painless bright red vaginal bleeding
Treatment:
Vaginal exam is contraindicated
Maintain maternal hemodynamic stability
Transport for C-section

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13
Q

Placental abruption

A

Separation of a normally positioned placenta from uterine wall
Painful bleeding with radiation to the back

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14
Q

Sinusoidal pattern

A

Indicates impending fetal demise
High rate of fetal morbidity/mortality

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15
Q

Early deceleration

A

Mirror contraction, normal during active labor, indicates head compression

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16
Q

Variable decelerations

A

Abrupt decrease in fetal HR, characterized by v/w- shapes
-Indicates cord compression
Treatment: change maternal position, fluid administration, 100% oxygen, tocolysis

17
Q

Late decelerations

A

Nearly symmetrical with contraction, but begins and returns to baseline after the contraction ends
-Indicates placental insufficiency
-Requires immediate intervention

18
Q

VEAL CHOP

A

Variable Decel = Cord compression
Early decel = Head compression
Acceleration = okay
Late Decel = Placental Insufficiency

19
Q

APGAR

A

Appearance
Pulse
Grimace
Activity
Respirations

20
Q

Suction

A

Mouth, then nose

21
Q

First stage of labor

A

Begins at onset of labor and ends when cervix is 100% effaced and dilated

22
Q

Second stage of labor

A

Begins when cervix is completely effaced/dilated and ends with birth of baby

23
Q

Third stage of labor

A

Begins with birth of baby and ends with delivery of placenta

24
Q

Normal serum magnesium level

A

1.5-2.5

25
Q

Premature rupture of membranes
(PROM)

A

Spontaneous rupture of amniotic sac before 37 weeks

Treatment:
-Delivery within 24 hours
Or
- Hospitalization with IV antibiotics until delivery

26
Q

Turtle Sign

A

Shoulder dystocia applied traction to pull head back towards uterus

Treatment:
Mcroberts maneuver
Flex mother’s knees against her chest during next contraction
Apply “suprapubic” pressure

27
Q

Amniotic fluid embolism

A

Small amount of amniotic fluid enters maternal circulation and induces anaphylactoid reaction

Treatment: “A-OK”
Atropine
Ondansetron
Ketorolac

28
Q

Normal fetal heart rate

A

110-169 bpm

29
Q

Fetal tachycardia

A

Compensates for transient hypoxia
Maternal fever

30
Q

Fetal bradycardia

A

Cord compression
Placental insufficiency
Maternal hypotension
Uterine rupture

31
Q

Absent variability

A

Associated with fetal distress

32
Q

Minimal variability

A

0-5 bpm

33
Q

Moderate variability

A

6-25 bpm

34
Q

Marked variability

A

> 25 bpm

35
Q

Acceleration heart rate

A

Increase > 15 bpm lasting > 15 seconds

Critical Care FP-C 2.0 (15 decks)

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