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► Med Misc 44 > OB facts > Flashcards

OB facts Flashcards

1
Q

all pt’s are considered what????

A

full stomachs

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2
Q

what type of induction should be done s needed

A

RSI

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3
Q

Respiratory Changes:

the diaphragm is displaced 4cm where by the expanding uterus

A

cephalad

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4
Q

Respiratory Changes:

the diaphragm being displaced 4 cm cephalic will cause what to FRC

A

decrease by 20%

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5
Q

Respiratory Changes:

what happens to VC, TLC, and IC ?

A

nothing they are all unchanged

-Unchanged d/t compensatory increase in thoracic anteroposterior diameter

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6
Q

Respiratory Changes:

as pregnancy increase thoracic breathing INcreases and _____ breathing decreases

A

Abdominal

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7
Q

Respiratory Changes:

the ventilatory changes produce what acid base problem? yet the compensation by metabolic acidosis will keep pH normal

A

respiratory alkolosis (PaCO2 =30)

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8
Q

Respiratory Changes:

would you anticipate the PaO2 to be higher in the pregnant or non pregnant state

A

Pregnant

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9
Q

Respiratory Changes:

Would you anticipate the PaCO2 to be higher in the pregnant or non-pregnant state

A

non-pregnant

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10
Q

Respiratory Changes:

the increase in O2 consumption produces a 70% increase in _____ _____ at term

A

alveolar ventilation

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11
Q

Respiratory Changes:

the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the ____ will increase by 40%

A

tidal volume

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12
Q

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%

A

respiratory rate

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13
Q

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?

A

alveolar ventilation

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14
Q

Respiratory Changes:

the increase in alveolar ventilation and decrease in FRC enhance maternal uptake of what?

A

Inhaled anesthetics

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15
Q

Respiratory Changes:

Increased AV + Decreased FRC = what to MAC

A

decreased MAC

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16
Q

Respiratory Changes:

Airway edema and engorgement is most evident during what trimester

A

3rd

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17
Q

Respiratory Changes:

Airway edema and engorgement is most evident in the 3rd trimester… what does this mean with our instrumentation?

A

Unexpected nose bleeds and airway bleeds can occur d/t careless instrumentation placement
oral airways, ETT, and NG tubes placed w/ caution
ETT need to be smaller (6/7 instead of 7/8)

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18
Q

Respiratory Changes:

a decrease in FRC may cause what complication

A

rapid desaturation

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19
Q

Respiratory Changes:

there is an increase in maternal O2 consumption and any episode of apnea will lead to what?

A

maternal hypoxia

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20
Q

Respiratory Changes:
During labor hyperventilation may be due to pain or specific breathing technique. Assess for alkalemia bc hypocarbia will cause what? and will result in what?

A

uterine vasoconstriction

result in decreased placental perfusion

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21
Q

Respiratory Changes:
with hyperventilation the alkalemia and hypocarbia will cause uterine vasoconstriction and results in decreased placental perfusion… is the fetus at risk?

A

yes

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22
Q

Changes in lung parameters: increase/ decrease/ NC:

Inspiratory reserve volume (IRV)

A

increase (5%)

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23
Q

Changes in lung parameters: increase/ decrease/ NC:

TV

A

Increase (45%)

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24
Q

Changes in lung parameters: increase/ decrease/ NC:

Expiratory reserve volume (ERV)

A

decrease (25%)

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25
Q 
Changes in lung parameters: increase/ decrease/ NC:
Residual Volume (RV)
A

decrease ( 15%)

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26
Q 
Changes in lung parameters: increase/ decrease/ NC:
Inspiratory capacity (IC)
A

increase (15%)
IC = IRV + TV
(since both IRV and TV increase obviously this must increase also)

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27
Q

Changes in lung parameters: increase/ decrease/ NC:

FRC

A

Decrease (20%)
FRC = ERV + RV
(since both ERV and RV decrease obviously this must also decrease)

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28
Q 
Changes in lung parameters: increase/ decrease/ NC:
Vital Capacity (VC)
A

no change

VC= IRV + ERV + TV

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29
Q

Changes in lung parameters: increase/ decrease/ NC:

Total lung Capacity (TLC)

A

decrease (5%)

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30
Q

Changes in lung parameters: increase/ decrease/ NC:

closing volume and capacity

A

no change

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31
Q

Changes in lung parameters: increase/ decrease/ NC:

Dead space

A

increase (45%)

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32
Q

Changes in lung parameters: increase/ decrease/ NC:

Respiratory rate

A

NC to Increase (15%)

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33
Q

Changes in lung parameters: increase/ decrease/ NC:

minute ventilation

A

increase (45%)

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34
Q

Changes in lung parameters: increase/ decrease/ NC:

Alveolar ventilation

A

Increase (45%)

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35
Q

Changes in lung parameters: increase/ decrease/ NC:

oxygen consumption

A

increase (20%)

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36
Q

Blood Gases:

PaCO2 what are the values for non pregnant? first? 2nd ? and 3rd trimester?

A 
normal 35-45 (40) mmHg
1st 30 mmHg
2nd 30 mmHg
3rd 30 mmHg
(key is it is always lower PaCO2 hence the respiratory alkalosis that ensues w/ pregnancy)
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37
Q

Blood Gases:

PaO2 what are the values for non pregnant? first? 2nd ? and 3rd trimester?

A 
Normal 100 mmHg
1st 107 mmHg
2nd 105 mmHg
3rd 105 mmHg
(key is once pregnant the PaO2 is always higher then the non pregnant)
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38
Q

Blood Gases:

pH what are the values for non pregnant? first? 2nd ? and 3rd trimester?

A 
Normal 7.35-7.45 (7.40) 
1st 7.44
2nd 7.44
3rd 7.33
(key is the body compensated with metabolic acidosis to keep pH WNL but slightly more alkolotic than normal)
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39
Q

Blood Gases:

HCO3 what are the values for non pregnant? first? 2nd ? and 3rd trimester?

A 
Normal 24
1st 21
2nd 20
3rd 20
(key is the pregnant pt is metabolic acidotic to compensate for the respiratory alkalosis)
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40
Q

Cardiovascular Changes:

Does BLOOD VOLUME increase/ decrease/ No change?

A

increase (35%)

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41
Q

Cardiovascular Changes:

Does PLASMA VOLUME increase/ decrease/ No change?

A

Increase (45%)

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42
Q

iCardiovascular Changes:

If blood volume increase why are prigs anemic?

A

dilutional anemia

plasma volume increases more

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43
Q

Cardiovascular Changes:

Does RBC VOLUME increase/ decrease/ No change?

A

increase (20%)

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44
Q

Cardiovascular Changes:

Does CARDIAC OUTPUT increase/ decrease/ No change?

A

increases (40%)

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45
Q

Cardiovascular Changes:

Does STROKE VOLUME increase/ decrease/ No change?

A

increases (30%)

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46
Q

Cardiovascular Changes:

Does HEART RATE increase/ decrease/ No change?

A

Increases (15%)

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47
Q

Cardiovascular Changes:

Does MAP increase/ decrease/ No change?

A

decrease (15 mmHg)

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48
Q

Cardiovascular Changes:

Does SYSTOLIC BP increase/ decrease/ No change?

A

decrease (0-15 mmHg)

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49
Q

Cardiovascular Changes:

Does DIASTOLIC BP increase/ decrease/ No change?

A

Decreases (10-20 mmHg)

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50
Q

Cardiovascular Changes:

Does CVP increase/ decrease/ No change?

A

No change

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51
Q

Cardiovascular Changes:

CO increases 30-40% during the 1st trimester d/t ___ and ___ while stroke volume remains the same.

A

increase in HR

decrease in Afterload

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52
Q

Cardiovascular Changes:

when is CO the greatest

A

after delivery and next couple of weeks

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53
Q

Cardiovascular Changes:
CO during Labor
CO increases how much during latent phase

A

15%

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54
Q

Cardiovascular Changes:
CO during Labor
CO increases how much during the Active phase/

A

30%

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55
Q

Cardiovascular Changes:
CO during Labor
CO increases how much during the 2nd stage?

A

45%

(15% increase each phase)

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56
Q

Cardiovascular Changes:
CO during Labor
CO increases how much in the postpartum phase?>

A

80%

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57
Q

Cardiovascular Changes:
After delivery blood volume increases when the uterus no longer obstructs the vena cava and aorta leading to ann increase in what?

A

Stroke Volume

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58
Q

Cardiovascular Changes:
Blood volume increases by 33-40% and the RBC increase 30 mL/kg and the plasma volume also increases 70 mL/kg the anemia is a result of what?

A

greater increase in plasma volume

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59
Q

Cardiovascular Changes:

you can correct the dilution anemia how?

A

w/ iron and folic acid administration

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60
Q

tCardiovascular Changes:

the increase in blood volume does not increase BP d/t what?

A

decreased peripheral vascular resistance

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61
Q

Cardiovascular Changes:

Near term blood volume increases about 1000mL (40%) probally d/t what?

A

peripheral vasodilation

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62
Q

Cardiovascular Changes:

CO to the uterine vasculature is apron ___-____ mL/min

A

700-800 mL/min

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63
Q

Cardiovascular Changes:

the CO must keep maternal SBP greater then _____ to maintain maternal perfusion to vasculature

A

100mmHg

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64
Q

Cardiovascular Hemodynamics at term:

Is there an INCREASE/ DECREASE/ NC in CO

A

increase (50%)

CO = HR + SV

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65
Q

Cardiovascular Hemodynamics at term:

Is there an INCREASE/ DECREASE/ NC in SV

A

increase (25%)

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66
Q

Cardiovascular Hemodynamics at term:

Is there an INCREASE/ DECREASE/ NC in HR

A

increase (25%)

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67
Q

Cardiovascular Hemodynamics at term:

Is there an INCREASE/ DECREASE/ NC in LVEDV

A

increase

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68
Q

Cardiovascular Hemodynamics at term:

Is there an INCREASE/ DECREASE/ NC in EF

A

increased

EF= SV / LVEDV

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69
Q

Cardiovascular hematologic changes at term:

Is there an INCREASE/ DECREASE/ NC in Blood volume

A

increase (45%)

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70
Q

Cardiovascular hematologic changes at term:

Is there an INCREASE/ DECREASE/ NC in Plasma volume

A

Increase (55%)

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71
Q

Cardiovascular hematologic changes at term:

Is there an INCREASE/ DECREASE/ NC in RBC

A

Increase (30%)

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72
Q

Cardiovascular hematologic changes at term:

Hgb Value

A

11.6 g/dL

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73
Q

Cardiovascular hematologic changes at term:

HCT value

A

35.5%

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74
Q

Cardiovascular:

what is maternal supine hypotensive syndrome

A

compression of inferior vena cava decreases venous return and this will result in a decreased stroke volume and hypotension. further compression will decrease uterine perfusion and may result in fetal distress

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75
Q

Cardiovascular:

what is the maternal response to maternal supine hypotensive syndrome?

A

tachycardia and vasoconstriction of lower extremities.

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76
Q

Cardiovascular:

how do you fix maternal supine hypotensive syndrome

A

LUD

-tilt pt to left with right hip bump 15 degrees

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77
Q

CV changes: Anesthetic Significance:

Ventilation may increase the incidence of accidental what

A

epidural vein punture

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78
Q

CV changes: Anesthetic Significance:

the healthy parturient will tolerate up to _____mLs of blood loss thus transfusion is rarely needed

A

1500ml’s

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79
Q

CV changes: Anesthetic Significance:

The drug _____ with free water IV infusion may lead to fluid overload

A

oxytocin

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80
Q

CV changes: Anesthetic Significance:

high Hgb level (>14) indicates low volume status caused by what?

A

pre-eclampsia
HTN
inappropriate diuretics

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81
Q

CV changes: Anesthetic Significance:

_____ reduces cardiac work during labor and may be beneficial in some cardiac disease states

A

Epidural

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82
Q

CV changes: Anesthetic Significance:

maternal SBP of

A
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83
Q

CV changes: Anesthetic Significance:

Always avoid what?

A

Aortocaval compression

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84
Q

CV changes- Coagulation at term:

Does the value Increase/ decrease/ NC for PT

A

Shorten

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85
Q

CV changes- Coagulation at term:

Does the value Increase/ decrease/ NC for PTT

A

shorten

86
Q

CV changes- Coagulation at term:

Does the value Increase/ decrease/ NC for Platelet count

A

NC

87
Q

Gastrointestinal Changes:
Prolonged gastric emptying time and a decrease in LES tine. The decreased GI motility, decreased food absorption, and LES pressure are all due to elevated levels of what hormone?

A

Progesterone

88
Q

Gastrointestinal Changes:
elevated _____ produces by from the placenta increases intragastric pressures and decreases the normal oblique angle if the GE junction. thus the pt is more prone to Gastric reflux

A

Gastrin

89
Q

Gastrointestinal Changes:

these pts are ALWAYS considered _______ and a risk for aspiration

A

full stomach

90
Q

Gastrointestinal Changes:

Narcotics, valium, and atropine all ____ LES tone and increase gastric emptying time

A

decrease

91
Q

Gastrointestinal Changes:

what else is wrong with narcotics and valium

A

fetal depression

92
Q

Gastrointestinal Changes:

what drug increases LES tone and increases gastric emptying

A

Metoclopramide

93
Q

Gastrointestinal Changes:

Secretion of gastric acid increases secondary to an increased _____ release

A

gastrin

94
Q

Maternal Renal Changes:

Normal decreases in BUN and serum creatinine are d/t what?

A

increases in renal blood flow and glomerular filtration

95
Q

Maternal Renal Changes:
renal plasma flow and glomerular filtration rate increases by __-__% above normal by the fourth month of gestation and slowly return to normal during the 3rd trimester

A

50-60%

96
Q

factors Causing decreased uterine blood flow:

what are 2 main causes for decreased uterine blood flow

A

Decreased perfusion pressure

uncreased uterine vascular resistance

97
Q

factors Causing decreased uterine blood flow:

what are 2 things that cause decreased perfusion pressure

A

Decreased uterine arterial pressure

Increased uterine venous pressure

98
Q

factors Causing decreased uterine blood flow:

what are 4 causes of decreaased uterine arterial pressure?

A

supine position
hemorrhage/hypovolemia
Drug induced hypotension
hypotension from sympathetic block

99
Q

factors Causing decreased uterine blood flow:

what are 4 causes of Increased uterine venous pressure

A

Vena caval contraction
Uterine contractions
Drug induced uterine hypertonus (oxytocin)
Skeletal muscle hypertonus (sz, valsalva)

100
Q

factors Causing decreased uterine blood flow:

name 2 things that can cause Increased uterine vascular resistance

A

endogenous vasoconstrictors

Exogenous vasoconstrictors

101
Q

factors Causing decreased uterine blood flow:

name 2 typs of endogenous vasoconstrictors that cause increased uterine vascular resistance

A

cathecholamines (stress)

Vasopressin (in response to hypovolemia)

102
Q

factors Causing decreased uterine blood flow:

name 3 types of exogenous vasoconstrictors that cause increased uterine vascular resistance

A

Epi
vasopressores (pheny, ephedrine)
LA (in high concentrations)

103
Q

Drug passage across placenta:

name 3 ways a drug crosses placenta

A

low molecular weight (

104
Q

Drug passage across placenta:

name 3 ways a drug will NOT cross the placenta

A

Large molecular weight > 500
Low lipid solubility
Ionized

105
Q

placental blood flow:

Blood is delivered to both the placenta and uterus how?

A

uterine artery

106
Q

placental blood flow:

in essence _______ is the ONLY factor that influences blood floe through the placenta

A

Mothers systemic arterial pressure

107
Q

placental blood flow:

Describe how maternal blood flow circulates through the placenta.

A

uterine arteries
intravenous space
fetal villi
uterine wall

108
Q

placental blood flow:
fetal blood and maternal blood are separated by the placental membrane. how many microscopic tissue layers are found in the placental membrane?

A

3

109
Q

General and regional Anesthesia during pregnancy:

what happens to MAC

A

reduced 15-40%

110
Q

General and regional Anesthesia during pregnancy:

what happens to rate of induction w/ inhalation agents

A

increases (faster inductions)

111
Q

General and regional Anesthesia during pregnancy:

w/ induction agents what happens to 1/2 life of propofol

A

nothing unaltered

112
Q

General and regional Anesthesia during pregnancy:

what happens to 1/2 life of meprdine

A

nothing unaltered

113
Q

General and regional Anesthesia during pregnancy:

what happens to sensitivity to SCh

A

reduced sensitivity

114
Q

General and regional Anesthesia during pregnancy:

what happens to duration of SCh block

A

unchanged to slightly decreased

115
Q

General and regional Anesthesia during pregnancy:

what happened to NDMR sensitivity

A

increased w. roc and Vec

116
Q

General and regional Anesthesia during pregnancy:

what happens to elimination 1/2 time w/ roc and vec

A

shortened

117
Q

General and regional Anesthesia during pregnancy:

what happens to Atacurium

A

unaltered

118
Q

General and regional Anesthesia during pregnancy:

what happened to chronotropics

A

diminished response

119
Q

general Anesthesia: implications of maternal physiologic changes:
4 things to remember with ETT intubation

A

Smaller tube
increased risk of trauma nasal
Increased risk of failed intubation
Increased risk if aspiration

120
Q

general Anesthesia: implications of maternal physiologic changes:
3 things to remember about maternal oxygenation

A

increased physiologic shunt when supine
increased rate of denitrogenation
Increased rate of decline in PaO2 w/ apnea

121
Q

general Anesthesia: implications of maternal physiologic changes:
what happens to MV

A

increased

122
Q

Regional Anesthesia: implications of maternal physiologic changes:
5 technical things to consider

A

lumbar lordosis increased
Apex of thoracic hypnosis at higher level
Head down tilt when in lateral position
CSF return unaltered
Reduced sensitivity to “hanging drop” tech

123
Q

Regional Anesthesia: implications of maternal physiologic changes:
what is a concern with hydration

A

increased fluid requirements to prevent hypotension

124
Q

Regional Anesthesia: implications of maternal physiologic changes:
3 concerns with LA dosing

A

SA dose decreased 25%

Epidural dose unaltered

125
Q

Regional Anesthesia Effects on Uterine Blood flow:

Increased uterine blood flow results from what 3 things

A

pain relief
Decreased sympathetic activity
Decreased maternal hyperventilation

126
Q

Regional Anesthesia Effects on Uterine Blood flow:

decreased uterine blood flow results from what 3 things

A

Hypotension
unintentional IV LA injection
Absorbed LA

127
Q

Stages of Labor:

how many stages are there

A

3

128
Q

Stages of Labor:

What is the first stage

A

onset of contractions to complete dilation of cervix

129
Q

Stages of Labor:

what is the second stage of labor

A

full cervical dilation (10cm) to delivery of infant

130
Q

Stages of Labor:

what is the 3rd stage

A

delivery of infant to delivery of placenta

131
Q

Stages of Labor:

what are the 2 phases of the first stage of labor

A

latent and active

132
Q

Stages of Labor:

what phase of stage 1 labor is little dilation of cervix, but it becomes softer

A

latent

133
Q

Stages of Labor:

what phase of stage 1 labor is regular cervical dilation in response to uterine contraction

A

active

134
Q

Stages of Labor: Stage 1

pain is initially at what dermatomes

A

T11-12

135
Q

Stages of Labor: Stage 1

pain is initially at T11-12 then progresses to ______ during active labor

A

T10-L1

136
Q

Stages of Labor: Stage 2

sensory innervation of the perineum is provided by the ____ nerve

A

pudendal nerve (S1-S4)

137
Q

Stages of Labor: Stage 2

the second stage of labor involves what dermatomes

A

T10-S4

138
Q

Parenteral Agents for Parturient:

what is the most commonly used opioid

A

Meperdine (demerol)

139
Q 
Parenteral Agents for Parturient:
what type of drug class is butorphenol and nalbupine
A

partial agonist

140
Q

Parenteral Agents for Parturient:

low doses of this drug is most helpful prior to delivery or as an adjunct to regional anesthesia

A

ketamine

141
Q 
Parenteral Agents for Parturient:
what drug class is not reccomended
A

NSAIDS

142
Q

Parenteral Agents for Parturient:

what are NSAIDS not recommended?

A

suppression of uterine contractions and promotes closure of fetal ductus arterious

143
Q

Parenteral Agents for Parturient:

what is the concern with Benzo’s

A

Strong potential for neonatal depression

144
Q

Regional:

Spinal opioids are free of what

A

Preservatives

145
Q

Regional:

Spinal opioids are useful in what pts

A

high risk

146
Q

Regional:

do they impair mother from pushing?

A

nope

147
Q

Regional:

what are 3 disadvantages of spinal opioids

A

less complete analgesia
lack of perineal relaxation
Pruritus, N/V, sedation, and resp depresion

148
Q

Regional:

what is the most common side effect

A

hypotension

149
Q

Regional:

treatment for hypotension

A

ephedrine/ phenylephrine
LUD
IV bolus

150
Q

Umbilical cord prolapse:

may lead to what?

A

fetal hypoxia

151
Q

Umbilical cord prolapse:

how is it diagnosed

A

sudden fetal bradycardia
profound decals
physical exam

152
Q

Umbilical cord prolapse:

treatment?

A

immetiade steep trendelenburg
maual pushing the presenting fetus buck up into pelvis
immediate c-section

153
Q

Signs of fetal distress

A

Repetative late decels
Loss of beat to beat variation
sustained FHR

154
Q

Placenta Previa:

For testing purposes think of what letter

A 
"P"
Painless
Preterm bleeding
Planned c-section
Pass on Pushing
155
Q

Placenta Previa:

how many types are there

A

3

156
Q

Placenta Previa:

what ar the 3 types

A

marginal
Partial
total

157
Q

Placenta Previa:

describe marginal

A

Placenta lies close to, but does not cover cervical os

158
Q

Placenta Previa:

describe partial

A

placenta partially covered cervical os

159
Q

Placenta Previa:

describe total

A

placenta covers over cervical os

160
Q

Placenta Previa:

delivery for marginal

A

up to ob

161
Q

Placenta Previa:

delivery for partial and total

A

c-section

162
Q

Placenta Previa:

1st episode of bleeding is typical when

A

preterm

163
Q

Placenta Previa:

are there contractions when bleeding

A

no

164
Q

Placenta Previa:

the onset of bleeding is not related to any articular event thus there is no what

A

No abdominal pain

Painless vaginal bleeding

165
Q

Placenta Previa:

there is usually painless vaginal bleeding when

A

2nd and 3rd trimester

166
Q

Placenta Previa:

is more common in women who have had what?

A

previous placenta previa

167
Q

Placenta Previa:

what are 3 risk factors?

A

Multiparity
Advanced maternal age
Large placenta that is disturbed

168
Q

Placenta Previa:

____ lying placenta previa increases the risk of bleeding for c-section

A

anterior

169
Q

Placenta Previa:

what is the treatment especially in the fetus is less than 37 weeks gestation and bleeding is mild to moderate

A

bedrest and observation

170
Q

Placenta Previa:

is fetal distress or demise common with first episode of bleeding?

A

no uncommon

171
Q

Placenta Previa:

what is common and may require blood component therapy

A

coagulopathy

172
Q

Placenta Previa:

is regional anesthesia appropriate is fluid resuscitation is complete?

A

yes

173
Q

Placenta Previa:
the goal is to delay delivery until the fetus is mature, the management is terminated and a c-section is performed if what things occur?

A 
Active labor persist
Documented lung maturity
gestational age reaches 37 weeks
excessive bleeding
another OB complication occurs
174
Q

Placenta Previa:

r/t anesthetic management what should we be ready for

A

massive blood loss

175
Q

Placental Abruption:

what is it

A

separation of placenta from the decimal basalis

176
Q

Placental Abruption:

what are the 3 types

A

marginal
Partial
Complete

177
Q

Placental Abruption:

what are risk factors

A 
HTN
Advanced age
parity
tobacco use
Cocaine use
trauma
PRM
hx of previous Placental Abruption

(basically anything that is bad for the vasculature)

178
Q

Placental Abruption:

what problem is seen with FHR

A

Late decels

179
Q

Placental Abruption:

fetal distress automaticaly signal what

A

c-section

180
Q

Placental Abruption:

what is the classic presentation

A

PAINFUL vaginal bleeding
uterine tenderness
increased uterine activity
Atypical presentation

181
Q

Placental Abruption:

large bleeding is expected.. the uterus can hold up to how much blood

A

2500 mL

182
Q

Placental Abruption:

what are the major complications from it

A 
DIC
Hemorrhagic shock
ARF
coagulopathy
fetal distress
183
Q

Placental Abruption:

management

A 
FHR monitorig
Large bore IVs
type and cross
H/H, coags
LUD
184
Q

Placental Abruption:

is regional anesthesia ok

A

not usually indicated d/t coagulopathy and uncertain uteroplacental blood flow

185
Q

Placental Abruption:

C-section- is problematic what type of anesthesia is prefered

A

General

186
Q

Abnormal Placental Implantation:

what are the 3 types?

A

placenta accreta
Placenta increta
Placenta percreta

187
Q

Abnormal Placental Implantation:

what one is the adherence of the placenta to the myometrium without invasion of or passage through the uterine muscle

A

Placenta Accreta vera

188
Q

Abnormal Placental Implantation:

what one is when the placenta invades and is confined to the myometrium

A

Placenta increta

189
Q

Abnormal Placental Implantation:

what one is when the placenta invades and penetrates the myometrium, the uterine series, or other pelvic structures?

A

placenta percreta

190
Q

Abnormal Placental Implantation:

what are 3 risk factors for developing it

A

placenta previa
previous c-section
uterine trauma

191
Q

Abnormal Placental Implantation:

it is the most common indication for what procedure

A

hysterectomy

192
Q

DIC labs:
Indicate increased or decreased
Plasma fibrinogen

A

decreased

193
Q

DIC labs:
Indicate increased or decreased
Platelet count

A

Decreased

194
Q

DIC labs:
Indicate increased or decreased
Thrombin time

A

increased

195
Q

DIC labs:
Indicate increased or decreased
Prothrombin time

A

Increased

196
Q

DIC labs:
Indicate increased or decreased
Partial thromboplastin time

A

Increased

197
Q

DIC labs:
Indicate increased or decreased
What is an easy way to remember all these

A

if its a count it’s decreased

If its a time its increased

198
Q

what is a syndrome of HTN, proteinuria, and generalized edema after the 20th week of gestation and usually abating within 48 hours of delivery

A

Pre-Eclampsia

199
Q

Pre-Eclampsia:

what is the cure?

A

delivery of baby

200
Q

what is the occurrence of convulsions superimposed on Pre-Eclampsia:

A

eclampsia

201
Q

Eclampsia/ Pre-eclampsia:

what is the drug of choice

A

magnesium sulfate (4-6 mEq/L)

202
Q

Eclampsia/ Pre-eclampsia:

what does Mag sulfate do

A

attenuates smooth muscle contraction with calcium at the cell membrane level and preventing an increase in free intracellular Ca++

203
Q

Eclampsia/ Pre-eclampsia:

principle SE of Mag sulfate

A

Hypotension

204
Q

Magnesium Sulfate:

is invers to what ion

A

Ca++

205
Q

Magnesium Sulfate:

normal plasma level

A

1.5-2.0

206
Q

Magnesium Sulfate:

what is therapeutic range

A

4-8 mEq/L

4x’s the normal range

207
Q

Magnesium Sulfate:

what level has EKG changes

A

5-10

208
Q

Magnesium Sulfate:

what level has loss of DTR

A

10

209
Q

Magnesium Sulfate:

what level has SA node and AV node block and respiratory paralysis

A

15

210
Q

Magnesium Sulfate:

what level will cause cardiac arrest

A

25

211
Q

What is normal FHR

A

125-150

► Med Misc 44 (72 decks)

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