OB/PEDS Flashcards
Post Delivery Hemorrhage & Control
Fundal Massage-stimulates secretion of pictocin and oxytocin (from pituitary gland)
Breast Feed
Trauma-control all external factors
Most important question of Child Birth
Do you have to move your bowels?-means child birth is imminent
Transport OB position
Left lateral recumbent, decreases chances of supine hypotension, Baby is putting pressure on the Vena Cava which decreases pre-load.
Pregnacy BP & HR
BP usually drops 10-20 & HR increases 10-20
Where is the egg fertilized?
Uteran tube (formerly the fallopian tube)
ECTOPIC Pregnancy S/S +time frame
Pregnancy that occurs outside the uterus. Excruciating abdominal pain, usually unilateral, Ovaries are in the RLQ &LLQ, vaginal bleeding(bright red), 4-10 WEEKS(most important sign), fertilized egg is coming down fallopian/uteran tube and seats somewhere other than the ovary
Abrutio Placentae S/S + Time Frame
Complete or partial rupture from of the placentae usually from deceleration injury(rear end type). Bright red vaginal bleeding, exruciating pn, LATE 2nd-3RD TRIMESTER
Placentae Previa S/S + Time Frame
LATE 2nd-3rd Trimester, PAINLESS spotting/vaginal bleeding,
Placentae is blocking the cervix preventing baby from birthing, can be partial or complete block causing fetal distress, If they have prenatal care they will know they have it. If they don’t they won’t(and in turn you won’t till after) know. C-Section is definitive and only Treatment
Breech Birth
someting other than the head presenting during child birth, only treatment is rapid transport. Put STERILE dressing on exposed limbs
Prolapse Cord & TX
umbilical cord precedes the baby during birth putting pressure on the cord, elevate the hips, doggy style, create a void space, whatever works. Never cut the cord or push or pull on the baby
Function of the Placentae? How many blood vessels and arteries
Transport O2 and nutrients to the baby via the umbilical cord. 2 arteries and 1 vein
Stage 1 of Birth
Onset of contractions to complete dilation of Cervix-10CM. 10CM is beginning of stage 2
Stage 2 of Birth
full dilation of (10Cm) to the delivery of the baby. Baby is fully out is the beginning of stage 3
Stage 3 of Birth
Baby is fully delivered to delivery of the placentae
PreEclampsia S/S
is gestational high blood pressure 140/90 +
N/V, weakness coupled with tinnitis, blurred vision, headaches
Eclampsia S/S & TX
seizures during pregnancy whether or not they have a previous history.
TX-mag sulfate 2-4 grams if mag don’t work goto Benzos. U have 2 stop seizures based on implied consent
OB Emergencies TX
Purely SUPPORTIVE, Positioning, fluids,
Pelvic Inflammatory Disease S/S
infection of the terus lining, fallopian tubes, or ovaries.
S/S-possible fever that comes and goes
Pain/tenderness in the lower abdomen, pelvis or back. Vaginal discharge w/ weird smell/texture/color
Chlamydia S/S Women
Women-painful peeing-painful fucking, rectal pain or discharge,possible fever that comes and goes
Pain/tenderness in the lower abdomen, pelvis or back. Vaginal discharge w/ weird smell/texture/color
Chlamydia S/S Men
Burning during peeing, discharge from the penis or rectum, testicular pain,
Gonorrhea S/S Women
Women-vaginal discharge, burning and pain while peeing, increased urination frequency, sore throat, painful fucking, severe pain in lower abdomen & fever (if infection spreads to stomach and fallopian tubes),
Gonorrhea s/s men
Men-burning and pain while pissing, increase in piss frequency, discharge from the penis (white, yellow of green), red swollen hole of penis, tender swollen testicles, sore throat,
Syphilis S/S
Look like blisters/bug bites, sexual activity spreads, wet warts on genital area, and can progress to bug bites on hands and feet.
PEDS most common emergencies is Respiratory 1st type & TX
CROUP-Laryngeal tracheal Bronchitis (croup wont be used on test) S/S-progressive onset not acute (virus), Low grade fever, N/V, maybe stridor, seal bark like cough, TX-supportive, humidified o2, Definitive-racimic epi(use this answer if given) if not use cortico steroids
Peds most common emergency Type 2 & TX
Epiglottitis-bacterial infection same s/s as laryngeal bronchitis minus the seal bark, n/v, low grade fever, DROOLING (EPIGLOTIS IS CLOSING) TX-humidified o2, Definitive TX- antibiotics then corticosteroids
TEST ? Pt has epiglotittis what do u do?
Intubate
Mag Sulfate?
Is a smooth muscle relaxer.
Meningitis S/S Kids & Adults
N/V. fever, headache, limb joint muscle pain, cold hands & feet shivering, pale or mottled skin, rapid breathing, stiff neck(less common in young kids), dislike of bright lights(less common in young kids), sleepy difficult to wake, confused, possible seizures, Kids also have bulging FONTANELLS
Sunken Fontanells
Means dehydration, fluid bolus 20ml/kg, ask parents about diarrhea, crying with no tears, not peeing?
Kids with respiratory issues do what…
put themselves in sniffing position i.e. croup, epigltittis, foreign body
Tripod position for lower airway issues such as asthma
NEW DEFIB FOR PEDS
1st shock is 2j/kg, then 4j/kg, then 10jj/kg then keep repeating at 10j/kg
ADULT SVT
above 150 HR with Narrow Complex
Peds SVT
above 180 HR with narrow complex
INFANT SVT
above 220HR
Newborn Resuscitation Series
HR falls below 100 but above 60 use BVM w/O2 every 3 seconds(don’t over bag)
HR falls below 60 give chest compressions
HR above 100 is purely supportive
BURNS newborn (also use newborn resuscitation) 2 are more serious
Hypothermia & Infection-more prone to both b/c of smaller BSA & immune system is not as developed. But number one concern is always AIRWAY
CPS s/s
bruises in different stages of healing and circumferential burns i.e. being dipped in hot water. #1 person to notify is physician so he can do due diligence.
Pediatric dose of morphine
.1mg/kg IV
.2mg/kg IM
up to adult dose of of 2mg max & repeat at max of 2mg
Greenstick Fracture Pattern Peds
Not a clean break-old tree branch makes a clean break, Fresh tree breaks a branch and it splinters
APGAR SCORE
don’t expect a 10 usually a 7-8 and a 0 is a possibility
