OB/PEDS

Question 1

Post Delivery Hemorrhage & Control

Answer 1

Fundal Massage-stimulates secretion of pictocin and oxytocin (from pituitary gland)
Breast Feed
Trauma-control all external factors

Question 2

Most important question of Child Birth

Answer 2

Do you have to move your bowels?-means child birth is imminent

Question 3

Transport OB position

Answer 3

Left lateral recumbent, decreases chances of supine hypotension, Baby is putting pressure on the Vena Cava which decreases pre-load.

Question 4

Pregnacy BP & HR

Answer 4

BP usually drops 10-20 & HR increases 10-20

Question 5

Where is the egg fertilized?

Answer 5

Uteran tube (formerly the fallopian tube)

Question 6

ECTOPIC Pregnancy S/S +time frame

Answer 6

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

Question 7

Abrutio Placentae S/S + Time Frame

Answer 7

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

Question 8

Placentae Previa S/S + Time Frame

Answer 8

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

Question 9

Breech Birth

Answer 9

someting other than the head presenting during child birth, only treatment is rapid transport. Put STERILE dressing on exposed limbs

Question 10

Prolapse Cord & TX

Answer 10

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

Question 11

Function of the Placentae? How many blood vessels and arteries

Answer 11

Transport O2 and nutrients to the baby via the umbilical cord. 2 arteries and 1 vein

Question 12

Stage 1 of Birth

Answer 12

Onset of contractions to complete dilation of Cervix-10CM. 10CM is beginning of stage 2

Question 13

Stage 2 of Birth

Answer 13

full dilation of (10Cm) to the delivery of the baby. Baby is fully out is the beginning of stage 3

Question 14

Stage 3 of Birth

Answer 14

Baby is fully delivered to delivery of the placentae

Question 15

PreEclampsia S/S

Answer 15

is gestational high blood pressure 140/90 +

N/V, weakness coupled with tinnitis, blurred vision, headaches

Question 16

Eclampsia S/S & TX

Answer 16

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

Question 17

OB Emergencies TX

Answer 17

Purely SUPPORTIVE, Positioning, fluids,

Question 18

Pelvic Inflammatory Disease S/S

Answer 18

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

Question 19

Chlamydia S/S Women

Answer 19

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

Question 20

Chlamydia S/S Men

Answer 20

Burning during peeing, discharge from the penis or rectum, testicular pain,

Question 21

Gonorrhea S/S Women

Answer 21

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),

Question 22

Gonorrhea s/s men

Answer 22

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,

Question 23

Syphilis S/S

Answer 23

Look like blisters/bug bites, sexual activity spreads, wet warts on genital area, and can progress to bug bites on hands and feet.

Question 24

PEDS most common emergencies is Respiratory 1st type & TX

Answer 24

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

Question 25

Peds most common emergency Type 2 & TX

Answer 25

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

Question 26

TEST ? Pt has epiglotittis what do u do?

Answer 26

Intubate

Question 27

Mag Sulfate?

Answer 27

Is a smooth muscle relaxer.

Question 28

Meningitis S/S Kids & Adults

Answer 28

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

Question 29

Sunken Fontanells

Answer 29

Means dehydration, fluid bolus 20ml/kg, ask parents about diarrhea, crying with no tears, not peeing?

Question 30

Kids with respiratory issues do what…

Answer 30

put themselves in sniffing position i.e. croup, epigltittis, foreign body
Tripod position for lower airway issues such as asthma

Question 31

NEW DEFIB FOR PEDS

Answer 31

1st shock is 2j/kg, then 4j/kg, then 10jj/kg then keep repeating at 10j/kg

Question 32

ADULT SVT

Answer 32

above 150 HR with Narrow Complex

Question 33

Peds SVT

Answer 33

above 180 HR with narrow complex

Question 34

INFANT SVT

Answer 34

above 220HR

Question 35

Newborn Resuscitation Series

Answer 35

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

Question 36

BURNS newborn (also use newborn resuscitation) 2 are more serious

Answer 36

Hypothermia & Infection-more prone to both b/c of smaller BSA & immune system is not as developed. But number one concern is always AIRWAY

Question 37

CPS s/s

Answer 37

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.

Question 38

Pediatric dose of morphine

Answer 38

.1mg/kg IV
.2mg/kg IM
up to adult dose of of 2mg max & repeat at max of 2mg

Question 39

Greenstick Fracture Pattern Peds

Answer 39

Not a clean break-old tree branch makes a clean break, Fresh tree breaks a branch and it splinters

Question 40

APGAR SCORE

Answer 40

don’t expect a 10 usually a 7-8 and a 0 is a possibility