OBGYN Flashcards
dysmenorrhea
pain during menstruation
mittelschmerz
pain as a result of follicular rupture and bleeding from ovary durign menstural cycle
pain in R or L lower quadrant and bleeding from ovary during menstrul cycle
gravida
got knocked up
# of pregnancies including this one
para
pushed one out
# of live births
antepartum
maternal period before delivery
intrapartum
during delivery
postpartum
after delivery
term
pregnancy lasting 40 weeks
first stage of labor
begins with contractions. ends when cervix is fully dilated at 10 cm
second stage of labor
full dilation to delivery of newborn
third stage of labor
begins with delivery of baby and ends with placental delivery
precipitous birth
onset of labor to birth is less than 3 hours
what is an ovarian cyst
thin walled fluid filled sac on surface of ovary.
can result in significant hemorrhage
ss of ovarian cyst
localized one sided abd pain, vaginal bleeding or a late/missed period at the time of rupture
what is ectopic pregnancy
pregnancy that develops outside uterus in fallopian tube or ovary. typically found at 8-12 weeks gestation
ectopic pregnancy ss
vaginal bleeding, crampy abd pain, spotting, rigid stiff board like abd. can cause sepsis and shock
ectopic pregnancy managemnt
IV and fluids
pain management
rapid transport
what is placenta previa
placental implantation in lower uterine segment partially or completly covering cervical opening
placenta previa ss
third trimester pain (aching)
can be painless
bright red bleeding
strongly associated with previous c sections
what is abruptio placenta
partial or full detachment of a normally implanted placenta at more than 20 weeks gestation
ss abruptio placenta
third trimester pain (stabbing)
painful
dark red bleeding
localized uterine tenderness
what is preeclampsia
gestational htn after 20 weeks
treat with iV o2 as needed and transport
what is eclampsia
preeclampsia and seizure
transport in left lateral position
treat with o2, mag 4g over 10-20 min
consider benzo
can occur postpartum
normal blood loss during labor
500 ml
postpartum hemorrhage treatment
fundal massage->breastfeed->give pitocin 10U/L 1drop every 2 sec
what is amniotic fluid embolism
amniotic fluid enters maternal circulation during labor, delivery, or immediatly after via laceration of endocervical veins, lower uterine segment, uterine veins
signs of imminent delivery
contractions 45-60 seconds in length 1-2 min apart measured between beginning of one contraction to beginning of next
where to clamp cord
4-6” away from newborn
A apgar
activity
0 absent
1 flexed arms and legs
2 active
P apgar
pulse
absent
below 100
over 100
G apgar
grimace
floppy
minimal
prompt response to stimulaiton
2nd a apgar
appearance
blue
pink body blue extremities
pink
r apgar
respirations
absent
slow
vigourous cry
when to assess apgar
1 and 5 min
cephalopelvic disproportion what is it and treatment
newborn has a big ass head and wont fit in the birth canal
o2, IV, transport
what is shoulder dystocia
fetal shoulders are wedged against symphysis pubis blocking shoulder delivery
position pt in mcroberts maneuver and apply pressure to suprapubic area
breech presentation
head delivered last
dont push
when to provide o2 to baby
central cyanosis
what percent o2 to give pre term newborns
21-30%
newborn target spo2 `
1 min 60-65
2 min 65-70
3 min 70-75
4 min 75-80
5 min 80-85
10 min 85-95
PPV indications newborn
hr <100 or no spontaneous breathing
1 breath every 2-3 sec
chest compressions indicaitons newborn
hr >60 at a ratio of 3:1
intubation indication newborn
failure to respond to bvm in 30 sec
resuscitation flow
dry warm suction
o2
bvm
chest compression
intubation
meds
allow each step 30 seconds before moving deeper
preferred IV site newborn
umbilical vein
umbilical cord prolapse
treatment
cord passes through cervix before kid.
if pulsating, wrap in dry dressing to maintain temp and continue to assess for pulse
if not pulsating, insert 2 fingers into vagina and attempt to move baby off cord, can also place mom in knee chest position
newborn bp forumla
80+(2xage)
fluid resuscitation for neonates and babys
10 ml/kg neonate
20 ml/kg newborn
about croup
viral
affects 6 months - 4 years
croup ss
hoarsness, stridorm barking cough
temp above 104
emergencies typically occur at night
croup treatment
cooled misted o2
racemic epi
epiglottitis ss
bacterial
occurs at any age
begins suddenly
muffled voice, drooling, difficulty or painful swallowing, temp above 104
can see tripod
epiglottits treatment
o2
bronchiolitis causes and age
casued by virus typically rsv
usually 2 years of age
bronchiolitis ss
coarse breath sounds
bronchiolitis treatment
abluterol or racemic epi
meningitis ss
stiff neck (kernigs or brudzinski sign)
fever
pertechiae
purpura
symptomatic brady
02 ->
cpr (if less than 60)->
epi .01 mg/kg
atropine .02mg/kg
tcp
SVT rate in infant
220
SVT stable
vagal (ice to face or blow through straw)
adenosine .1 mg/kg
adenosine .2mg/kg
unstable svt
cardioversion
.5-1j/kg
followed by 2 j/kg
v tac stable
amiodarone 5 mg/kg over 20-60 min
or
procainamide 15 mg/kg
defib dose
2j/kg followed by 4j/kg
benadryl dose kids
1mg/kg up to 25 mg
