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NREMT® Paramedic > EMT-P (6) Special Populations > Obstetrical Emergencies > Flashcards

Obstetrical Emergencies Flashcards

Explore the Obstetrical patient and the prehospital emergencies that exist

1
Q

List down the female reproductive organs.

A
  • Ovaries
  • Fallopian tubes
  • Vagina
  • Uterus
  • Mammary glands
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2
Q

Fill in the blank.

Each follicle contains an ____.

A

oocyte (egg)

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3
Q

Define:

Follicle-Stimulating Hormone

(FSH)

A

Stimulates growth of the ovaries before it releases an egg.

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4
Q

Define:

Luteinizing Hormone

A

Stimulates the process of ovulation.

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5
Q

Fill in the blank.

The release of an egg is called a(n) ____.

A

ovum

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6
Q

What do the uterus and placenta produce at the end of pregnancy?

A

Prostaglandins

It signals the uterus to contract.

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7
Q

What are fallopian tubes?

A

Tubes that the ovum passes through.

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8
Q

Fill in the blank.

A muscular organ that lies between the urinary bladder and the rectum is called the ______.

A

uterus

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9
Q

What is the pH inside the vaginal cavity?

A

low

It helps rid the vaginal cavity of invaders, such as sperm and bacteria.

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10
Q

Define:

episiotomy

A

Incision of the perineum.

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11
Q

At what week of pregnancy does the heart beat?

A

Third week after conception.

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12
Q

At what week of pregnancy does the placenta begin to form?

A

At fourth week it becomes more fully formed and functional.

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13
Q

What is the function of the placenta?

A
  • Respiratory gas exchange.
  • Transport nutrients.
  • Excretion of waste.
  • Transfer of heat.
  • Hormone production
  • A barrier is formed.
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14
Q

How many veins and arteries are in the umbilical cord?

A
  • two arteries
  • single vein

Remember: ___V___ ← The “V” touches once and has two branches above it.

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15
Q

How does the blood flow in the umbilical vein?

A

It carries oxygenated blood from the placenta to the fetus.

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16
Q

How does the blood flow in umbilical arteries?

A

It carries arteriovenous blood to the placenta.

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17
Q

How does a baby receive oxygen while still in the utero?

A

Through the placenta.

Blood bypasses the lungs.

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18
Q

What is the function of the amniotic fluid?

A

It provides a weightless environment.

Approximately 1L of fluid in the utero.

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19
Q

What happens during the 4th-8th week of embryonic development?

A

Development phase - major organs and body systems start to form.

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20
Q

Fill in the blank.

The normal gestational period is around ____ weeks.

A

38

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21
Q

What is the purpose of measuring the fundus?

A

It helps to estimate the gestational age and monitor the progress of the pregnancy.

Length in centimeters = weeks in gestation.
E.g. 28cm = 28 weeks

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22
Q

What hormone causes GI tract relaxation and constipation in women during pregnancy?

A

Progesterone

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23
Q

Define:

linea nigra

A

Dark line of pigment down the middle of the stomach of a pregnant patient.

This is normal.

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24
Q

How much does pregnancy increase blood volume?

A

40 - 50%

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25
Q

Define:

gravidity

A

The number of times a person has been pregnant.

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26
Q

Define:

para

A

The number of live births.

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27
Q

How much do white blood cells increase during pregnancy?

A

300%

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28
Q

How does the anatomical position of the heart change during pregnancy?

A

Displaced upward and to the left.

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29
Q
  1. How does the blood pressure change during the 12th week of pregnancy?
  2. What happens to the BP after the 36th week?
A
  1. Decreases at 5-10 mmHg
  2. Increases
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30
Q

Define:

Lithotomy position

A

Laying in supine with the knees spread apart.

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31
Q

How does the diaphragm change anatomically during pregnancy?

A

It moves up to 1 - 1.5’’.

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32
Q

Define:

postpartum

A

after delivery

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33
Q

What is the function of the hormone relaxin?

A

It relaxes the tissue, joints, and ligaments to prepare for birth.

Relaxin - relaxes

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34
Q

Define:

Primigravida

A

first pregnancy

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35
Q

Define:

Primipara

A

single delivery/birth

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36
Q

Define:

Multigravida

A

two or more pregnancies

37
Q

Define:

Multipara

A

two or more deliveries/birth

38
Q

Define:

Nullipara

A

never delivered

39
Q

What are the signs/symptoms of true labor?

A
  • Regularly spaced contractions.
  • Shortening intervals between contractions.
  • Increasing intensity.
  • Analgesics are ineffective.
  • Progressive cervical dilation.
40
Q

What are the signs/symptoms of imminent delivery?

A
  • multiple pregnancies/deliveries
  • crowning
41
Q

Define:

Supine Hypotensive Syndrome

A

Laying in supine compresses the inferior vena cava and causes hypotension.

Treatment: Left lateral positioning.

42
Q

What is pregnancy-induced hypertension?

A

It develops after the 20th week of gestation and patient is typically normotensive.

43
Q

Define:

preeclampsia

A
  • peripheral edema
  • hypertension
  • proteinuria
44
Q

Define:

eclampsia

A

Seizure activity from hypertension.

45
Q

What is considered hypertension in pregnancy?

A

A systolic of 160-180 mmHg and a diastolic of 105 mmHg.

46
Q

Treatment:

obstetrical seizures

A
  • Administer magnesium sulfate.
  • Consider benzodiazepines (cross placental barrier).
  • Supplement oxygen.
47
Q

Name typical causes of respiratory disorders during pregnancy

A
  • dyspnea - due to physical changes.
  • asthma - typically occurs during the first pregnancy.
  • pneumonia
48
Q

Define:

Hyperemesis Gravidarum

A

Chronic nausea/vomiting during pregnancy.

49
Q

Treatment:

Hyperemesis Gravidarum

A
  1. 100% oxygen NRB
  2. Fluid bolus of 250ml
  3. Diphenhydramine 10-50mg IV/IM
  4. BGL
  5. Orthostatic vitals
50
Q

How much does urine output increase during pregnancy?

A

25 - 50%

51
Q

Define:

Rh Sensitization

A

It can produce maternal antibody isoimmunization and the fetus can be attacked by the mother’s immune system.

Fetus is Rh+, mom is Rh-

52
Q

How can HIV be contracted by the fetus if the mother is HIV+?

A
  • breastfeeding
  • during pregnancy
  • delivery
53
Q

What is TORCH syndrome?

A
  • Toxoplasmosis
  • Other Agents
  • Rubella
  • Cytomegalovirus
  • Herpes simplex

Infections that can occur in the fetus due to agents passed by the mom.

54
Q

What causes toxoplasmosis in a fetus?

A

Parasites from contaminated food that the mom ingested.

55
Q

What is rubella?

A

viral infection

Otherwise known as the “German measles.”

56
Q

What are the complications of a fetus contracting cytomegalovirus?

A

Encounter problems with lungs, blood, liver and nutrition.

Apart of herpesvirus.

57
Q

Define:

abortion

A

Expulsion of fetus at < 20 weeks.

58
Q

Define:

threatened abortion

A

Abortion trying to take place characterized by bleeding.

59
Q

Define:

imminent abortion

A

Spontaneous abortion that can not be prevented.

60
Q

Define:

incomplete abortion

A

Some parts of the fetus are left inside the mother’s utero.

61
Q

Define:

complete abortion

A

When all parts have been cleared.

62
Q

Define:

ectopic pregnancy

A

Fertilized ovum becomes implanted other than in the uterus, typically in the fallopian tubes.

Women of reproductive age with abdominal pain and risk factors should consider ectopic pregnancy.

63
Q

Define:

placental abruption

A

Early separation of placenta from uterine wall.

The most common cause is due to hypertension.

64
Q

Assessment:

placental abruption

A
  • vaginal bleeding
  • bright red blood
  • pain
65
Q

Define:

placenta previa

A

Placenta is placed in the uterine canal and may try to exit before the baby.

66
Q

Assessment:

placenta previa

A
  • dark blood
  • painless bleeding
  • Cullen’s/Grey Turner’s sign
67
Q

Treatment:

placenta previa

A
  • Position in the left lateral recumbent.
  • 100% oxygen via NRB at 15L per minute.
  • IV fluids
  • Place loose trauma pads over vagina to manage bleeding.
68
Q

Describe:

First stage of labor

A

Onset of contractions and end when the cervix is fully dilated.

69
Q

Describe:

Second stage of labor

A

Begins with crowning and ends with delivery of the baby.

70
Q

Describe:

Third stage of labor

A

Placenta is cleared from the uterus.

71
Q

List the common birthing positions.

A
  • standing birth
  • Semi-Fowlers position
  • kneeling birth
  • side-lying position
72
Q

How do you assist with the delivery of the placenta?

A
  • Explain to bear down with following contractions.
  • Place placenta in plastic bag.
  • Examine for tears and apply pressure with pads.
73
Q

Treatment:

postpartum hemorrhage

A
  • fundal massage
  • pitocin
74
Q

What is a magnesium sulfate?

A

Smooth muscle relaxer

75
Q

What is a calcium chloride/gluconate?

A

Increases contractility

Antidote for Magnesium Sulfate toxicity.

76
Q

What is Terbutaline and what is its use?

A
  • tocolytic: smooth muscle relaxer
  • used for preterm labor: in attempt to slow down labor
77
Q

Dose and Mechanism of action.

oxytocin

A
  • It causes uterine contraction to shunt bleeding.
  • 3-10 units IM
78
Q

Define:

Preterm Labor

A

Labor between 20-37th week gestation.

79
Q

Define:

Post-term Labor

A

Delivery after 42 weeks.

80
Q

What is an amniotic fluid embolism?

A

Amniotic fluid enters the woman’s pulmonary and circulatory system.

81
Q

Define:

hydraminos

A

Too much amniotic fluid.

82
Q

Define:

Cephalopelvic Disproportion

A

Baby with large head.

83
Q

What is cephalon presentation?

A

Baby is positioned face first.

84
Q

What is breech presentation?

Describe management for delivery.

A

Baby is positioned to be delivered buttocks or feet first instead of head first.

Management:

  • Flex knees (McRoberts Manuever).
  • Give gentle traction to deliver legs.
  • Let legs hang for gravity to assist in delivery.
  • Support body and head.
85
Q

What is shoulder dystocia?

Describe management for delivery.

A

The baby’s shoulders get stuck inside the mother’s pelvis during delivery.

Management:

  • McRoberts maneuver
  • Apply suprapubic pressure
  • Corkscrew Maneuver
86
Q

Treatment:

nuchal cord

A
  • Slip finger and remove cord over fetus head.
  • Cut if too tight.
87
Q

Treatment:

prolapsed umbilical cord

A
  • Push: presenting part back into vagina until no longer presses on cord.
  • Cover: exposed portion of cord with dressings moistened in saline.
88
Q

Define:

pregnant trauma

A

If trauma occurs and the mother is bleeding, blood will shunt from the fetus and be used for the mother. When signs of shock are present, fetal mortality is between 70 - 80%.

The normal fetal heart rate is 120–180 bpm. If transported supine, elevate the right hip to 6 inches.

If a recumbant position is not necessary, elevate the backboard underneath.

EMT-P (6) Special Populations (5 decks)

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