Obstetrics 6 Flashcards

1
Q

All the risk factors for placental abruption

A

increase the driving pressure to the placenta

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2
Q

Placental abruption is a

A

partial or complete separation of the placenta from the uterine wall before delivery

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3
Q

With placental abruption, ______ is possible if the fetus is stable

A

vaginal delivery

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4
Q

Anesthetic management for the placental abruption includes

A

obtain large-bore IV access
have blood products available
prepare for C-section

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5
Q

Placental abruption increases the risk of

A

amniotic fluid embolism leading to DIC

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6
Q

What is the MOST common cause of postpartum hemorrhage?
a. uterine atony
b. retained placenta
c. disseminated intravascular coagulopathy
d. uterine inversion

A

A. uterine atony

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7
Q

Risk factors for uterine atony include

A

multiparity
multiple gestations
polyhydramnios
prolonged oxytocin infusion before surgery

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8
Q

Etiologies of uterine bleeding include

A

retained placenta
laceration
uterine inversion
coagulopathy
placenta previa
placental abruption
abnormal placental implantation

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9
Q

Risk factors for maternal DIC include

A

amniotic fluid embolism, placental abruption, intrauterine fetal demise

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10
Q

Describe treatments for obstetric bleeding

A

uterine massage
oxytocin
ergot alkaloids
manual massage
intrauterine balloon

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11
Q

Describe what drugs are considered minimally cardiovascular depressive in the bleeding obstetric patient.

A

ketamine
etomidate
midazolam
opioids

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12
Q

In the hemodynamically unstable patient, it may be prudent to

A

convert a regional anesthetic to a general anesthetic with RSI

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13
Q

Five minutes following delivery, a newborn has an irregular respiratory rate with a heart rate of 105. He is grimacing, has some flexion in the extremities, and has a pink body with blue extremities. Calculate his Apgar score.

A

6
(1+2+1+1+1)

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14
Q

The Apgar score at 1 minute correlates with

A

fetal acid-base status

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15
Q

The Apgar score at 5 minutes may be predictive of

A

neurologic outcome

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16
Q

The Apgar score is used to

A

assess the newborn and guide resuscitative efforts

17
Q

Describe normal, moderate distress, and impending demise Apgar scroes.

A

normal: 8-10
moderate distress: 4-7
Impending demise: 0-3

18
Q

Describe the points assigned for heart rate with Apgar scores.

A

absent: 0
<100 bpm: 1
>100 bpm: 2

19
Q

Describe the points assigned for respiratory effort for Apgar scores.

A

absent: 0
slow, irregular: 1
normal, crying: 2

20
Q

Describe the points assigned for muscle tone for Apgar scores.

A

limp: 0
some flexion of extremities: 1
active motion: 2

21
Q

Describe the points assigned for reflex irritability for Apgar scores.

A

Absent: 0
grimace: 1
cough, sneeze, or cry: 2

22
Q

Describe the points assigned for color for Apgar scores.

A

pale, blue: 0
body pink, extremities blue: 1
completely pink: 2

23
Q

_____ of all newborns require some degree of resuscitation, and _ require full CPR.

A

10%; 1%

24
Q

______ protects against hypothermia

A

Radiant heat

25
Q

The normal respiratory rate for newborns is

A

30-60 bpm

26
Q

The normal heart rate for newborns is

A

120-160 bpm

27
Q

A heart rate <100 bpm significantly

A

reduces cardiac output and impairs tissue perfusion for the neonate

28
Q

Breathing begins about _____ after delivery, and a normal pattern is established at

A

30 seconds; 90 seconds

29
Q

Immediately after delivery, the normal SpO2 for neonates is _____. It should rise to _____ after 10 minutes.

A

60%; 90%

30
Q

Supplemental oxygen for the neonate increases the risk of

A

an inflammatory response; if assisted ventilation is required, use room air instead of 100% fiO2

31
Q

If _____________, the use of supplemental O2 must be balanced with the risk of inflammatory response.

A

bradycardia or inadequate oxygenation persists

32
Q

_______ is the best indicator of adequate ventilation

A

The resolution of bradycardia

33
Q

While ______ should be removed from the airway, there is no clinical benefit gained from removing ____________

A

thick meconium; thin or watery meconium

34
Q

If ventilation does not improve cardiovascular performance, then emergency drugs can be given through three possible routes:

A

umbilical vein
endotracheal tube
intraosseus

35
Q

Describe the dosage of PRBCs, NS, and LR for neonates.

A

10 mL/kg over 5-10 minutes

36
Q

Describe the dose of IV epinephrine for the neonate

A

1:10,000
10-30 mcg/kg IV