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SBVAC Week 7 > Obstetrics and Gynecology > Flashcards

Obstetrics and Gynecology Flashcards

1
Q

Internal Anatomy Definition: Ovaries

A
  • the gonads of a female, and primary reproductive organ; releases ovum during ovulation
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2
Q

Internal Anatomy Definition: Fallopian Tubes

A
  • connects ovaries to uterus; fimbriae catch developed follicle/egg and fallopian tubes transport unfertilized egg to uterus
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3
Q

Internal Anatomy Definition: Uterus

A
  • muscular organ in which the fertilized egg implants itself to begin growth
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4
Q

Internal Anatomy Definition: Cervix

A
  • opening of the uterus into the vaginal canal; this dilates during childbirth
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5
Q

Internal Anatomy Definition: Vagina/Vaginal Canal

A
  • opening between the external and internal genitalia
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6
Q

External Anatomy Definition: Labia Majora/Minora

A
  • outer foldings of tissue that surround the urethra and vagina
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7
Q

External Anatomy Definition: Urethral Orifice

A
  • exit of the urinary system
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8
Q

External Anatomy Definition: Vaginal Orifice

A
  • opening of the vaginal canal into the internal reproductive system
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9
Q

External Anatomy Definition: Clitoris

A
  • erectile organ
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10
Q

External Anatomy Definition: Perineum

A
  • skin between the anus and vagina
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11
Q

External Anatomy Definition: Anus

A
  • exit of digestive system
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12
Q

Menstruation

A
  • endometrium (inner layer of uterus) thickens throughout uterine cycle to prepare for implantation of a fertilized egg into the uterus
  • if this does not occur, uterine wall will shed alongside the unfertilized egg as a result of muscle contraction
  • menstrual cycle normally lasts 28 days with 7 days of shedding/bleeding
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13
Q

Menstruation Terms: Menarche

A
  • time period in which a female first experiences menstruation; normally occurs between 11-16 years of age
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14
Q

Menstruation Terms: Menopause

A
  • occurs when female ceases to menstruate; occurs around 50 years of age
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15
Q

Birth Control Terms: Condoms

A
  • low risk, protects from most STDs, may cause reaction if allergic to latex
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16
Q

Birth Control Terms: Oral Contraceptives

A
  • increase likeliness of clots which may lead to further complications (extreme case: pulmonary embolism)
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17
Q

Birth Control Terms: NuvaRing

A
  • vaginal ring implanted through various times of menstrual cycle; can increase likelihood of clots
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18
Q

Birth Control Terms: Implant

A
  • hormonal implant usually in the arm; increases likeliness of clots
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19
Q

Birth Control Terms: Diaphragm

A
  • bendable cup implanted that closes off cervix to prevent pregnancy; no associated risks
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20
Q

Birth Control Terms: Intrauterine Device

A
  • T-shaped device that is implanted in the uterus; some are made out of varying metals, while others utilize hormones; increase likelihood of PID, perforate through the uterus, and lead to ectopic pregnancies
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21
Q

Urinary Tract Infection (UTI)

A
  • occur when bacteria enters urethra and begins to infect the urinary tract
  • if left untreated, it may begin to infect the renal system and therefore infect the kidneys
  • patients will display the frequent need to urinate however when they do so it is in small amounts, hematuria, and cloudy odorous urine
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22
Q

Yeast Infections

A
  • product of imbalance of vaginal fungus
  • extremely common and effect 3/4 women
  • causes inflammation of the vagina and surrounding tissue
  • patients will display itching/burning sensations, painful urination and intercourse, and thick white “cottage cheese” discharge
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23
Q

Sexually Transmitted Infections (STIs)

A
  • HIV/AIDS
  • Chlamydia
  • Gonorrhea
  • Genital Warts
  • Genital Herpes
  • HPV
  • Syphilis
  • Pubic Lice (crabs)
  • be concerned if patients displays itching, burning, painful urination, discharge with unusual odor and color, painful intercourse, fever, flu-like symptoms, abdominal pain, vaginal bleeding
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24
Q

Ovarian Cysts

A
  • fluid filled or solid pockets that develop in ovary
  • commonly occur due to imbalance of hormones, which can be resolved by taking oral contraceptives that regulate hormones
  • rupture of cysts can lead to sepsis
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25
Q

Endometriosis

A
  • occurs when inner lining of the uterus (endometrium) thickens and grows outside of the uterus
  • endometrium will continue to thicken during menstrual cycle, but has no means of exiting which leads to severe inflammation and scarring of surrounding tissues
  • can lead to ovarian cysts infertility
  • S/Sx: severe pain in abdomen, heavy bleeding, abnormal bleeding in between periods, painful urination/bowel movements, and painful intercourse
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26
Q

Pelvic Inflammatory Disease

A
  • infection of the upper female reproductive system, most commonly the result of an untreated infection
  • may cause scarring on fallopian tubes and lead to various complications such as infertility and an ectopic pregnancy
  • as infection spreads to ovaries, it may lead to formation of abscess which has potential to burst; can lead to sepsis
  • S/Sx: severe lower abdominal pain, odorous discharge, painful intercourse, fever/chills, nausea/vomiting, and inability to walk due to pain “PID Shuffle”
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27
Q

Non-Menstrual Vaginal Bleeding

A
  • can be many underlying causes, treat as if worst case scenario: cancer, ectopic pregnancy, spontaneous abortion, or vaginal trauma
  • ensure you know extent of impact of blood loss on your patients stability during ABC
  • if actively bleeding, you can give them an OB pad to hold their vagina
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28
Q

Vaginal Trauma

A
  • most commonly the result of penetration
  • sexual assault is the primary mechanism of vaginal trauma
  • document times and mileage
  • communication and emotional support is essential
  • have a female perform assessment
  • request a SANE nurse 10 minutes before arrival
  • encourage patients not to change clothes or wash themselves
  • be aware of potential shock
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29
Q

Pregnancy Terms: Placenta

A
  • medium for exchange of vital nutrients such as oxygen and carbon dioxide
30
Q

Pregnancy Terms: Umbilical Cord

A
  • connects the mother and fetus via the placenta
31
Q

Pregnancy Terms: Amniotic Sac/Fluid

A
  • insulates and cushions the fetus
32
Q

Pregnancy Terms: Full Term

A
  • 38-40 weeks
33
Q

Pregnancy Terms: Premature

A
  • birth before 38 weeks
34
Q

Pregnancy Terms: Postmature

A
  • birth after 42 weeks
35
Q

Pregnancy Terms: Trimester

A
  • stages of pregnancy
36
Q

Pregnancy Terms: Gravida

A
  • amount of times patients has been pregnant
37
Q

Pregnancy Terms: Para

A
  • amount of live births
38
Q

Pregnancy Terms: Abortus

A
  • number of miscarriages, stillbirths, and abortions
39
Q

Pregnancy Terms: Neonate

A
  • any infant under 28 days old
40
Q

Prenatal Development

A
  • Germinal Period/Zygote: fertilized egg is implanting itself into the uterine wall
  • Embryo (3-8 weeks): major organs begin forming such as the heart and brain
  • Fetal Period (9-38 weeks): Body systems begin to function
  • Age of Viability: age range in which fetus is born and still has a chance of surviving and developing normally; 23-25 weeks
41
Q

Major Changes during Pregnancy

A
  • increased blood volume, heart rate, cardiac output, stroke volume, and clot factor
  • uterus grows with baby, which compresses organs and may expose fetus to injury
  • pressure may be put on diaphragm and make breathing difficult and increase likeliness of vomiting and aspiration when pt. experiences trauma
  • prone to falls due to shift in center of gravity
42
Q

Ectopic Pregnancy

A
  • occurs when fetus develops outside of the uterus
  • rupture could cause mastic hemorrhaging
  • high index of suspicion when we have pt of childbearing age with abdominal pain
  • presents with sudden sharp abdominal pain that may be one-sided, heavy vaginal bleeding
43
Q

Preeclampsia

A
  • high BP during pregnancy with proteinuria
  • not uncommon due to large increase in blood
  • present with headaches, blurred vision, proteinuria, hypertension, and peripheral edema
44
Q

Eclampsia

A
  • S/Sx of preeclampsia with presence of seizures

- call ALS, lay patient in left lateral recumbent and transport rapidly; get SpO2 and give O2

45
Q

Miscarriages

A
  • spontaneous abortions that occur within 20 weeks of pregnancy
  • caused by hormone imbalances, infection/disease, exposure to harmful teratogens, and age of mother
  • women over 35 have increased risk of miscarriage, risk after first trimester decreases
46
Q

Stillbirth

A
  • death of fetus after 20 weeks of pregnancy; generally uncommon
47
Q

Abruptio Placenta

A
  • placenta separates from uterus abruptly
  • result of high BP and trauma
  • presents with port wine vaginal bleeding, abdominal pain, uterine contractions
  • may be in shock due to loss of blood
48
Q

Placenta Previa

A
  • placenta forms over cervix due to uterine abnormalities
  • patients will have bright red vaginal bleeding, usually painless
  • may be in shock due to loss of blood
49
Q

Gestational Diabetes

A
  • occurs in pregnant women who have never experienced diabetes prior to pregnancy
  • result of hormones released by placenta that inhibit action of insulin, creating insulin resistance
  • increases risk of Type II diabetes in both mother and fetus, as well as obesity and increased birth weight
  • increased risk for eclampsia and high BP
  • this can be managed by changing diet and other lifestyle factors such as exercise
  • treat as general diabetic patients
50
Q

Three Stages of Labor

A
  1. Contractions and full dilation of cervix: longest period of labor; amniotic sac ruptures (water breaks)
  2. Complete dilation of cervix to the delivery of infant: baby will be crowning and mother will feel urge to bear down
  3. Once baby is delivered to delivery of placenta: may take up to 30 minutes
51
Q

Staging the birth

A
  • if patient is displaying crowning, delivery is immediate
  • call for ALS
  • BSI: gloves, gown, face shield
  • private spot with a flat surface (rig)
  • place sheets and towels throughout the floor
  • place towels and pillows underneath the patient to elevate their hips 2-4 inches
  • take sterile sheet from OB kit and position one underneath the patient, one draped around each thigh that wraps around the back, and one on the abdomen
52
Q

Roles during Birth

A
  • should be clear and defined roles for delivery
  • one crew member delivers the baby: continually visualize and check for crowning, apply pressure to avoid peritoneum from tearing
  • one coaches patient and monitors well-being: talking them through process, coaching breathing, providing O2 if necessary
  • one should be focused on neonate care: APGAR score, post procedural protocols
53
Q

Delivery Procedures

A
  • instruct patient to push during contractions
  • support infants head, apply pressure to perineum
  • carefully puncture amniotic sac, then ensure it is not covering head or airway of infant
  • once head is out, tell patient to stop pushing
  • ensure umbilical cord is not wrapped around the neck; try to gently slip it off, if this doesn’t work, clamp cord in two places and wait for cord to stop pulsating, then cut cord in-between two clamps
  • suction airway if there is an obstruction or ventilations are required; insert bulb syringe in oropharynx no more than 1.5 inches and suction
  • once delivered, use a towel to keep infant warm and dry, keep infant in face up position with head lower than the feet level to the vagina until the umbilical cord is cut
  • may be green substance called meconium surrounding the infant; report this and ensure airway is not compromised
  • cut umbilical cord approx. one minute after birth; place clamps three inches apart and 8-10 inches from infant; wait for pulsating to stop and cut between clamps
  • keep infants head warm with hat in OB kit
  • give a fundal massage to mother by kneading the abdomen to prepare for delivery of the placenta (encourages uterine contractions, helps promote clots to prevent hemorrhaging)
  • if both patients are stable, give infant to mother to hold
54
Q

APGAR Score

A
  • obtain one after birth and one 5 minutes after initial recording
  • healthy range is 7-10
  • Activity (muscle tone): absent, flexed limbs, active
  • Pulse: absent, < 100bpm, > 100bpm
  • Grimace: floppy, minimal response to stimulation, prompt response to stimulation
  • Appearance: blue pale, pink body blue extremities, pink
  • Respiration: absent, slow and irregular, vigorous cry
55
Q

Breech Delivery

A
  • when buttocks present first, rather than the head
  • administer high flow O2
  • place fingers in a v-shape into birth canal to establish open path for infant to receive air
  • elevate hips and transport rapidly
56
Q

Limb presentation

A
  • when limb is presented first during delivery; elevate hips and transport rapidly
57
Q

Prolapsed Umbilical Cord

A
  • cord is presented first during delivery
  • elevate hips, palpate cord for pulses
  • insert fingers into birth canal to relieve pressure of infant on the cord; do this until you pass off to ED staff
  • wrap cord in sterile dressing and sterile water to keep it moist
  • transport rapidly
58
Q

Shoulder Dystocia

A
  • when shoulder of infant gets stuck behind patients pubic bone; extreme life threat, can cause mass hemorrhaging in the mother and hypoxia for the infant
  • elevate hips and transport rapidly
59
Q

Questions to Ask

A
  • how far along are you?
  • when are you due?
  • have you ever experienced any complications/are you anticipating them?
  • when was the last time you visited your OBGYN?
  • have you ever given birth before? Were there any complications?
60
Q

Reflexes

A
  • primate reflexes occur until 4-6 months of age
  • Rooting: stroke baby cheek and they will turn towards stimuli
  • Moro: if baby feels as if they are falling, they will spread their arms out and try to catch themselves
  • Walking/stepping: if you hold baby up, they will feel the need to step
  • Sucking: if object touches roof of mouth, it will begin sucking
  • Palmar: if you place anything in infants palm, it will grasp onto it
61
Q

Male Anatomy Terms: Penis

A
  • male sex organ
62
Q

Male Anatomy Terms: Testicles

A
  • male gonads that produce hormones and sperm
63
Q

Male Anatomy Terms: Epididymis

A
  • located on top of the testicles and store mature sperm
64
Q

Male Anatomy Terms: Scrotum

A
  • skin that surrounds testicles that aid in thermoregulation
65
Q

Male Anatomy Terms: Prostate

A
  • gland surrounding the urethra, it secretes various fluids that are added semen
66
Q

Testicular Torsion

A
  • one testicle of scrotum rotates and twists, cutting off circulation to other testicle
  • present with severe scrotum pain, swelling, fever, abdominal pain
  • emergency care to prevent permanent nerve damage to infertility
67
Q

Benign Prostatic Hyperplasia

A
  • prostate gland is enlarged
  • prostate can cut off urethra causing inability to urinate, UTIs, kidney stones, and possible kidney damage
  • more common in older males with history of heart disease, obesity, and heart diseases
68
Q

Prostate Cancer

A
  • will present with many of the same symptoms of BPH

- usually associated with pelvic pain, blood in semen, and erectile dysfunction

69
Q

Phimosis

A
  • when foreskin narrows around head of the penis
  • usually occurs in infants, but can occur in older males due to infection or inflammation
  • presents with difficulty urinating, painful arousal, different secretions that may be stuck under foreskin causing infection or even bleeding
70
Q

Erectile Dysfunction

A
  • often points to a larger medical issue
  • seen in patient of oder age
  • keep tract of ED medications patient is on and document
71
Q

Neonatal Resuscitation

A
  • once baby is delivered, warm, and dry, stimulate it
  • if you believe there is an airway obstruction or you’ll need to initiate artificial ventilation, suction oropharynx, CALL FOR ALS
  • if infant is apnea or gasping or heart rate is below 100 or infant displays central cyanosis, insert an OPA and BVM at 40-60 breaths per minute
  • connect to supplemental O2 of O2 saturation falls below 95%
  • take infants apical pulse when assessing heart rate
  • after 30 seconds of ventilations, if heart rate is still below 60, begin chest compressions at 120/min
  • rate: 3 compressions to 1 breath using any method
  • never use AED on a neonate; hearts are underdeveloped and can’t withstand electrical current
72
Q

Apical Pulse

A
  • back, little circle of stethoscope on the middle of the chest

SBVAC Week 7 (4 decks)

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