Paramedic National Test Medical Flashcards
Normal lung sounds
Bronchial- loud, high pitch, hollow. Heard over upper sternum
Bronchovesicular- soft, lower pitch. Heard over scapula and 2,3 intercostal space lateral to sternum
Vesicular- soft, low pitch. Heard in lung periphery.
Apneustic breathing pattern
Long, deep breaths that are stopped during inspirations then periods of apnea. (CNS injury or stroke)
Biot’s (ataxic)
Irregular periods of breathing or gasping with apnea
Usually due to increased ICP
Cheyne-Stokes
Increasing in rate and depth, decreasing in rate and depth with period of apnea
Neurological condition
Kussmaul’s
Rapid and deep
DKA
Right Upper Quadrant
Liver
Gall bladder
Stomach
Left upper quadrant
Spleen
Liver
Stomach
Pancreas
Right lower quadrant
Appendix
Right ovary and tube
Bladder in distended
Left lower quadrant
Left ovary and tube
Bladder if distended
Types of pain
Visceral
Somatic
Referred
Visceral
Internal organs damaged or injured
Vague, lull, aching, pressure
Somatic
Irritation of peritoneal lining.
Sharp, localized, throbbing, deep breath increases pain
Referred
Discomfort perceived in other parts of body, such as cardiac pain referred to jaw or arm.
Cullens sign
Ecchymosis around umbilicus
Bleeding in abdominal cavity
Grey turner’s
Ecchymosis in flank
Bleeding from kidneys
Hemorrhagic pancreatitis
Kehr’s sign
Referred pain to shoulder
Ectopic or spleen injury
Blood under diaphragm
Murphys sign
Right upper quadrant pain
Cholecystitis
Brudzinski’s sign
Hip sleeves when neck is flexed
Meninges irritation, meningitis
Hammans Sign
Crunching, rasping sound that correlates with heartbeat.
Heard over mediastinum
Spontaneous mediastinal emphysema, tracheobronchial trauma
Homan’s sign
Pain in calf on dorsiflexing foot while leg is straight
DVT
Kernig’s sign
Inability to straighted leg when hip is flexed 90 degrees
Meninges irritation, meningitis
Blood pressure, what is it? (Formula)
B/P= Cardiac output X Systemic vascular resistance
B/P= CO X SVR
Pulse pressure
Difference between systolic and diastolic pressure (narrows in shock and widens in increasing ICP)
Map (mean arterial pressure)
Average pressure in arteries during one cardiac cycle, good indicator of perfusion
Normal between 70-110 mmHg
Add diastolic + 1/3 of pulse pressure
HR, respiratory rate, and systolic BP for infants
100-160 bpm at birth
120 bpm after birth
Resp: 40-60 initially
20-30 by one year
BP: 70 mmHg at birth
90 mmHg at 1 year
Hr, respiration rate and systolic BP for toddlers
80-130 bpm
24-40 respiratory rate
70-100 mmHg
HR, Respiratory rate, and systolic BP for preschool
80-120 bpm
22-34 respiration rate
80-110 mmHg
HR, Respiratory Rate, and systolic BP for school age
70-110 bpm
18-30 respiratory rate
80-120 mmHg
HR, Respiratory rate, and systolic BP for adolescents
55-105 bpm
12-16 respiratory rate
11-120 mmhg
Infant ages
Birth to 1 year of age
Toddler
1-3 years of age
Preschool
3-5 years of age
School age
6-12 years of age
Adolescent
13-18 years of age
Pediatric triangle
Appearance
Work of breathing
Circulation to skin
Normal BGL
70-140 mg/dL
Troponin
Found in cardiac muscle
Most specific to cardiac muscle injury
Myoglobin
Found in striated muscle
Damaged to cardiac or skeletal muscle
Methemoglobin
Hemoglobin that is oxidized. Oxygen cannot attach
What causes methemoglobin?
Drugs such as: Amyl nitrate Benzocaine Nitrates Nitroglycerin Nitroprusside Exposure to cyanide
Symptoms of methemoglobinemia
Color change from gray to cyanosis
CNS changes
Delirium
Death
When do we use blood as a choice of fluid replacement?
Hemorrhage
Colloid
Does not leak out of blood vessel quickly
Has large particles or proteins
Examples of colloid solutions
Albumin
Hespan
Dextran
Blood plasma
Crystalloid solutions
Normal saline
Lactated ringers
5% D/W
Osmosis
Fluid movement from an area of less particle concentration to an area of greater concentration
Isotonic
Stays in blood vessels longer, field fluid replacement (NS, LR)
Hypertonic
Mor particles, fluid moves into vascular space while solution moves into cells
Example of hypertonic solution
D10
Hypotonic
Fluid moves out of vascular space into cells
5% dextrose in water, when to give it
MI
CHF
Giving drugs
KVO
Cations
Positive charged ions
Anions
Negative charged ions
Erythrocyte
Red blood cell
Hemoglobin
Red blood cells carry oxygen on hemoglobin molecule
Hematocrit
Percentage of red blood cells in whole blood, approx. 45%
Leukocytes
White blood cells
Types of white blood cells
Eosinophils (fight parasites and other infections) Neutrophils Basophils Lymptcytes Monocytes
Thrombocytes
Platelets
What do platelets do?
Promotes clotting
Type 0- blood
Can give blood to any blood type
AB+
Can receive blood from any type
Fluid replacement dosing for adult and child
20 mL/kg
Fluid replacement for a newborn
10 mL/kg
Max for fluid replacement
60 mL/kg
Complication of IV, local
Infiltration, cellulitis, phlebitis, and thrombophlebitis
Systemic complications of an IV
Air or pulmonary embolus
Catheter shear
Sepsis
PICC
Peripherally inserted central catheters
Usually in arm, but long enough to go into central circulation
What is HCO3 and what’s the normal ranges
Bicarb, 22-26
Above 26= alkalosis
Types of shock
Hypovolemic Cardiogenic Anaphylactic Neurogenic (spinal)(distributive shock) Septic (distributive shock) Obstructive
Hypovolemic shock causes and findings
Loss of volume
Increased heart rate Increased respirations Eventually decreased BP Pale/cyanotic Flat neck veins
Cardiogenic shock causes
MI
Heart failure
Etc
Cardiogenic shock findings
Increased or decreased heart rate
Possible pulmonary edema
Pale or cyanotic skin
Anaphylactic shock causes
Severe allergic reaction
Anaphylactic shock assessment findings
Increased heart rate Decreased BP Severe respiratory difficulty Wheezing Stridor Hives Vasodilation Capillary permeability Angioedema
Neurogenic shock causes
Spinal injury
Sympathetic nerve conduction interrupted
Neurogenic shock assessment findings
Decreased BP HR normal or decreased Skin dry and normal below injury (possible pale and clammy above) Vasodilation Hypothermia
Septic shock causes
Overwhelming infection, sepsis
Septic shock findings
Decreased BP Possible increased or decreased temp Pale Cyanotic or red Vasodilation Capillary permeability
Obstructive shock causes
Pulmonary embolus
Cardiac tampanode
Tension pneumothorax
Obstructive shock assessment findings
Obstruction that does not allow blood to circulate through the heart.
Chemical and physical responses to shock
- ) Baroreceptors in aortic arch and carotid sinuses sense change in BP and send message to cardiovascular centers in medulla
- antidiuetic hormone (ADH) from pituitary, increases PVR, retains water in kidneys
- Renin release by kidney to convert angiotensin 1 into angiotensin 2
(Angiotensin 2 is a potent vasoconstrictor) - Epinephrine and norepinephrine released secreted from adrenal glands
- increases systemic vascular resistance (maintains BP), stimulates aldosterone which retain sodium and water in kidneys
Pharmacodynamics
Study of biochemical and physiological effects of drugs on the body
Pharmacokinetics
What body does to drug after administered
Controlled substance act (1970)
Places drugs that are addictive into 5 schedules
Schedule 1
Abuse potential high
No recognized medical indication
Ex: heroin, LSD, mescaline, crack cocaine
Schedule 2 drugs
Cocaine, morphine, fentanyl, methadone, etc. small medical indications
Autonomic nervous system is made up of what?
Sympathetic and parasympathetic nervous system
Parasympathetic nervous system
Feed or breed
Sympathetic nervous system
Fight or flight q
Parasympathetic nervous system chemical control
Acetylcholine found in nerve synapses
Sympathetic nervous system control and chemical control
Nerve roots in lower thoracic and upper lumbar area of spine
Norepinephrine
Inotropic
Contraction
Chronotropic
Rate
Dromotropic
Velocity of conduction through electrical system of heart
Catecholamines
Dopamine
Epinephrine
Norepinephrine
Sympathomimetic or adrenergic
Stimulates the SNS (such as epi)
Enteral
Drugs given via GI tract such as orally, SL, nasogastric tube, rectally
Parenteral
All other routes besides enteral
IV bolus calculation formula
Total volume X Order dose
————————————
Total medication in vial
Grand mal seizure
Generalized seizure
Status epilepticus
Prolonged seizure over 5 min or 2 or more seizures without consciousness
Febrile seizure
Most common cause of seizures in young children, rapid spike in temp
Petit mal seizure
Occur in children, no loss of consciousness, many a day
Stare into space
Focal motor seizures (partial seizure)
From electrical disruption of one area of the brain.
Subarachnoid bleed
Described as “the worse headache ever”
Usually a cerebral aneurysm
Sudden onset of severe headache, neuro symptoms, unconsciousness
Cephalgia
Headache
Photophobia
Sensitivity to light
Syncope
Brief period of unconsciousness due to lack of blood supply to the brain
Lay patient supine
CNS neoplasm
Brain and spinal cord tumor
Diplopia
Double vision
Delirium
Sudden onset of confusion which is reversible
Dementia
Chronic deterioration of memory, reasoning, judgement
Not reversible, usually progressive deterioration
Alzheimer’s disease causes
Neurons die, buildup of plaque in brain
Signs and symptoms of Alzheimer’s
Memory loss, confusion, can be aggressive and violent; eventually cant communicate and requires complete care
Creutzfeldt-Jakob Disease cause
Infection usually due to eating contaminated beef
Always fatal
Creutzfeldt-Jakob disease signs and symptoms
Ataxia (incoordination of muscle movements), jerking, visual impairment, mental deterioration
Gillian-Barre Syndrome signs and symptoms
tingling in fingers and toes, progressive muscle weakness, trouble talking and swallowing, difficulty breathing, paralysis
Gillian-Barre Syndrome causes
Autoimmune, usually viral, inflammation and destruction of myelin sheath
Multiple Sclerosis signs and symptoms
Diplopia, nystagmus, speech difficulties, weakness, impaired coordination
Progressive
Multiple sclerosis causes
Inflammation of nerve cells, loss of myelin sheath, inhibits nerve impulses, autoimmune
Myasthenia Gravis causes
Autoimmune disease, breakdown of between nerves and muscles
Myasthenia Gravis signs and symptoms
Neuromuscular weakness, fatigue, drooping of eyelids (ptosis), double vision, trouble swallowing.
Parkinson’s disease causes
Unknown cause, loss of dopamine producing brain cells
Parkinson’s Disease signs and symptoms
Impaired movements and coordination, tremors, rigidity, chronic and progressive
Pick disease causes
Genetic disease, damage to neurons
Actual cause not known
Pick disease signs and symptoms
Obsessive behavior, social inappropriate, mental highs or depression, tremors, incontinence
Wernicke Encepholopathy causes
Thiamine deficiency (vitamin B1) Usually in chronic alcoholic (may be reversible)
Wernicke Encephalopathy signs and symptoms
Mental confusion, abnormal eye movements, ataxia
Viral meningitis
Most common type of meningitis
Presents with flu like symptoms
Usually not communicate
Less severe than bacterial
Bacterial meningitis
Presents with 1-2 days of fever Head and back ache Unchallenged rigidity AMS Bulging Fontanel Rash Irritability
Bacterial meningitis PPE
Can spread through droplets, saliva, mucus
Wear surgical mask on you and patient
Hydrocephalus
Buildup of fluid in ventricles of the brain
Appendicitis: location of pain, assessment findings
Location: RLQ (McBurney’s point), May have periumbilical pain initially, may have rebound, generalized if ruptured.
Assessment findings: Sick for several days, nausea and vomiting, low grade temperature (only high if ruptured), low appetite.
Cirrhosis of the liver- Location of pain, assessment findings
Location: RUQ
Assessment findings: Jaundice, nausea and vomiting, weight loss, fatigue, bruising easily
Crohn’s Disease: Location of pain, Assessment findings
Location: RLQ
Assessment findings: Diarrhea, rectal bleeding, constipation, nausea, weight loss
Diverticulitis: Location of pain, Assessment findings, what it is
inflammation fo the pouch-like herniation in intestines
Location: usually LLQ
Assessment findings: Fever, nausea and vomiting, diarrhea or constipation.
Mallory-Weiss Tear: Location of pain, Assessment Findings
Esophageal tear usually due to vomiting
Location of pain: absent pain
Assessment findings: Hematemesis, melena
*transport in revers Trendelenburg position
Pancreatitis: Location of pain and assessment findings
Location: LUQ and may radiate to back or epigastric area
Assessment findings: Diaphoresis, tachycardia, appears acutely ill, sepsis, shock
Peritonis: Location of pain and assessment findings
Inflammation of abdominal lining
Location: Pain can be anywhere, usually entire abdomen involved
Assessment findings: Fever, elevated heart rate, vomiting, localized guarding, rebound tenderness, distended and rigid abdomen.
Ulcerative colitis: location of pain and assessment findings
Location: Most often LLQ, rectal pain
Assessment findings: Loose or bloody stools, constipation, fever, weight loss.
Abdominal aortic aneurysm: Location of pain, assessment findings
Location: Tearing or shearing abdominal pain and possibly back pain
Assessment findings: Unequal pulses in lower extremities, urge to defecate due to blood in retroperitoneal space, many times hypertensive history
(Transport rapidly and carefully, could rupture in route to hospital.)
Thoracic aortic aneurysm Locations of pain and assessment findings
Location: tearing pain in upper chest and between shoulder blades
Assessment findings: Unequal pulses in upper extremities
(Transport rapidly and carefully, could rupture in route to hospital)
ileostomy
Diverts from ileum, contents don’t pass through large intestine, liquid stool, may be green.
Colostomy
Diverts stool away from colon or large intestine, has bag on abdomen, usually has soft stool in bag.
Pathophysiology of acute kidney failure (AKF)
Prerenal
Intrarenal
Postrenal
Prerenal
Low blood flow to kidneys- hemorrhage, heart failure, shock, sepsis
Intrarenal
Disease or damage within the kidneys- glomerular blood vessels- diabetes, certain drugs
Postrenal
Blockage to urine collecting system
Erythropoietin
Hormone secreted by kidneys to increase production of red blood cell in response to decreased oxygen.
End stage renal disease
Kidneys have completely and permanently shut down.
Dialysis
Movement of blood across membrane to remove toxins
Hemodialysis
Patient attached to machine to filter water products
Shunt
Connects artery to a vein, fistula is under skin, graft is a tube- may be external.
Due for or missed dialysis s/s
Fluid overload, pulmonary edema, hyperkalemia with tall- peaked T waves, p-waves flattened and PR lengthens
During or right after dialysis-shock
Hypokalemia, ST depression, small T waves, prominent U waves (found after T wave)
Peritoneal dialysis
Tube inserted into abdominal cavity uses patient’s peritoneal membrane to exchange fluids and remove toxins/waste products.
Renal calculus
Kidney stone
S/S of a kidney stone
Unilateral severe flank pain, may have flank to groin pain, hematuria, pale, sweating, renal colic waves of pain due to peristalsis of ureter
Pyelonephritis
Inflammation (infection) of kidneys
Pyelonephritis S/S
Back or flank pain, hematuria, cloudy and foul smelling urine, high fever.
Cystitis
Inflammation (infection) of the kidneys
S/S of Cystitis
Lower mid abdominal pain/tenderness, frequent urination with burning, hematuria, urgency, cloudy, foul-smelling urine.
Epididymitis
Inflammation of epididymis- pain in groin, foul-smelling urine
Testicular torsion
Testicle twists on spermatic cord which provide blood to scrotum
Testicular torsion S/S
Sudden, severe scrotal pain and swelling; usually boy over 6 years old; true emergency
Endocrine System
Purpose is to produce hormones which affect other endocrine glands of body systems
Hypothalamus
Located in lower part of brain above brain stem, stimulates pituitary gland, plays a role in sleep, temperature, hunger, thirst, BP and water balance
Pituitary gland
Located in brain
Called “master” gland
Hormones it produces: ACTH, ADH, FSH, GH, Oxytocin, TSH
Parathyroid
Behind thyroid
Helps to increase calcium levels in blood
Hyperparathyroid
Tired, weak, increased thirst and urination, kidney stones and can increase calcium
Thymus
Located in chest between sternum and heart
Produces T-lymphocytes to help fight infection; not present in adults, atrophied during adolescence
Thyroid gland
In neck below the thyroid cartilage
Affects metabolism and decreases calcium levels
Thyroid conditions
Grave’s disease
Thyrotoxicosis, thyroid storm (most severe form of hyperthyroid)
Myxedema
Myxedema coma (most severe form of hypothyroid)
grave’s disease s/s
Agitation and nervous Heat intolerance (always hot) Weight loss Tachycardia Hot and flushed skin Goiter (enlarged thyroid) Exophthalmos (protrusion of eyeballs)
Graves’ disease management
Can use beta blockers
Thyrotoxicosis s/s
Fever Sweating Diarrhea AMS Hypoglycemia Seizures Hypotensive
Thyrotoxicosis management
Cool down
Beta blocker
Glucose if indicated
Bentos for seizures
Myxedema s/s
Fatigue and lethargy Cold intolerance (always cold) Bradycardia Weight gain Dry Cold skin Constipated
Myxedema management
Common thyroid meds: synthroid/ levothyroxine,
Adrenal glands
Located on top of each kidney
Produce epinephrine and norepinephrine, aldosterone which increases reabsorption of sodium, cortisol which increases energy
Adrenal insufficiency
Fails to produce adequate Cortisol and aldosterone
Addison’s disease S/S
Fatigue Loss of appetite Vomiting Diarrhea Weight loss
Addison’s disease management
Usually on steroids like Prednisone
Addisonian crisis
Brought on by stress including trauma
Waterhouse friderichsen syndrome
Bleeding in adrenal glands due to infection
Addisonian crisis S/S
Severe vomiting and diarrhea
Hypotension
Shock
Addisonian crisis management
Fluids
May need D50
May need Calcium chloride if hyperkalemic
Patient may carry a kit with hydrocortisone or dexamethasone if in crisis (decreases BS and BP)
Cushings symdrome
Increased cortisol (tumors)
Cushing’s syndrome S/S
Weight gain “Moon faced” “Buffalo hump” Increased facial hair but decreased scalp hair Mood swings
Cushing’s syndrome management
Check blood sugar
Treat symptomatically
Pineal gland
Center of brain
Plays role in sleep
Pancreas
Upper abdomen behind stomach
Produces insulin and glucagon
Insulin
Lowers blood glucose
Produced in beta cells of Islets of Langerhans
Serves as carrier for glucose to enter cells
Glucagon
Produced in alpha cells
Increase blood glucose by stimulating liver which breaks down glycogen into glucose
Diabetes mellitus
Type 1 and 2
Diabetes mellitus type 1
Does not produce insulin
Juvenile diabetic
IDDM- insulin dependent diabetes mellitus
Type 2 diabetic
Insufficient insulin production or has insulin resistance
Can control with diet or takes pills
HHNK
Hyperosmolar, hyperglycemic, nonketotic coma
(Also called hypersmolar nonketotic coma (HONK))
No ketones- S/S of DKA but no fruity odor breath or Kussmaul’s breathing, type 2 diabetic
Complications of diabetes
Stroke kidney and heart disease Decreased blood supply to legs Vision changes- blindness Neuropathy- nerve damage
Allergic reaction
Mast cells stimulate H1 histamine receptors:
- Vasodilates
- increased capillary permeability
- bronchoconstriction and laryngospasm
- Eosinophils (type of WBC) are elevated
Best drug to counteract histamine
Epinephrine
What kind of drug is benadryl
Antihistamine
Anaphylactic shock
Due to 3rd space fluid loss and vasodilation
Most common cause of anaphylactic shock
1- Penicillin injection
2nd- Hymenoptera stings (bee, wasps, hornets)
Anaphylactic reaction
Like anaphylaxis but not caused by IgE reaction, produced by injection of serum or protein.
Is symptomatic after first exposure
Collagen disease
Systemic lupus erythemotosus
Autoimmune disease
Swelling of joints, damage to skin, kidneys, heart, lungs, blood
Best way to prevent spread of disease
Hand washing
Hepatitis A
Fecal-oral contamination, not blood borne
Overseas travel
Contaminated food or water
Hepatitis B and C
Both blood borne, fluid borne
TB
May be antibiotic resistant
Spreads by droplets
N-95 mask worn by medic, regular surgical mask on patient
Influenza
8th leading cause of death in US
Respiratory spread, can be spread by droplet contaminated surfaces
Incubation 1-4 days
Contagious the day before symptoms and last 5-10 days
Vaccines 60% effective
Gonorrhea
Men- pain on urination and discharge from penis
Women- fever, vaginal discharge, PID
Most common STD
Chlamydia
Second most common STD
Gonorrhea
Methicillin resistant staphylococcus (MRSA)
Transferred from one person to another through break in skin
Local skin abscesses, cellulitis, sepsis especially in elderly
Vancomycin resistant staphylococcus (VRSA)
Usually from catheters, recent hospitalizations, open wounds
S/S- Fever chill, localized skin lesions, pneumonia, sepsis
Vancomycin resistant enterococcus (VRE)
Bacteria usually found in bowel and female genital tract.
Clostridium difficult (C diff)
Usually after hospital stay or course of antibiotics
S/S:
- watery diarrhea, green and foul smelling
- nausea
- vomiting
Excited delirium stimulants
MDMA Bath salts Flakka Synthetic THC Cocain PCP Methamphetamine
Narcotic
Opium, heroin, fentanyl, morphine, codeine, oxycodone, methadone, meperidine, hydrocodone, dilaudid
Stimulants
Cocaine, methamphetamine, bath salts, MDMA- ecstasy
Hallucinogens
LSD, PCP, Angel Dust, mushrooms
Assessment findings in a narcotic OD
Respiratory and central nervous system depression
Decreased respirations and level of consciousness
Small pupils
Stimulants assessment findings
Dilated pupils Increased heart rate Increased respirations Increased BP Increased body temp, excited, agitated/restless Seizures Vfib
Hallucinogens OD assessment findings
Behavioral changes Paranoid Could be danger to self or others Increased BP and pulse Pupils usually dilated Hyperthermia Chest pain Epistaxis
Carbon monoxide poisoning findings and management
Headache
Confusion
Cyanosis
Cherry-red lips
Remove patient from source, high flow O2, CO monitor, hyperbaric
Organophosphate poisoning assessment and management
Salivation, lacrimation, urination, diarrhea, GI symptoms, emesis, constricted pupils, bradycardia
Scene safety, have patient remove clothes and then spray down, large doses of atropine
Salicylates- aspirin acetylsalicylic acid assessment and management
Metabolic acidosis, respiratory alkalosis, hyperventilation, tachycardia, fever, sweating, tinnitus (ringing in ears), hearing loss
Large amounts of IV fluids, may need dialysis
Hemophilia
Genetic disease, blood clotting disorder
Smallest cut can cause uncontrolled bleeding
Sickle cell anemia
Genetic disease
More common in African Americans, also can occur in people of Mediterranean decent
Pain and swelling joints, pain in chest, back or flank pain, priapism, infections, stroke or MI, spleen involvement
Leukocytosis
Too many WBC
Leukemia
Cancer of blood cells
Lymphoma
Cancer of lymphatic system
Thrombocytosis
Too many platelets
Thrombocytopenia
Decrease of platelets
Menstrual cycle
Proliferative phase
Secretory phase
Ischemic phase
Proliferative phase
First two weeks of cycle
- increased estrogen
- causes endometrium to thicken and become engorged with blood
Secretory phase
Time surrounding ovulation
Ischemic phase
If fertilization doesn’t occur, estrogen and progesterone decrease
Dysmenorrhea
Painful menses
Endometriosis
Endometrial tissue grows outside of uterus, abdominal pain
Menarche
Onset of messes, first period
Menopause
Ending of menses, irregular bleeding
Mittelschmerz
Unilateral lower abdominal pain during ovulation
PID
Pelvic inflammatory disease
Pain usually in both lower quadrants, fever, foul smelling discharge
Most common causes are gonorrhea and chlamydia
Most definitive sign of pregnancy is amenorrhea
Without a period
Bloody show
Blood tinged mucus plug from cervix, occurs during cervical dilation
Braxton Hicks contractions
Irregular contractions
“False labor”
Cephalon delivery
Head first
Gravida
Number of pregnancies including the current one
Primagravida is being pregnant for the first time
Para
Number of deliveries
Primapara- first delivery
Postpartum
After birth
Prenatal and antepartum
Conception til birth
Size of the uterus at 3 months
Top of pelvis
Size of uterus at 4-6 months
Umbilicus
Size of uterus at 9 months
Diaphragm
Placenta
Provides fetus with nutrients and gets rid of waste products
Normal length of pregnancy
40 weeks (nine months)
Blood volume during pregnancy
Increases by 45%, anemia is common
Umbilical cord
Attaches fetus to placenta.
2 arteries, 1 vein
Fetal circulation
O2 to fetus via umbilical vein-
- 1/2 of blood goes to the fetus’ liver
- 1/2 of blood goes to fetal circulation via ductus venosus