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Term 3 > Pt Care Theory 3 > Flashcards

Pt Care Theory 3 Flashcards

1
Q

How much does BP decrease in the 2nd trimester of pregnancy?

A

10-15 mmHg
Typically returns to normal in the third trimester.

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2
Q

How much does the pulse rate increase in the third trimester?

A

15-20 bpm above baseline

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3
Q

How much does blood volume increase during pregnancy?

A

30%

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4
Q

What causes peripheral edema during pregnancy?

A

Increased blood volume.

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5
Q

What does the CRAP acronym for Cardiac Output stand for?

A

Contractility
Rate
Afterload
Preload

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6
Q

How much does cardiac output increase in the third trimester?

A

30%

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7
Q

How much does the Functional Residual Volume of the lungs decrease during pregnancy?

A

25%

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8
Q

Gravida

A

of pregnancies – current & past (counting miscarriages and abortions)

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9
Q

Para

A

of past pregnancy’s that remain “viable” to delivery. Number is recorded with both live & dead fetus. Twins/triples count as 1

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10
Q

Primip

A

short for primipara – means the patient has only had one birth/delivery

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11
Q

Multip

A

short for multipara – means the pt. has had 2 or more deliveries

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12
Q

What are the child bearing years?

A

From 14-50 years of age.

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13
Q

Nulipara

A

None

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14
Q

At what maternal age is a pregnancy considered geriatric?

A

35+

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15
Q

1st Trimester

A

Week 1 – Week 12 (approx. 3 months)

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16
Q

2nd Trimester

A

Week 13 – Week 27 (months 4 – 6 months)

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17
Q

3rd Trimester

A

Week 28 – birth. Usually approx. 40 – 42 weeks (months 7 – 9)

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18
Q

What age gestation is considered viable?

A

20 weeks+

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19
Q

Stage 1 of labour

A

Early labour and active labour.

20
Q

Stage 2 of labour

A

Passive and active phases

21
Q

Imminent birth as per ALS

A
  • Crowning or other presenting part is visible or;
  • in primips, presenting part is visible during and between contractions, maternal urge to push or bear down, and contractions are less than two (2) minutes apart, or;
  • in multips, contractions five minutes apart or less and any other signs of second stage labor present.
22
Q

When does the BLS say we should assume pre-eclampsia?

A

Pre-eclampsia should be assumed for patients beyond 20 weeks of gestation with a blood pressure ≥140/90 (severe pre-eclampsia = diastolic BP ≥110), with:
• generalized edema (e.g. face, legs), or
• non-specific complaints of headache, nausea, abdominal pain with or without vomiting, blurred vision, fatigue, generalized swelling or rapid weight gain.

23
Q

What is eclampsia?

A

A seizure (pre-eclampsia=pre-seizure).

24
Q

What do Beta 1 receptors do?

A

Innervate HR

25
Q

What do Beta 2 receptors do?

A

Innervate respirations

26
Q

What do beta agonists do?

A

Increase HR

27
Q

What do beta antagonists do?

A

Decrease HR

28
Q

What is considered spontaneous abortion/miscarriage?

A

Loss of pregnancy without outside intervention before 20 weeks gestation.

29
Q

How common is miscarriage?

A

Occurs in 1 in 4 pregnancies.

30
Q

What is Gestational Trophoblastic Disease?

A

When abnormal cells or tumors develop in the uterus from cells that would normally develop the placenta. Most benign but can be malignant.

31
Q

What are risk factors for gestational trophoblastic disease?

A
  • Maternal age younger than 20 or older than 35,
  • Previous spontaneous abortion or molar pregnancy (egg/sperm join incorrectly and a tumor forms instead of the placenta)
32
Q

What are symptoms of endometriosis?

A
  • Dysmenorrhea
  • Lower back and pelvic pain
  • Pain during or after intercourse
  • Painful bowel movements or pain when urinating during menstrual periods
  • Infertility
  • GI complaints, especially during menstrual periods
33
Q

What percentage of fetal loss results from minor injury?

A

60-70%

34
Q

What is uterine atony?

A

Uterus lacks tone/firmness. Not contracted enough.

35
Q

What is primary postpartum hemorrhage?

A

Hemorrhage within 24 hours of delivery.

36
Q

What is secondary postpartum hemorrhage?

A

Hemorrhage within 12 weeks of delivery.

37
Q

What’s the Ductus Venosus?

A

Continuation of the umbilical vein, which bypasses most of the blood from the liver and connects the umbilical vein to the inferior vena cava.

38
Q

What is the Foramen Ovale?

A

A shunt (opening in the septum) that allows blood to travel from the right atrium to the left atrium.

39
Q

What is the Ductus Arteriosus?

A

The artery that joins the pulmonary system directly to the aorta.

40
Q

What is primary apnea?

A

The absence of spontaneous respirations after birth; often self limiting and reversed with minimal resuscitation efforts.

41
Q

What is secondary apnea?

A

Apnea that exceeds 20 seconds and can occur for the following reasons:
- Difficult labour
- Airway obstruction
- Hypoglycemia
- Respiratory muscle weakness
- Narcotics or CNS depressants (do not reverse with Narcan if drug abuse is suspected, due to withdrawals)

42
Q

Where should the Sp02 monitor be placed on a neonate to get the most accurate reading?

A

The right hand.

43
Q

What does the acronym MR SOPA mean?

A

Mask (adjust it to try for a better seal)
Reposition airway (sniffing position)
Suction secretions, if necessary
Open mouth manually.
Pressure (increase it to ensure chest rise)
Alternate Airway.
Use MR SOPA during neonate resus to troubleshoot.

44
Q

What do we do for a pt greater than 24 hrs old, less than 30 days, who has a HR of 0?

A

CPR.
Obviously.

45
Q

If a pt greater than 24 hrs but less than 30 days has a HR greater than 0 but less than 60 what do we do?

A

Still start with room air ventilations before moving to CPR with 100% O2.

46
Q

If a baby is preterm (<32 weeks), how do we keep them warm?

A

Don’t dry the infant, place neck down into a plastic bag, put on hat. This retains moisture and prevents hypothermia.
Can use freezer bag, cut hole in bottom for head, then seal ziploc beneath feet.

47
Q

What is the pediatric triangle of assessment?

A

Appearance, Work of breathing, circulation

Term 3 (6 decks)

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