Sep 2 Flashcards
1
Q
TCA example
A
Amitriptyline
2
Q
TCA SE
A
A, B, C, D, E Anticholinergic Blurred vision Constipation Drowsy Euphoria
3
Q
How to identify a Benzo
A
contain “zep” in the name
4
Q
4 uses for Benzos
A
- pre op
- sz
- alcohol WD
- help when someone fighting the ventilator
5
Q
MAOI SE
A
htn crisis (avoid tyramine)
6
Q
MAOI things to avoid
A
BAR (banana, avocado, raisins)
organ meat
yogurt, cottage cheese, caffeine
7
Q
Lithium SE, the 3 Ps
A
Pee, poop, paresthesia
8
Q
Lithium TE
A
Tremor
Metallic Taste
Severe diarrhea
9
Q
Top lithium intervention
A
give fluids
10
Q
Lithium: what do you monitor regarding Na levels
A
decreased Na = toxicity
increased Na = under medicated
11
Q
SSRI SE
A
ABCDEI Anticholinergic Blurred vision Constipation Drowsy Euphoria Insomnia
12
Q
Haloperidol
A
1st gen anti psyc
13
Q
NMS
A
Neuro malignant syndrome-
- Crazy high temp
- to prevent in the elderly, give 1/2 the dose
- Medical emergency
14
Q
Difference between NMS and EPS
A
NMS has the high temp
15
Q
Clozapine
A
2nd gen aka atypical
16
Q
Clozapine SE
A
decreased WBC
17
Q
How to identify 2nd gen anti psycs
A
they end in zapine
18
Q
If a patient is on sertraline, you will likely need to do what
A
lower the dose of all other medications
19
Q
Serotonin Syndrone
A
Sad Head
Sweating
Apprehension
Dizzy
Headache
20
Q
Sertraline + Warfarin
A
you will bleed out
21
Q
Total weight gain during pregnancy
A
28 lbs (plus or minus 3)
22
Q
weight gain in the first trimester
A
1 lbs each month (total of 3 lbs)
23
Q
weight gain in the 2nd trimester
A
1 lbs each week
24
Q
When is the fundus palpable
A
week 12 (2nd trimester)
25
If you palpate the fundus before week 12
it could be a hydatiform mole
26
What does the fundus tell you about the trimester
no fundus = 1st trimester
fundus at or below naval = 2nd
fundus above naval = 3rd
27
"when would you first?"
pick the earliest in the range
28
"when would you most likely?"
pick the middle of the range
29
"when should you ___ by?"
pick the latest range
30
When is quickening
16 to 20
31
Pregnancy: What kind of signs are urine/blood tests
not positive
32
What is the order of the pregnancy signs
alphabetical:
Chadwick
Goodell
Hegar
33
Goodell
softening of cervix
34
Hegar
softening of uterus
35
Pregnancy: Provider visits: 0 to 28
once a month
36
Pregnancy: Provider visits: 29 to 36
twice a month
37
Pregnancy: Provider visits: 37 on
weekly or until week 42
38
Hemoglobin ___ is normal in 1st trimester
11
39
Hemoglobin ___ is normal in 2nd trimester
10.5
40
Hemoglobin ___ is normal in 3rd trimester
10
41
Pregnancy: when do you eat dry carbs
before getting OOB
42
Pregnancy: Urinary incontinence tx
void Q 2 h
43
Pregnancy: Dyspnea tx in 2nd and 3rd trimester
tripod
44
Pregnancy: back pain tx
pelvic tilt
45
Truest sign of being in labor
onset of regular, progressive contractions
46
Effacement means
thinning of the cervix
47
Not effaced cervix means
its still thick
48
fully effaced cervix is called
100%
49
Station
relation of fetal presenting point to ischial spines (tightest space)
50
Negative station means
baby still above the tight space
51
positive station means
baby is below the tight space
52
zero station means
baby is right at the tight space
53
If the baby is at negative station for a long time
you might need a C section
54
Vertical lye
its a good thing
means the baby and moms spines are parallel
55
Transverse lye
its a bad thing, means the spines are perpendicular
56
4 stages of LD: stage 1
Labor
This stage includes all the 3 "phases"
- latent
- active
- transition
Contractions here are to dilate and efface
57
4 stages of LD: stage 2
Delivery of baby
58
4 stages of LD: stage 3
Delivery of placenta
59
4 stages of LD: stage 4
Next 2 hours
Contractions are to stop the bleeding
60
Latent phase
1 to 4 cm
contractions 5 to 30 apart
last for 15 to 30 seconds
61
Active phase
5 to 7 cm
contractions 3 to 5 apart
last for 30 to 60 seconds
62
Transition
8 to 10 cm
contractions 2 to 3 apart
last for 60 to 90 seconds
63
If contractions are closer than __ min and longer than __ seconds, mom is in trouble
2 min, 90 seconds
64
If contractions are closer than 2 min and longer than 90 seconds, mom is in trouble, its an indication to
stop pitocin
65
Complications of LD: Painful back labor tx
Position knee to chest and push on her sacrum
66
Complications of LD: Prolapse cord tx
its an emergency
push the baby's head back up (so that it's not pushing on the cord) and then position in knee chest
67
What is the tx for all LD complications (besides painful back labor and prolapse cord)
LION
Left side
Increase IV
Oxygenate
Notify Doc
68
Don't give pain meds to labor patient if the baby is likely to be born when
the med peaks
for example a primigravida at 5 cm could have IV pain med. But a multigravida at 8 cm could Not get IM meds
69
Low fetal HR (under 110)
Bad!
LION
Left side
Increase IV
Oxygenate
Notify Doc
70
High fetal HR (over 160)
not that serious
71
fetal: Low baseline variability
Bad
Fetal HR not fluctuating. Do LION
72
fetal: High baseline variability
Good. Document
73
Late deceleration
HR gets slow near the end or after contraction.
Bad. Do LION
74
Early deceleration
Slow before or at beginning of contraction.
Good
75
Variable decelerate
Very bad. (think Vary = Very)
It's caused by prolapse cord
Push and position
76
VEAL
Variable ... Cord compression
Early decel ..... Head compression
Acceleration .... OK (it's fine)
Late decel ..... Placental insufficiency
77
In general, a good OB answer is
check fetal HR
78
4 steps of delivering the baby
1. Deliver Head
2. Suction Mouth then Nose (alphabetical)
3. Check for nuchal cord
4. Deliver body
79
woman named Ava
2 arteries and 1 vein
80
the 4th stage of LD is recovery. In the 4th stage there are 4 things you do 4 times an hour:
Vitals
Fundus check
Check pads
Roll her over to check for bleeding
81
Recovery phase of LD: Check pads Q 15 min. What do you look for
If saturated in 15 min, that's bad
