Special Populations Flashcards
1
Q
An oocyte matures when the anterior pituitary gland releases:
A
Follicle-stimulatig hormone
2
Q
___ is the hormone that stimulates the maturation of an oocyte
A
Follicle-stimulating hormone
3
Q
___ stimulates the release of the ovum
A
Luteinizing hormone
4
Q
What is left of the follice after the egg/ovum has been released becomes the ___
A
Corpus luteum
5
Q
The corpus luteum secretes:
A
Estrogen, progesterone, and inhibin
6
Q
3 layers of the uterus
A
Perimetrium, myometrium, endometrium
7
Q
On implantation, the egg adheres to the ___
A
Endometrium
8
Q
Implantation of the blastocyst occurs approximately ___ after fertilization
A
1 week
9
Q
The formation of placental tissues stimulates the release of ___
A
Human chorionic gonadotropin hormone
10
Q
The ___ carries oxygenated blood from the placenta to the unborn baby
A
Umbillical vein
11
Q
Kidney volume can increase as much as ___% during pregnancy
A
30
12
Q
Number of live births
A
Parity
13
Q
Cardiac output may increase by as much as ___% during pregnancy
A
30-50
14
Q
ECG changes that can occur during pregnancy include:
A
Ectopic beats and SVT
15
Q
Standard birthing position in the US
A
Lithotomy position
16
Q
Elevated BP, facial edema, or hyperactive reflexes strongly suggest the presence of ___ in a pregnant woman
A
Preeclampsia
17
Q
Management for supine hypertensive syndrome involves:
A
Placing the PT in the left lateral recumbent position & treating underlying causes
18
Q
Uncommon form of heart failure that happens during the last month of pregnancy
A
Peripartum cardiomyopathy
19
Q
DBP greater than ___ places the pregnant PT in an increased risk category
A
110 mmHg
20
Q
Severe preeclampsia may require administration of ___ to prevent seizures along with emergency antihypertensive meds
A
Magnesium sulfate
21
Q
Severe preeclapmsia is defined as a SBP greather than ___ mmHg or DBP greater than ___ mmHg
A
160; 110
22
Q
Seizures that result from severe hypertension in a pregnant woman
A
Ecalmpsia
23
Q
___ is the recommended treatment for a pregnant PT with seizures, especially when eclampsia is present
A
Magnesium sulfate
24
Q
___ and ___ are contraindicated for seizures in a pregnant PT due to their ability to cross the placental barrier
A
Diazepam (valium) and phenobarbital
25
Inability to process carbohydrates during pregnancy
Gestational diabetes
26
The ___ produces hormones designed to support pregnancy until the placenta is fully developed
Corpus luteum
27
In the ___ week after conception, the egg is officially recognized as an embryo
3rd
28
Beginnings of the CNS, CV system, spine, and skeletal anatomy begin to appear during the ___ week after conception
3rd
29
The placenta begins to develop around the ___ week of pregnancy
4th
30
The placenta acts as an early liver for the unborn baby, synthesizing ___ & ___
glycogen & cholesterol
31
THe umbillical ___ carries oxygenated blood from the placenta to the baby, while the umbillical ___ carry arteriovenous blood to the placenta
vein; arteries
32
The ___ connects the umbillical vein and the inferior vena cava in the unborn baby
ductus venosus
33
The ___ connects the pulmonary artery and the aorta in an unborn baby
ductus arteriosus
34
The ___ separates the right & left atria of the unborn baby’s heart
foramen ovale
35
By the end of a full-term pregnancy, the uterus has an internal volume of approximately ___
5,000 mL
36
Kidney volume can increase as much as ___ during pregnancy
30%
37
A dark line down the midline of the abdomen that develops during pregnancy in many women
linea nigra
38
Total number of time a woman has been pregnant
gravidity
39
Number of live births a woman has had
parity
40
At term, the uterus normally contains ___ % of the woman’s total circulating blood volume
15 -16%
41
Shunting of blood back into maternal circulation during uterine contraction
autotransfusion
42
RBC count may increase by as much as ___% during pregnancy
33%
43
Cardiac output in a pregnant woman may increase by ___% above pre-pregnancy level
30%-50%
44
Cardiac output reaches it’s maximum at about ___ weeks gestation
22
45
At term, a pregnant woman’s HR will increase by an average of about ___ bpm
15-20
46
SBP & DBP may decrease until approximately ___ weeks gestation
24
47
By 8 weeks gestation, increasing levels of ___ cause the tidal volume to increase by as much as 30%-50% of the non-pregnant level
progesterone
48
Increased joint laxity is due to the release of the hormone ___ during pregnancy
relaxin
49
Hormone which decreases the utilization of insulin by cells during pregnancy
progesterone
50
A woman who has had 2 or more pregnancies:
Multigravida
51
A woman who has had 2 or more deliveries
multipara
52
Irregularly spaced contractions are most likely signs of ___
false labor
53
If the fundus is palpable just above the symphisis pubis, the gestational age is ___
12-16 weeks
54
If the fundus is palpable at the level of the umbillicus, the gestational age is ___
20 weeks
55
Fetal HR less than ___ bpm suggests fetal distress in most pregnancies
120
56
Maternal hypotension translate into:
placental hypoperfusion
57
Early signs of supine hypotensive syndrome
Nausea, dizziness, tachycardia, anxiety
58
PPCM
peripartum/postpartum cardiomyopathy
59
Triad of symptoms associated with preeclampsia
Edema (face, ankles, hands),
gradual onset HTN,
Proteinuria
60
Visual disturbances in a pregnant PT may indicate ___
Severe preeclampsia
61
HELLP stands for:
Hemolysis, Elevated Liver enzymes, Low Platelets
62
Inability to process carbohydrates during pregnancy
Gestational diabetes
63
If protocols allow, administer ___ for persistent N/V in pregnant patients
diphenhydramine or ondansetron
64
___ is the leading cause of life-threatening infections in newborns during their first week after birth
Group B streptococcus
65
___ is a bloodborne pathogen that can be passed from mother to infant during the birthing process
HIV
66
TORCH stands for:
```
Toxoplasmosis,
Other agents
Rubella
Cytomegalovirus
Herpes
```
67
___ refers to infections that occur in neonates because of organisms passing through the placenta from woman to baby
TORCH syndrome
68
Member of the herpes family of viruses that pregnant women are at increased risk of contracting
cytomegalovirus
69
___ occurs naturally in 10-25% of all pregnancies
spontaneous aboriton
70
3 or more consecutive pregnancies that end in miscarriage
habitual abortion
71
An abortion that is attempting to take place, may not always lead to abortion of the baby
threatened abortion
72
Spontaneous abortion that cannot be prevented
imminent abortion
73
When treating a PT experiencing spontaneous abortion, treatment goals should include:
maintaining BP and preventing hypovolemia
74
___ occurs when the uterus becomes infected, often by normal vaginal flora
septic abortion
75
A pregnant woman can lose up to ___% of circulating volume before significant S&S of hypovolemia become apparent
40%
76
Life-threatening condition in which a fertilized ovum becomes implanted somewhere other than the uterus
ectopic pregnancy
77
All female PTs of child-bearing age reporting severe, lower abdominal pain should be considered to be experiencing:
ectopic pregnancy
78
Premature, or incomplete separation of the placenta from the uterine wall
abruptio placenta
79
Abruptio placenta most commonly occurs during the ___ trimester
3rd
80
Tender abdomen, rigid uterus, and sudden, severe abdominal pain that radiates to the back, is indicative of:
abruptio placenta
81
In ___ the placenta is implanted low in the uterus, and partially or fully obscures the cervical canal
placenta previa
82
Leading cause of painless vaginal bleeding in the 2nd and 3rd trimester of pregnancy
placenta previa
83
Signs of shock with sudden & severe abdominal pain along with decreased fetal heart tones indicates:
abruptio placenta
84
Painless vaginal bleeding with bright red blood, and normal fetal heart tones & fetal movement indicates:
placenta previa
85
Fluid resucitation in a pregnant PT should continue as indicated, up to ___mL/kg, or until SBP reaches ___ mmHg
20; 90mmHg
86
In pregnancy, a feeling of relief of pressure in the upper abdomen
lightening
87
___ begins with the onset of labor pains
The first stage of labor
88
The first stage of labor lasts until ___
the cervix is fully dilated
89
The second stage of labor begins when:
the head of the baby descends and flexes to enter the birth canal
90
The 3rd stage of labor is the period that involves:
separation of the placenta from the uterine wall
91
Vaginal discharge of blood & mucus that occurs following delivery of a newborn
Lochia
92
Placnetal delivery may be delayed as long as:
30 minutes
93
Magensium sulfate is classified as a(n):
electrolyte
94
Magneseium sulfate acts as a ___ when given during pregnancy
CNS depressant
95
Magnesium sulfate is principally used in pregnancy in the management of ___
eclampsia
96
Mag sulfate is given to treat/prevent ___ in pregnancy/delivery
seizures
97
If mag sulfate administration causes respiratory depression, administer ___ as an antidote to counter the effects
calcium gluconate/chloride
98
Side effects of clacium cholride include:
N/V, syncope, bradycardia, & dysrhythmias
99
Tocolytic and sympathetic agonist
Terbutaline
100
Side effects of terbutaline:
```
HTN,
N/V,
dizziness,
chest pain,
dysrhythmias
```
101
___ is indicated to treat exclampsia when seizures do not respond to mag sulfate
diazepam/Valium
102
Principle side effects of diazepam (Valium) administration
N/V,
respiratory depression,
hypotension
103
___ is also useful in treating hyperemesis gravidarum
Benadryl/Diphenhydramine
104
Diphenhydramine is classified as an:
antihistamine
105
Side effects of diphenhydramine
Drowsiness
Headache
Tachycardia
Hypotension
106
Side effects of Zofran include potential ___
QT segment prolongation
107
Naturally occurring hormone that triggers uterine contractions
Oxytocin
108
Preterm labor is that which begins between gestation weeks ___ & ___
20 & 37
109
___ means that the entire labor time and birth of the infant occurred in less than 3 hours
Precipitous labor & birth
110
The first stool passed by the unborn baby
meconium
111
Rare but life threatening condition caused by amniotic fluid and fetal cells entering the woman’s pulmonary & circulatory system via the umbillical veins
Amniotic fluid embolism
112
Condition in which there is too much amniotic fluid
Hydramnios/polyhydramnios
113
In ___ the head of the baby is larger than the mother's pelvis
cephalopelvic disproportion
114
If 2 chords are coming out of one placenta, the twins are ___
identical
115
If there are 2 placentas, the twins are ___
freternal
116
Vaginal presentation of a body part other than the baby’s head
breech presentation
117
___ occurs after the head has been delivered and the shoulder cannot get past the woman’s symphisis pubis
Shoulder distocia
118
In ___, one or both feet dangle down through the vaginal opening
footling breech
119
___ may cause Inefficient contraction of the lower segment of the uterine muscles
Placenta previa
120
Sudden dyspnea, tachycardia, a-fib, or hypotension in the postpartum state may indicate ___
Pulmonary embolism
121
A respiratory rate less than ___ breaths/min is not considered adequate ventilation in a pregnant trauma PT
20
122
A normal fetal heart rate is between _____ bpm
120-160
123
A fetal heart rate slower than ___bpm means fetal distress
120
124
The gestational period normally lasts ___ weeks
38
125
___ is the only distinguishing characteristic that can verify a PT is experiencing eclampsia instead of PPCM
Proteinuria
126
Gestational hypertension may be an early sign of ___
Preeclampsia
127
Signs & symptoms of preeclampsia
Face & extremity edema; gradual onset HTN; proteinuria
128
Visual disturbances as well as elevated BP may suggest the presence of ___ in a pregnant PT
Severe preeclampsia
129
Painfully itchy hands and feet during pregnancy are the most common symptom of ___
Cholestasis
130
In a pregnant PT, sporadic contracions, first-trimester bleeding, and menstrual-like cramps are indicative of:
threatened abortion
131
A pregnant woman who feels a strong urge to move her bowels is in the ___ stage of labor
2nd
132
Rapid series of events that occur to enable a newborn to breath
Fetal transition
133
APGAR stands for:
```
Appearance
Pulse rate
Grimmace
Activity
Respiratory effort
```
134
A pulse rate less than ___ in a newborn indicates the need for resucitation
100
135
Cyanosis of the extremities
Acrocyanosis
136
An OPA should be insterted into a neonate/infant’s airway using this modifier:
Do not rotate the OPA
137
Artificial ventilation of the newborn is indated in these 3 scenarios:
Apnea
Pulse rate < 100 bpm
Persistant central cyanosis despite 100% oxygenation
138
Typical tidal volume of a newborn
3-6 mL/kg
139
Ventilation rate for a newborn
40-60 breaths/min
140
Chest compressions are indicated in a newborn if the pulse rate remains at:
less than 60 bpm
141
___ is indicated in a neonate after 60 seconds of CPR if the pulse rate remains less than 60 bpm
Epinephrine
142
If neonatal bradycardia persists after adequate ventillation, chest compression, and volume expansion, suspect:
metabolic acidosis
143
A bolus of normal saline for a newborn should equal a volume of:
10 mL/kg
144
___ is more common in postterm babies
meconium staining
145
Abnormal opening in the diaphragm
Diaphragmatic hernia
146
Right-shifted heart sounds, decreased left side breath sounds, and a sunken-in abdomen, is likely indicative of:
diaphragmatic hernia
147
___ is the single most common risk factor of respiratory distress and cyanosis in the neonate
prematurity
148
Newborns delivered before ___ weeks gestation are considered premature
37
149
Newborns weighing less than ___ lbs are considered low birth weight.
5.5
150
Premature newborns are at greater risk for respiratory distress owing to ___
surfactant deficiency
151
Type of neonatal seizure characterized by eye deviations, blinking, chewing, episodes of high BP, and apnea, more common in premature infants
Subtle seizures
152
Persistant posturing of one limb, the neck, or the trunk with horizontal eye deviation is characteristic of what type of neonatal seizure?
Focal tonic seizure
153
___ seizure activity often involves flexion of the arms of the newborn
Focal myoclonic seizure
154
One cause of neonatal seizures that has 2 major peaks of incidence, the first being 2-3 days after delivery, is caused by:
hypocalcemia
155
In full-term or preterm newborns, hypoglycemia is a BGL of less than ___
45 mg/dL
156
BGL in a healthy newborn during the first 1-2 hours may be as low as ___
30 mg/dL
157
Limpness or floppiness of a newborn
hypotonia
158
Feeding intolerance and abdominal distension in conjunction with vomiting in the first 1-2 days after birth may indicate ___ or ___
intestinal atresia or intestinal stenosis
159
Type of maternally-used drugs that most commonly cause vomiting in newborns
barbiturates
160
The signle most common cause of seizures in term and preterm newborns
Hypoxic-ischemic encephalopathy
161
Average normal body temp of a newborn at birth
99.5 F or 37.5 C
162
A thermogenic tissue unique to the newborn
Brown fat
163
___ is the primary source of heat production in the newborn
nonshivering thermogenesis
164
Abnormalities of the heart during development
congenital heart defect
165
In ____, oxygenated blood is shunted from the left side of the heart to the right side
noncyanotic congenital heart diseases
166
An abnormal opening in the septum separating the atria
atrial septal defect
167
Atrial septal defect is caused by failure of the ___ to close after birth
foramen ovale
168
Narrowing of a section of the aorta
Coarctation of the Aorta
169
Damage to the pulmonic valve, resulting in decreased blood flow to the lungs
pulmonary stenosis
170
In ___ the pulmonary artery and aorta are combined into one vessel
truncus arteriosus
171
In ___ the patient lacks the tricuspid valve
tricuspid atresia
172
Complete underdevelopment of the left side of the heart
hypoplastic left heart syndrome
173
Combination of Ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta
Tetrology of Fallot
174
Bradycardia in a neonate is considered a rate less than:
100 bpm
175
Increased work of breathing to maintain oxygenation/ventilation
Respiratory distress
176
partial or complete occlusion of the glottic opening due to swollen glottic tissues
epiglottitis
177
Acute, bacterial infection of the subglottic area of the upper airway, complicated by thick, pus-filled secretions
bacterial tracheitis
178
The most common chronic illness of childhood
Asthma
179
Common & contagious virus that causes bronchiolitis & pneumonia in children
RSV/Respiratory syncytial virus
180
RSV is spread via:
droplets & contaminated surfaces
181
Inflammation of the bronchioles
Bronchiolitis
182
An infant with a first time wheezing episode occurring in late fall or winter is likely experiencing:
bronchiolitis
183
Infants up to age 1 yr should be intubated with an ET tube size ___
3.5mm
184
Children ages 1-2 should be intubated with a size ___ ET tube
4mm
185
Cuffed ET tube size Formula for children older than 2
3.5+(age / 4)
186
A ___ laryngoscope blade is used to directly lift the epiglottis to view the chords
Miller/straight
187
Typical blood volume in pediatrics
70 mL/kg
188
Decreased vascular tone resulting in vasodilation & third spacing of fluids
Distributive shock
189
First line treatment of pediatric PTs in distributive shock
fluid resuscitation
190
When fluid resuscitation fails to resolve persistent hypotension in a septic PT, consider:
vasopressors
191
In children, bradydysrhythmias most often occur secondary to ___
hypoxia
192
For a stable PT in SVT , consider treating with ___
vagal maneuvers
193
SVT that persists in a stable PT despite vagal maneuvers should be treated with ___
adenosine
194
For an unstable PT in SVT, ___ is recommended
synchronized cardioversion
195
If wide complex tachycardia is suspected in a stable PT, consider ___ to distinguish it from SVT
adenosine
196
If wide complex VT persists despite treatment with Adenosine, ___ is the medication of choice
Amiodarone
197
Electricity dosage for sync-cardioversion in a pediatric PT
0.5-1 joule/kg
198
Condition resulting from impaired circulation & absorption of CSF
Hydrocephalus
199
A PT who suffered a head trauma who presents several hours later with delayed rapid deterioration is most likely experiencing the effects of:
epidural hematoma
200
Children rely on ___ to maintain adequate cardiac output
Pulse rate
201
In pediatrics, Tachycardia usually suggests ___ whereas bradycardia is suggestive of ___
Shock; hypoxia
202
The ___ & ___ are more likely to be injured in children due to “handlebar” injuries
Duodenum & pancreas
203
The pediatric assessment triangle consists of:
Appearance
Work of breathing
Circulation to the skin
204
Most out of hospital pediatric cardiopulmonary arrests are the result of:
Respiratory failure
205
___ is primarily a cognitive disorder that appears during childhood
Intellectual disability
206
Inability of sound to travel from the outer ear through to the inner ear
conductive hearing loss
207
Hearing loss caused by problems with the uptake of sound through the tiny hairs within the ear and subsequent conduction of nerve impulses
sensorineural hearing loss
208
Inability to interpret sounds, particularly speech, when background noise is present
central auditory processing disorder
209
Condition characterized by normal function of ear structures without corresponding stimulation of auditory centers in the brain
auditory neuropathy
210
You should suspect ___ in PTs who experience a sudden onset of unilateral eye or peri orbital pain with visual changes
Acute angle-closure glaucoma
211
___ is a failure of neurotransmission between the nervous system and muscles of the face & throat that cause impaired speech
Dysarthria
212
Neurologic impairment of the brain that inconsistently activates muscles needed to form words or sounds
Apraxia
213
Life threatening condition of paralysis patients, caused by a stress within the body that triggers a release of catecholamines from the ANS that causes vasodilation above the level of a previous spinal cord injury.
Autonomic dysreflexia
214
Increased sensitivity that may cause a PT to interpret touch as pain
Hyperesthesia
215
Nonprogressive neurologic disorder that results from injury to brain tissue during brain development
Cerebral palsy
216
When cerebral palsy effects all four limbs, it is known as:
spastic tetraplegia
217
Newborns who present with meconium or odd-smelling/-appearing stool should be suspected of having:
Cystic fibrosis
218
Severe, incurable degenerative disorder in which the myelin sheath of certain nerve fibers is attacked by the body's immune system
Multiple sclerosis
219
Category of incurable genetic diseases that cause a slow, progressive degeneration of muscle fibers
Muscular dystrophy
220
Following delivery of a neonate, small spinal cord openings should be treated by:
covering with a moist, sterile dressing
221
The gestational period usually lasts ___ weeks
38
222
The 2nd stage of labor begins when ___
the fetus' head enters the birth canal
223
Initial resuscitation efforts for a neonate should include providing ___% oxygen
21 (room air)
224
O2 monitor placement for a neonate showing signs of hypoxia/poor respiratory effort/apnea
pre ductal (right ear lobe, right hand)
225
For a neonate with a pulse rate < 60bpm:
initiate chest compressions in addition to PPV
226
FOr a neonate with a pulse rate < 100bpm:
Initiate assisted ventilation with a BVM (PPV)
227
Condition characterized by dyspnea and wheezing seen in children younger than 2:
bronchiolitis
228
Spectrum of lung conditions found in premature infants who required long periods of high-concentration oxygen & ventilator support post delivery
Bronchopulmonary dysplasia
229
Catheter inserted into the superior vena cava to permit monitoring of central venous pressure & sampling for chemical analysis
Central venous catheter
230
type of seizure characterized by alteration of consciousness with or without complex focal motor activity
complex partial seizure
231
Inadequate production of cortisol & aldosterone by the adrenal gland
congenital adrenal hyperplasia
232
Common disease of infancy/childhood characterized by stridor, hoarseness, & barking cough; caused by upper airway obstruction
Croup
233
Tube inserted directly into the PT’s stomach through the skin to provide nutrition
gastrostomy tube
234
seizures manifested in a way that indicates involvement of both cerebral hemispheres
generalized seizures
235
Abnormal buildup of CSF in the ventricles of the brain, can be acquired or congenital
hydrocephalus
236
Unusual thickening of the heart muscle wall, requiring the heart to pump harder to eject blood from LV
hypertrophic cardiomyopathy
237
Group of congenital conditions that cause either accumulation of toxins or disorders of energy metabolism in neonates; characterized by failure to thrive or poor feeding
inborn errors of metabolism
238
Condition that occurs when there is a twisting of the bowel around its mesenteric attachment to the abdominal wall
malrotation with volvulus
239
Common congenital malformation of the small intestine, presents with painless rectal bleeding
Meckel diverticulum
240
Inflammation of the myocardium
myocarditits
241
Where cartilage is transformed into new bone through calcification
ossification center
242
Seizure type that involves only one part of the brain
partial seizure
243
Small, non-blanching spots on the skin
Petechiae
244
hypertrophy of the pyloric sphincter
pyloric stenosis
245
Virus that causes pneumonia & bronchiolitis; may affect upper and lower respiratory tracts
RSV/respiratory syncytial virus
246
Congenital narrowing/blockage of the nasal airway by membranous or bony tissue
Choanal atresia
247
Neonate injury resulting from stretching of cervical nerve roots during delivery of the newborn’s head
Erb palsy
248
Septal opening of the heart that closes after birth
foramen ovale
249
Injury of childbirth affecting spinal nerves C8 to T1
Klumpke paralysis
250
Congenital anomaly in which the small intestine is found predominantly on the right side of the abdomen
malrotation
251
Seizure activity that involves more than one site in the cerebrum
multifocal seizure
252
Decreased volume of amniotic fluid during pregnancy
Oligohydramnios
253
Failure of the ductus arteriosus to transition to the ligamentum arteriosum
Patent ductus arteriosus
254
Delayed transition from fetal to neonatal circulation causes:
persistent pulmonary hypertension
255
Overabundance/overproduction of RBCs, WBC,s & platelets
polycythemia
256
Too much amniotic fluid
polyhydramnios
257
Disease of the eye that effects premature infants, can lead to blindness
retinopathy of prematurity
258
Rare congenital defect in which the pulmonary veins connect to the right atrium
total anomalous pulmonary venous return
259
Defect in which the great vessels are reversed
transposition of the great arteries
260
Defect in which the pulmonary artery & aorta are combined
truncus arteriosus
261
Term for an oocyte once it has fertilized and multiplies
blastocyst
262
Persistent nausea & vomiting during pregnancy
hyperemesis gravidarium
263
Situation in which the fetus has died during the first 20 weeks of gestation, but remains in utero
missed abortion
