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NMETC > Special Populations 2 > Flashcards

Special Populations 2 Flashcards

1
Q

Gyn Questions

A

When was your last period How long is your period normally Anything different Type of bleeding Clots Discharge Smell Pregnancy On birth control Any trauma What is normal for pt How many pads have you gone through in 24 hours

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2
Q

Basic Gyn Tx

A

Support pt

Position of comfort

O2 if SpO2 low

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3
Q

Hypermenorrhea/Menorrhagia

A

abnormally heavy bleeding

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4
Q

Polymenorrhea

A

period more frequent than 24 days

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5
Q

Dysmenorrhea

A

painful menses

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6
Q

Metorrhagia

A

spotting that occurs bw periods

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7
Q

Vaginal bleeding <20 weeks

A

likely spontaneous miscarriage

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8
Q

Vaginal bleeding >20 weeks

A

Abruptio placenta Placenta Previa

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9
Q

Ectopic pregnancy S/S

A

Unilower abdominal px

Gradually worsens over few days

Rebound tenderness

diffuse px

may have cullen or grey turner sign

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10
Q

Ectopic pregnancy tx

A

ABCs Cardiac monitor IV Fluids px management warm and tx for shock

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11
Q

PID S/S

A

diffuse lower abdominal px

shuffling gait

fever

chills

discharge

px on urination

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12
Q

Sexual assault tx

A

focus on what hurts and what pt needs tx don’t ask for retelling ask for gender preference in provider don’t examine vagina tx px and anxiety document well

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13
Q

Fetal Circulation

A
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14
Q

Ductus Arteriosus

A

allows blood to pass from pulmonary artery directly into aorta t

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15
Q

Gravida

A

number of times pregnant

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16
Q

Parida

A

number of births

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17
Q

Nulligravida

A

never been pregnant

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18
Q

Nulliparious

A

never given birth

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19
Q

Primigravida

A

female who is pregnant first time

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20
Q

Multigravida

A

female who has been pregnant multiple times

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21
Q

Multiparity

A

given birth multiple times

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22
Q

Grand multiparity

A

female who has given birth more than 5 times

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23
Q

Hyperemesis gravidarum tx

A

ABCs

Position of comfort

EKG

500mL NS if hypotensive

Zofran and maybe benadryl

check BGL

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24
Q

PreEclampsia S/S

A

edema hands, feet, face

seizures

SBP >160

DBP >105

20th week of pregnancy or greater

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25
Q

PreEclampsia Tx

A

O2

Position of comfort

4-6g of Mag over 15mins

Maintenance infusion of 1-2g

if seizure persists, 4mg of lorazepam

Contact Med control for Labetalol

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26
Q

Abruptio Placenta S/S

A

dark red blood

lots of px

external blunt trauma most common cause

can be deep in shock with minimal bleeding

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27
Q

Abruptio Placenta Tx

A

ABC

Shock tx

O2

fluids if hypotensive

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28
Q

Placenta Previa S/S

A

bright red blood

more minimal px

may be unknown if not receiving prenatal care

bleeding begins towards end of pregnancy

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29
Q

Placenta Previa Tx

A

ABCs

tx for shock

O2

IV fluids for hypotension

breathe slow and deep through contractions

txp in knee to chest position

pelvis should be highest point

rapid txp

30
Q

Labor Stages

A

Stage 1: fully dilated cervix and full effacement signals end of first stage

Stage 2: delivery of child is end of second stage

Stage 3: concludes with delivery of placenta

31
Q

Labor steps

A

Mama in semi fowlers with knees drawn up

PPE

Once baby crowns, apply gentle pressure to head

After head delivers, apply downward pressure, check for cord

After first shoulder delivers, apply upward pressure

Be prepared to catch after shoulder delivery

Dry baby and suction mouth/nose

place baby on mama

keep back super warm

APGAR score at 1, 5 minutes

32
Q

APGAR

A
33
Q

Contractions seem to be getting weaker, differential diagnosis?

A

Uterine rupture

34
Q

Pre term labor window

A

20-37 weeks

35
Q

Prolapsed Cord tx

A

mama in knee to chest position

pelvis high

keep baby off cord

rapid txp

36
Q

Nuchal cord

A

loosen cord if possible

if not possible, clamp in two places and cut in middle

37
Q

Breech tx

A

lift ankles towards abdomen

if it doesn’t free head, place fingers on either side of face and press up to allow for baby to breathe

38
Q

Uterine inversion tx

A

O2

at least one line

fluid titrated for BP

Oxytocin withheld

Mag sulf can be useful

39
Q

Postpartum hemorrhage definition

A

in under 24 hours >500mL in vaginal birth

>1000mL in C section

40
Q

Postpartum hemorrhage tx

A

fundal massage

breastfeed

10 unit of oxytocin in 1000 NS over 20-30mins

two large bore IVs

do not pack vagina

41
Q

Important pregnant trauma question

A

have you felt the baby move since incident

42
Q

Baby born, first steps

A

warm

dry

position

suction

stimulate feet

if no response to this after 30s, oxygenate

43
Q

central cyanosis with HR >100

A

blow by O2

if baby pinks up, stop O2

44
Q

HR <100

nasal flaring

grunting

retractions

head bobbing

see saw respiration

A

ventilate at rate of 40-60 bpm

*if no improvement in 30s, intubate and CPR

45
Q

Congenital Diaphragmatic Hernia tx

A

intubation over BVM

NG or OG tube

rapid txp

46
Q

Pneumo tx in infant

A

insert 22g in 2nd intercostal

intubate

47
Q

Umbilical Catherization Steps

A
  1. Clean umbilical cord outward 3cm
  2. Attach 3-5ml prefilled syringe with 3 way stop cock that is attached to 3.5-5 Fr catheter and flush saline through
  3. Cut cord bw infant and first cord clamp
  4. Insert cather into umbilical vein
  5. advance catheter about 2-4cm into vein until blood aspirated
  6. do not advance beyond 5cm
  7. flush catheter and tape into place
48
Q

Inverted Triangle of Newborn Resuscitation

A

Warm, Dry, Suction, Stimulate

Oxygen

BVM, ETT

Chest compressions

Medications

49
Q

Acidosis tx in Newborns

A

If ventilation, oxygenation, chest compressions not resolving bradycardia, acidosis may be cause. Do not use sodium bicarb. Focus on volume expansion to clear metabolic acids.

50
Q

Seizure cause in Infants under 3 days old

A

hypoxic encephalopathy

hypoglycemia

other metabolic disturbances

51
Q

Seizure cause in Infants over 3 days old

A

meningitis

epilepsy

intracranial bleeding

birth defects

drug withdrawal

52
Q

Esophageal atresia

A

failure of esophagus to develop properly and connect to stomach

frothing, vomiting, choking during feeding

53
Q

Infantile Hypertrophic Pyloric Stenosis

A

stomach is unable to empty normally into small intestine

causes projectile vomiting

infants can be dehydrated and hypoglycemic as a result

54
Q

Intestinal Atresia or Stenosis

A

narrowing and malformation of upper intestine

projectile vomiting with green tinge

baby avoids eating and has distended stomach

reduced bowel movements

55
Q

Malrotation

A

intestines fail to coil properly

bloody vomit

vomit may smell of feces

56
Q

Meningitis

A

projectile vomiting

nuchal stiffness

fever

bulging fontanelles

57
Q

Vomiting tx in infants

A

ABCs

IV access

BGL

be prepared to suction

look for dehydration

fluid bolus of 10ml/kg x3

antiemetics not indicated

58
Q

Premature Infant tx

A

ABCs

keep warm

keep dry

blow by O2

get to hospital

59
Q

Jaundice tx

A

IV fluids can dilute bilirubin

txp to hospital

60
Q

Hypothermia consequences in infants

A

increased metabolism

hypoglycemia

bradypnea

bradycardia

metabolic acidosis

61
Q

Acrocyanosis

A

cyanosis of hands and feet

62
Q

Ventricular Septal Defect

A

malformation of septum causing blood flow bw ventricles

leads to pulmonary HTN

leads to decreased SBP

63
Q

Pulmonary Stenosis

A
  • pulmonary valve is damaged and doesn’t open fully
  • right ventricle hypertrophies as result of needing more pressure to move blood through valve to lungs
  • pt often presents with JVD and cyanosis, especially during feeding
64
Q

Tetralogy of Fallot

A
  • combines Pulmonary stenosis, RVH, VSD, and overriding aorta
  • aorta receives some deoxy blood from right ventricle
  • results in baby who is mostly cyanotic during day but especially while crying eating or active
  • have tet spells where become centrally blue and may pass out if working to breathe too hard
65
Q

Atrial Septal defect

A

failure of foramen ovale to close so blood shifts bw atria

pt can become cyanotic as result

66
Q

Patent Ductus Areriosus

A

failure of ductus arteriosus to close

blood shunted away from lungs

if SpO2 doesn’t increase with O2, this may be issue

can lead to CHF in infant

67
Q

Truncus Arteriosus

A

cdxn where pulmonary artery and aorta are single vessel

often have CHF due to massive blood flow to lungs

68
Q

Tricuspid Atresia

A

lacks a tricuspid valve

frequently fatal

significantly decreased blood flow to lungs

69
Q

Transposition of the Great Vessels

A
  • pulmonary artery is connected to left ventricle
  • aorta is connected to right ventricle
  • this systemic hypoxia can allow ductus arteriosus and foramen ovale to remain open
70
Q
A
71
Q

Stages of Uterine Prolapse

A

NMETC (11 decks)

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