Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex Review > Obstetrics 4 > Flashcards

Obstetrics 4 Flashcards

1
Q

_______ is indicated for induction or augmentation of labor, stimulating uterine contraction (c-section), and combating uterine hypotonia and hemorrhage

A

Oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Side effects of oxytocin include

A

water retention, hyponatremia, hypotension, reflex tachycardia, and coronary vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rapid IV administration of oxytocin can cause

A

cardiovascular collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The second-line uterotonic is typically

A

Methergine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Methergine is administered

A

IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If methergine is given IV it can cause

A

significant vasoconstriction, hypertension, and cerebral hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Prostaglandin F2 side effects include

A

N/V, diarrhea, hypotension, and bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The dose of methergine is

A

0.2 mg IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The half-life of methergine is

A

2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Methergine is metabolized

A

hepatically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The third line uterotonic is

A

Prostaglandin F2 (hemabate or carboprost)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The dose of prostaglandin F2 is

A

250 mcg IM or injected into the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During a C-section, oxytocin is administered

A

after the delivery of the placent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The half-life of oxytocin is

A

4-17 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Oxytocin is metabolized

A

hepatically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oxytocin is primarily synthesized in the

A

paraventricular nuclei of the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oxytocin is stored in and released from

A

the posterior pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endogenous oxytocin is released following stimulation of

A

the cervix, vagina, and breasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

____ is the synthetic equivalent of oxytocin

A

Pitocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anesthetic implications for cesarean section under general anesthesia include:
a. administration of a dopamine agonist
b. prolonged neonatal respiratory depression
c. increased MAC
d. rapid sequence induction

A

D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What situations would be appropriate for a general anesthetic for a Cesarean delivery?

A

maternal hemorrhage
fetal distress
coagulopathy
patient refusal of regional anesthesia
contraindications to regional anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In the obstetric population, mortality is ________ with a general anesthetic

A

17 x higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When choosing a general anesthetic for a parturient, plan for

A

a difficult intubation

24
Q

Aspiration prophylaxis for a C-section for a general anesthetic is

A

sodium citrate
H2 receptor antagonist
gastrokinetic agent

25
Q

_________ should be used to minimize aortocaval compression

A

Left uterine displacement

26
Q

When performing general anesthesia for C-section, allow the surgical team to

A

prep and drape the patient before induction

27
Q

For general anesthesia for a C-section, preoxygenate for

A

3-5 minutes or give four vital capacity breaths

28
Q

Describe the HELP position for the general anesthetic C-section patient.

A

Head elevated laryngoscopy position

29
Q

Emergent C-sections carry a high risk of

A

recall

30
Q

Volatile agents reduce

A

uterine contractility, but be sure to use enough agents to produce amnesia

31
Q

The risk of neonatal acidosis increases when the time between uterine incision and delivery

A

exceeds 3 minutes

32
Q

How should C-section patients be extubated?

A

fully awake!
still considered a full stomach and is at risk for airway obstruction

33
Q

Sodium citrate is used to

A

neutralize gastric acid

34
Q

H2 receptor antagonist (ranitidine) is used to

A

reduce gastric acid secretion

35
Q

Gastrokinetic agents (metoclopramide) is used to

A

hasten gastric emptying and increase LES tone

36
Q

With succinylcholine, pregnancy reduces the risk of

A

myalgia

37
Q

Describe the induction doses of propofol, etomidate, and ketamine for the C-section general anesthetic patient.

A

propofol 2-2.5 mg/kg
etomidate 0.3 mg/kg
ketamine 1 mg/kg

38
Q

Consider the use of ________ & ______ after the baby is delivered for general anesthesia for C-section.

A

opioid and benzodiazepine

39
Q

Normal amniotic fluid volume is ______, so keep this in mind when assessing blood loss for C-section.

A

700 mL

40
Q

Describe the concentration of anesthetic gases to use for general anesthesia for a C-section

A

low concentration of volatile agent (0.8 MAC) + 50% nitrous oxide

41
Q

List the 3 benefits of a GA during a c-section.

A

speed of onset
secure airway
greater hemodynamic stability

42
Q

An obstetric patient at 33-weeks gestation requires a laparoscopic appendectomy. What drug presents the GREATEST risk to fetal well-being?
A. ketorolac
B. succinylcholine
C. Propofol
D. Morphine

A

A.- after the first trimester, NSAIDs can close the ductus arteriosus

43
Q

Approximately _____ of parturients undergo non-obstetric procedures involving anesthesia each year.

A

2%

44
Q

The most significant maternal risks for non-obstetric surgery during pregnancy include

A

difficult intubation & aspiration

45
Q

The best time for surgery for the pregnant patient is

A

ideally 2-6 weeks after delivery
otherwise- second semester

46
Q

_______ is linked to congenital defects in animal studies, but many practitioners avoid _____ altogether during the first two trimesters.

A

Nitrous oxide

47
Q

The most significant fetal risks for non-obstetric surgery during pregnancy include

A

growth restriction
low birth weight
demise
increased incidence of preterm labor

48
Q

The highest incidence of preterm labor in the non-obstetric parturient surgical patient is

A

intraabdominal and pelvic surgery

49
Q

Iatrogenic hyperventilation reduces

A

placental blood flow (risk of fetal asphyxia)

50
Q

Avoid ______ after the first trimester, as they potentially close the ductus arteriosus.

A

NSAIDs

51
Q

At approximately _______, pregnant patients are considered a “full stomach”.

A

18-20 weeks gestation

52
Q

Teratogenicity can occur at any time during pregnancy, however, the risk is highest during

A

organogenesis (day 13-60)

53
Q

Normal maternal PaCo2 is

A

~30 mmHg

54
Q

Anesthesia and surgery do not increase the incidence of

A

congenital anomalies

55
Q

What drugs have a long track record of safety for the parturient patient?

A

opioids
inhalational agents
all muscle relaxants
thiopental

Apex Review (224 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions