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EMT Section 6 > Ch 36 Obstretric And Gynecologic Emergencies > Flashcards

Ch 36 Obstretric And Gynecologic Emergencies Flashcards

1
Q

External genitalia

A

Labia (soft tissues protecting entrance of birth canal)
Perineum (soft tissue between vaginal opening and anus)
Mons pubis (area where pubic hair grows)

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2
Q

Internal genitalia

A

Vagina (connects uterus to outside)
Ovaries
Fallopian tubes
Uterus (located along midline of lower quadrant)

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3
Q

Cervix

A

Muscle separating uterus and vagina

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4
Q

Embryo

A

Ovum becomes this once combined with sperm

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5
Q

Embryonic stage

A

Fertilization to eight weeks

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6
Q

Fetal stage

A

After eight weeks, fetus will develop over next 32 weeks

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7
Q

First trimester

A

Three months, fetus is being formed

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8
Q

Placenta

A

Organ composed of maternal and fetal tissues
Exchange area between maternal and fetal blood

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9
Q

Umbilical cord

A

Blood from fetus sent through here to the placenta where, diffusion, blood picks up nutrient from mother and offloads waste
One vein
Two arteries

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10
Q

Amniotic sac

A

Float
Cushion
Maintain temp

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11
Q

Cardiovascular changes in pregnancy

A

Increase blood volume, cardiac output, and heart rate
But number of red cells remain, anemia
BP slightly decreased
Increase in uterus vascularity

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12
Q

All third trimester patients

A

Transported on left side

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13
Q

First stage of labor (dilation period)

A

Starts with regular contractions and thinning and gradual dilation of cervix
Ends when cervix is fully dilated

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14
Q

Second stage of labor

A

Starts when baby enters birth canal and lasts until baby is born

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15
Q

Third stage of labor

A

Begins after baby is born and lasts until afterbirth (placenta, cord, tissues from amniotic sac, uterus lining) is delivered

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16
Q

Lightening

A

Fetus moving down toward birth canal
Can occur well before labor or indicate beginning of labor

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17
Q

Contraction times

A

Begins 30 min apart
Near delivery is 3 min apart or less

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18
Q

Contraction time

A

Time from beginning of contraction to end

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19
Q

Contraction interval or frequency

A

Start of contraction to beginning of the next

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20
Q

Contractions imminent delivery

A

30sec-1 min duration
2-3 min apart

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21
Q

Bloody show

A

Watery, bloody discharge of mucus from mucous plug (typical) first stage of labor

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22
Q

Pt assessment questions for pregnancy

A

Due date
If this is her first pregnancy
If she has seen a doctor for pregnancy

Transport questions:
When labor pains started
If water broke or bloody show
If she feels urge for bowel movement
Examine for crowning
Take vitals

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23
Q

Transporting mother

A

If no delivery after 10 min, contact MD again
Transport unless delivery is imminent

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24
Q

Indications for neonatal rescucitation

A

No prenatal care
Premature delivery
Labor induced by trauma or medical conditions
Multiple births
History of pregnancy problems
Meconium staining with water breaking

25
Q

Delivery position

A

Floor, bed, or ambulance stretcher
Elevate buttocks with pillow
2 ft workspace below buttocks
Assistant at mother’s head

26
Q

Prevent explosive delivery

A

One hand to maintain slight pressure on baby’s head
Hand below head as it delivers

27
Q

Meconium present

A

Prepare to suction neonate

28
Q

Assist with shoulders

A

Downward to birth upper shoulder
Guide upwards to birth lower shoulder

29
Q

After baby is delivered

A

Lay on side with head lower than body
Same level as mother’s vagina until cord stops pulsating

30
Q

Suctioning baby

A

If baby is not moving or breathing or if airway is obstructed
Suction mouth then nose
1-1 1/2 inches into mouth
1/2 inch into nostril

31
Q

Birth written info

A

Mothers last name
Time of delivery
Location

32
Q

Neonate

A

Less than 1 month old

33
Q

APGAR appearance

A

0 blue or pale all over
1 extremities blue
2 pink all over

34
Q

APGAR pulse

A

0 0
1 less than 100
2 greater than 100

35
Q

Grimace

A

0 no reaction
1 facial grimace
2 sneeze cough or cry

36
Q

Activity

A

0 no movement
1 only slight activity extremities flex
2 moving around normally

37
Q

Respiratory effort

A

0 none
1 slow or irregular breathing weak cry
2 good breathing, strong cry

38
Q

Cutting cord

A

No sooner than 30-60 seconds after birth
Don’t cut cord still pulsating unless complicated
One clamp 10 inches from baby, another 7 inches
Never unclamp a cut cord
Placenta end of cord placed on drape

39
Q

If transporting baby and placenta attached

A

Placenta at same level of baby or higher

40
Q

Central cyanoises but otherwise fine

A

Blow by oxygen

41
Q

When to resuscitate neonate

A

If no breathing after 30 seconds of drying and warming
If heart rate less than 100
30 sec interventions and then assess again

42
Q

Not active or breathing

A

Stimulate for 30 sec

43
Q

Neonate pulse check

A

Auscultate or brachial or end of cord

44
Q

Neonate PPV rate

A

1 every three seconds
40-60 breaths/min

45
Q

When neonate chest compressions

A

Less than 60 bpm
Two thumbs encircling
1/3 depth of chest
3:1 ratio of compressions to breath

46
Q

Waiting for placenta to deliver

A

Transportation can be delayed up to 20 min with good conditions

47
Q

Bleeding after birth usually

A

No more than 2 cups (500 cc)

48
Q

Breech presentation

A

Initiate Rapid transport in case
High concentration oxygen
Head down position with legs elevated

49
Q

Limb presentation

A

Immediate transport
Head down position with pelvis elevated
Oxygen

50
Q

Prolapsed cord

A

Cord presents first
Position mother head down and pelvis raised with blanket or pillow
Check cord for pulse and wrap exposed cord with towel
Push up on baby’s head until physician relieves

51
Q

Multiple births

A

Clamp cord of first baby before second baby is born
Second may be delivered before or after placenta is delivered

52
Q

Premature infant

A

Less than 5 1/2 lb or 2 1/2 kg
Before 37 weeks

53
Q

Placenta previa

A

Placenta formed in abnormal location
Covering if implanted in an area blocking birth canal or over cervical opening
Occurs in third trimester, heavy bleeding, no abdominal pain

54
Q

Abruptio placentae

A

Placenta prematurely separates from wall
Often caused by trauma but also hypertension and drug use
Heavy bleeding with abdominal or back pain
Third trimester

55
Q

Ectopic pregnancy

A

Early on
Shock indications
Assume any woman with abdominal pain and/or bleeding to have this
Acute abdominal pain often beginning on one side
Rapid and weak pulse late
Low BP late

Treatment: do not give anything by mouth

56
Q

Seizures in pregnancy

A

Caused by eclampsia
Tend to occur late in pregnancy
Result of preeclampsia (pregnant retains large amounts of fluid and has hypertension)

Signs:
ALOC
Swollen extremities and face
High BP
Excessive weight gain

57
Q

Spontaneous abortion (miscarriage)

A

Fetus and placentas deliver before twenty weeks
Cramps
Moderate to severe bleeding
Noticeable discharge of tissue and blood
Prepare OB kit if more than 24 weeks

58
Q

Stillborn

A

Fetus dies in uterus

EMT Section 6 (2 decks)

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