ECare - Chapter 32 (Obstetric & Gynecologic) Flashcards
(66 cards)
1
Q
labia
A
soft tissues that protect the entrance to the vagina
2
Q
perineum
A
surface area between vagina and anus
3
Q
mons pubis
A
soft tissue covering pubic symphysis; where hair grows
4
Q
vagina
A
birth canal
5
Q
ovary
A
female reproductive organ that produces ova
6
Q
fallopian tubes
A
narrow tube that connects ovary to uterus
7
Q
ectopic pregnancy
A
ovum implants in the fallopian tubes
8
Q
uterus
A
muscular abdominal organ where fetus develops (womb)
9
Q
cervix
A
neck of uterus at entrance of birth canal; constricts in non-pregnant women, dilates to push baby out
10
Q
ovulation
A
phase in reproductive cycle where ovum is released from ovary
11
Q
embryo
A
baby from fertilization to 8 weeks
12
Q
fetus
A
8 weeks to birth
13
Q
placenta
A
organ where exchange of oxygen, nutrients, and wastes occurs between mom and fetus
14
Q
umbilical cord
A
fetal structure that has vessels carrying blood to/from placenta
15
Q
amniotic sac
A
“bag of waters: surrounding developing fetus
16
Q
supine hypotensive syndrome
A
dizziness and drop in BP caused by mom in supine position and weight of infant, etc compressing inferior vena cava reducing return of blood to heart and CO
17
Q
transporting moms in 3rd trimester
A
must transport on left side!
18
Q
first stage of labor
A
regular contractions, thinning, and dilation of cervix; ends when cervix is fully dilated
19
Q
second stage of labor
A
baby enters birth canal
20
Q
third stage of labor
A
baby is born; lasts until afterbirth (other materials are delivered)
21
Q
Braxton-Hicks contractions
A
irregular prelabor contractions of the uterus
22
Q
lightening
A
sensation of fetus moving from high in the abdomen to low in birth canal
23
Q
labor pains
A
contraction time or duration: time from beginning of contraction to when uterus relaxes
contraction interval or frequency: time from one contraction to the next (start to start)
24
Q
contractions: delivery of baby
A
duration: 30 -60seconds
frequency: 2-3 minutes
25
meconium staining
green/brownish-yellowish amniotic fluid due to fetal defecation; indicated maternal or fetal distress
26
patient assessment: pregnant woman about to go into labor
1. name, age, expected due date
2. is this your first pregnancy?
3. Have you seen a doctor regarding your pregnancy? (important for multiple gestations, complications, etc).
4. When did labor pains begin? and how often? Did your water break? Any bleeding?
5. Do you feel the urge to push as if you need to move your bowels?
6. Examine for crowning
7. Feel for uterine contractions
8. Vitals
27
crowning
part of baby is visible
28
cephalic presentation
baby appears headfirst (normal)
29
Patient Assessment: Neonatal Resuscitation
no prior prenatal care, premature delivery, labor induced by trauma, multiple births, history of pregnancy problems, labor induced by drug use, meconium staining with water breaking
30
preparing mom for delivery
1. control scene
2. PPE (ex. surgical gloves)
3. put mother in position: elevate butt with cushion, knees drawn up and spread apart
4. remove clothes from vaginal opening and cover mom with clean sheets
5. position someone at mom's head (in case she vomits)
6. make environment as warm as possible
31
delivering the baby
ALWAYS HAVE ONE HAND ON BABY'S HEAD
1. spread hands above and below the baby's head for support
2. one hand should have towel to support tissue between vagina and anus to prevent tearing
3. puncture amniotic sac if not broken by time of delivery
4. be prepared to suction if meconium is present
5. unwrap umbilical cord is wrapped around neck; if can't, clamp cord between two places and cut in between
6. guide head upwards to lower shoulder is hard to devlier
7. once delivered, lay baby on side with head lower; keep baby at same level of mom's vagina until umbilical cord is cut
8. assess airway ; suction if needed by using bulb (mouth first then nose)
32
neonate
newly born baby (less than one month)
33
AGPAR score
appearance, pulse, grimace, activity, respiratory
normal for hands and feet to be blue
34
neonate care
dry baby (dont wash), keep head covered, allow for breastfeeding
35
cutting the cord
around the neck, impedes resuscitation efforts, interferes with urgent transport, protocols
cut it after 1 minute of birth; dont cut if still pulsating
36
umbilical cord care
1. clamp cord 10 inches and 7 inches from baby
2. clamp again if bleeding continues
3. no clamps? clean shoelaces; no scissors? dip in alcohol
4. wrap placenta in towel and place on same level as baby
37
initial care for neonate
1. warm baby
2. assess airway (suction if needed)
3. check breathing, if not adequate, rub baby's back or flick at foot
4. assess heart rate; if less than 100 bpm, ventilate at rate of 40-60/min; if less than 60 bpm, 120 compression/min
38
care for mother
deliver the placenta, control vaginal bleeding, make her comfy
39
delivering the placenta
usually right after birth and indicated by labor pains; if not delivered after 20 minutes, transport
40
controlling vaginal bleeding after birth
1. place sanitary napkin over vaginal opening
2. help mom lower leg and knees together
3. massage uterus (grapefruit-size object on abdomen)
4. mom should nurse baby
41
breech presentation
baby's butt or leg appears first during birth
42
patient care: breech presentation
1. rapid transport
2. don't pull on legs
3. high concentration oxygen
4. place mom head down with pelvis elevated
5. if body delivers, support it and prevent explosive delivery
6. make a V with your fingers and put it into the vagina in case baby starts to spontaneously breathe
43
limb presentation
infant's limb protrudes from vagina first
44
patient care: limb presentation
1. care for prolapsed cord
2. push up on baby until seen by physician
3. transport
4. mom in head down pelvis up position
5. oxygen
45
prolapsed umbilical cord
umbilical cord is presented first
46
patient care: prolapsed umbilical cord
1. mom in head down pelvis first position
2. oxygen to mom
3. check cord for pulse, wrap cord to keep warm
4. put fingers inside vagina to lift head off cord
5. transport as a unit
47
patient care: multiple births
1. clamp cord of first baby before second baby
2. second baby can be born before or after delivery of placenta
3. keep them warm
48
premature birth
baby is born less than 5.5 pounds OR born before 37th week
49
patient care: premature birth
1. keep baby warm
2. keep airway clear
3. ventilations/chest compressions if necessary
4. check umbilical cord for bleeding
5. transport
50
patient care: meconium
1. suction
2. stimulate infant
3. maintain open airway
4. ventilations and chest compressions if needed
5. transport
51
placenta previa
placenta is in weird location; can't delivery fetus and causes prebirth bleeding
52
abruptio placentae
placenta separates from uterine wall; causes prebirth bledding
53
patient care: excessive prebirth bleeding
1. if shock, give oxygen and transport
2. sanitary napkin over vaginal opening and note time
3. save all tissue that passes and the blood soaked pads
54
ectopic pregnancy
implantation of fertilized egg is not in uterus
55
patient care: ectopic pregnancy
1. consider transport
2. position pt for shock
3. care for shock
4. oxygen via nonrebreather
5. nothing by mout
56
eclampsia
complication of pregnancy causing seizure and coma
57
preeclampsia
complication of pregnancy where mom retains fluid and has hypertension
58
patient care: seizures in pregnancy
1. open airway
2. oxygen via nonrebreather
3. transport on left side
4. keep pt warm
5. suction if needed
6. ALS
59
spontaneous abortion (miscarriage)
fetus and placenta delivers before week 28
60
patient care: miscarriage and abortion
1. vitals
2. if shock, oxygen via NRM
3. sanitary napkin over vaginal opening
4. transport
5. save blood soaked pads
6. save tissues expelled
61
patient care: trauma in pregnancy
1. resuscitation if needed
2. oxygen via NRM
3. suction if needed
4. control external hemorrhage
5. transport
62
patient care: stillborn
1. no resuscitation if baby had obviously died
2. if in pulmonary or cardiac, full resuscitation measures
3. life support if needed
63
resuscitation in 20 week+ pregnant woman
displace uterus by two hands on abdomen and move it to the left OR tilt backboard 30 degrees
1-2 in higher on sternum
consider early transport esp if witnessed
64
patient care: vaginal bleeding
1. PPE
2. adequate airway
3. signs of shock
4. oxygen by NRM
5. transport
65
patient care: trauma to external genitalia
1. control bleeding with direct pressure over bulky dressing; dont remove undergarments unless necessary
2. treat for shock
66
patient care: sexual assault
1. treat immediate life threats
2. don't disturb criminal evidence
3. examine genitals only if severe bleeding
4. do not move items on scene
5. discourage pt from bathing, voiding, or cleansing wounds
6. document carefully
7. social services
