Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Mar: Sem 5 - Adv. Principles A > Exam 3: Labor Anesthesia & Analgesia Pt. 1 > Flashcards

Exam 3: Labor Anesthesia & Analgesia Pt. 1 Flashcards

(61 cards)

Start Studying
1
Q

What does SROM stand for?

A

Spontaneous Rupture of Membranes

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

What does AROM stand for?

A

Artificial Rupture of Membranes

Also known as Amniotomy - the OB provider artifically breaks the water

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

Is OA or OP preferred for delivery?

A

OA (Baby’s Occiput Anterior)

OA: Back of the baby’s head is facing anterior - best way to deliver.
OP: another way to phrase = “sunny-side-up” (baby is facing up)

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

What is CLE, DPE, and CSE?

A

Continuous labor epidural
Dural Puncture Epidural
Combined spinal epidural

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

What do the expanded numbers for the Gs and Ps mean?

A

numbers after the P:
- How many term
- how many preterm
- how many abortions
- how many living children

i.e. G2P0101
2 pregnancies, P: (0 term) (1preterm) (0 abortions) (1 living child)

Theodore Please Absorb Lichens

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

Once the amniotic sac ruptures, you should give birth within ____ hours becasue the risk for infection increases substantially

A

12 hours

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

What is the first stage of labor called?

A

Latent phase and active phase (1a and 1b)

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

How long will the first stage of labor last for a woman having her first baby?

A

If Primiparous, 8 - 12 hours typically.

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

How long will the first stage of labor last for a woman having already had a child before?

A

If Multiparous, 5 - 8 hours typically.

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

What three things characterize the Latent phase of the first stage of labor?

A
  • Cervical Effacement
  • Minor (2-4cm) cervical dilation
  • Contractions q5-7 min w/ 30 sec duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What characterizes the active phase of the first stage of labor?

A
  • Cervical dilation ramps up to 10cm
  • Contractions q2-5min w/ 50-70sec duration

the woman cannot start pushing until the cervix is complete (10cm)

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

How long does the 2ⁿᵈ stage of labor last?

A

Typically 15 - 120 min

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

What characterizes the 2ⁿᵈ stage of labor?

A
  • Full (10cm) cervical dilation
  • Contractions q 2min w/ 60-90s duration
  • Fetal Descent
  • Ends with Delivery of fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The 2ⁿᵈ stage of labor is considered prolonged if it lasts more than….

A

3 - 4 hours

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

What can cause prolonged 2nd stage of labor?

A

Cephalopelvic disproportion (large head)

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

Risks of prolonged 2nd stage of labor

A
  • risk of fetal trauma
  • severe umbilical cord compression possible
  • maternal trauma (physical and emotional)
  • increased risk for postpartum hemorrhage
  • increased risk for infection
  • increased admission to NICU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long does the 3rd stage of labor last?

A

15 - 30 min

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

When does the 3rd stage of labor begin and end?

A

Begins after fetal delivery, ends with the delivery of the placenta

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

The 3rd stage of labor is prolonged if it lasts more than ….

A

30 minutes

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

What is the 4th stage of labor?

A

1st hour postpartum

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

In what stage of labor is the highest risk of uterine atony and post-partum hemorrhage present?

A

4th stage

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

What are some reasons labor pain varies to each individual?

A
  • Complex type of pain
  • has genetic influence
  • can be because of pelvic siize and shape
  • can be d/t fetal presentation
  • could be d/t natural labor vs induction of labor vs augmented labor

most women c/o severe pain during contraction and with pushing

women say augmented labor with pitocin is more painful earlier on

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

What causes pain via mechanoreceptor stimulation in the 1st stage of labor?

A

Stretching and distention of lower uterine segment and cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What causes the visceral pain associated with the 1st stage of labor?

A

Small, unmyelinated C-fibers entering spinal cord at T10 - L1

difficult to treat with opioids because of the diffuse nature, but these fibers can be blocked!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What spinal levels are primarily affected during the latent phase of the 1st stage of labor?
T10 - T12
26
What spinal levels are primarily affected during the active phase of the 1st stage of labor?
T12 - L1
27
What type of pain becomes more predominant in the 2ⁿᵈ stage of labor? What are the characteristics of this pain?
Somatic Pain is more prominent (visceral pain is still there though) - Sharp, easily localized - Caused by stretching & compression of pelvic/perineal structures
28
What type of nerve fibers are responsible for the somatic pain characteristic of the 2ⁿᵈ stage of labor?
Aδ fibers of the pudendal nerve
29
What spinal levels are relevant to the somatic pain associated with the 2ⁿᵈ stage of labor?
T12 - S4
30
What non-pharmacological modality could help with labor pain management?
Intradermal sterile water injections - inject water under the dermus - gate control theory (releasing endorphines) - physical distraction ## Footnote creates a noxious stimuli to distract the body
31
What inhaled anesthetic can a patient use to "self-anesthetize"?
N₂O
32
What receptors does N₂O work on?
- Inhibits: NMDA glutamate - Stimulates: dopaminergic, opioid, and α 1 and 2
33
How much does N₂O depress uterine contractility?
Trick question. It does not.
34
Does N₂O causes neonatal depression?
No
35
What nerve block is often used in conjunction with N₂O ?
Pudendal nerve block
36
What are adverse effects associated with N₂O?
N/V, Dizziness, Paresthesias, Xerostomia
37
Combination of N₂O and ____ can result in hypoxia, LOC changes, and loss of airway reflexes.
Opioids
38
Volatile anesthetic agents will cause uterine smooth muscle ____ in a dose-dependent modality.
relaxation
39
Preeclampsia and hypertension prevent this use of this drug.
Ketamine
40
What is the obstetric dose of ketamine?
0.2 - 0.5 mg/kg
41
What is the IV onset & duration of ketamine?
Onset: 30 seconds Duration: 5-10 min
42
What is the IM onset & duration of ketamine?
Onset: 2-8 min Duration: 10 - 20 min
43
What is the ketamine infusion loading dose and rate?
Loading: 0.2 mg/kg (over 30 min) Infusion: 0.2 mg/kg/hr
44
What are the neonatal consequences of benzodiazepines?
- Neonatal respiratory depression - Neonatal hypotonicity - Neonatal impaired thermoregulation ## Footnote usually give benzos after the baby is born
45
What is the IM dose of meperidine?
50 - 100mg IM q4hours
46
What is the IV dose of Meperidine?
12.5-25 mg IV q2-4 hours
47
What is the weight based dose of IV morphine?
0.05 - 0.1 mg/kg IV
48
What is the weight based dosing of IM morphine?
0.1 - 0.2 mg/kg IM
49
What is the active metabolite of morphine than can accumulate in the neonate?
Morphine-6-glucuronide
50
What is the PCA dosing of remifentanil?
20 - 40mcg (lockout of 2-3 min)
51
What is the IV/IM dose of butorphanol?
1-2mg IV/IM q3-4 hours ## Footnote Most common OB med b/c there is less side effects to fetus and mom
52
What is the dose of nalbuphine?
5 - 20 mg IV/IM/SQ
53
What opioid can result in significant fetal bradycardia?
Nalbuphine
54
Why is toradol typically not used in labor?
- Suppresses uterine contractions - Premature constriction of fetal DA - Inhibits PLT aggregation | Pregnancy Unravels....Duh
55
What nerve block is typically provided by the OBGYN during the 1st stage of labor?
Paracervical Block - goal is the block transmission through the paracervical ganglion (actual cervix, not neck lol)
56
What are the two fetal complications that can occur with paracervical block?
Fetal LAST (more severe) Fetal Bradycardia (more common) *Risk of paracervical injection into fetal scalp*
57
What nerve block is an alternative to pharmacologic pain management in the 2ⁿᵈ stage of labor?
Pudendal nerve block
58
Side effects and risks of pudendal nerve block
- minimizes urge to push - risk of injection into pudendal artery (LAST risk) - fetal trauma or injection of LA risk
59
What form of anesthesia covers both 1st and 2ⁿᵈ stage of labor?
Neuraxial
60
Epidural veins are decompressed in what position?
Lateral lying *Harder to place*.
61
Why is there an increase for cephalad spread of neuraxial LA in pregnant patients?
Due to apex of thoracic curvature shifting from T8 to T6. *Also from epidural vein engorgement*.

Mar: Sem 5 - Adv. Principles A (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions