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Complex care 2 > Module 6 > Flashcards

Module 6 Flashcards

1
Q

surgery and trauma cases

A
  • Appendectomy, cholecystectomy, Bartholins’s cysts
  • Motor vehicle accidents, DV and other trauma
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2
Q

basic and advanced life support
left lateral position

A

use a wedge to avoid vena caval compression and improve cardiac output and venous return. Ensure the direction of compressions remains perpendicular when a tilt is used

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3
Q

basic and advanced life support oxygen

A

due to increased risk if hypoxia during pregnancy high flow oxygen (100%) is required whenever ventilation is assisted

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4
Q

basic and advanced life support stablising airway

A

take care as the risk of aspiration during resus is more likely due to increased gastric emptying/decreased motility and relaxation of the cardiac sphincter

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5
Q

basic and advanced life support drugs

A

consider increased drug dosages during resus if the standard dosages do not have desired effects due to the increased maternal fluid volume

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6
Q

basic and advanced life support blood volume

A

restore circulating blood volume, blood products, these may improve oxygen delivery to vital organs

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7
Q

basic and advanced life support surgery

A

if >20 weeks gestation and resus is not successful within 5 mins a perimortem caesarean section is advocated to assist with resus of the mother

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8
Q

top causes of maternal death

A
  • Complications of pre-existing CV disease
  • Sepsis
  • Non-obstetric haemorrhage (brain, ruptured aneurysm)
  • Thromboembolism
  • Obstetric haemorrhage
  • Amniotic fluid embolism
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9
Q

preventing maternal mortality

A
  • If a midwife is unhappy with a medical opinion then they should consult a more senior doctor and seek support
  • Poor communication
  • Inadequate documentation
  • Failure to perform observations
  • Failure to act when a woman reported feeling unwell
  • Failure to visit or revisit during the postnatal period
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10
Q

red flags (signs and symptoms) BP

A
  • Systolic over 160
  • Systolic under 90
  • Diastolic over 80
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11
Q

red flags (signs and symptoms) sepsis

A
  • Sore throat
  • Pyrexia >38 degrees
  • Sustained tachycardia >100bpm
  • Breathlessness (rr >20)
  • Abdominal or chest pain
  • Diarrhoea and/or vomiting
  • Reduced or absent fetal movements
  • Reduced or absent fetal heart
  • SROM or vaginal discharge
  • Uterine or renal angle pain and tenderness
  • Generally unwell, unduly anxious or panicking
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12
Q

red flags (signs and symptoms) breathlessness

A
  • Sudden onset
  • Associated with chest pain
  • Orthopnoea (severe difficulty in breathing)
  • Paroxysmal nocturnal dyspnoea
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13
Q

red flags (signs and symptoms) headache

A
  • Sudden onset
  • Neck stiffness
  • Abnormal signs on neurological exam
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14
Q

red flags (signs and symptoms) mental health

A
  • Ideas of suicide
  • Marked change from normal functioning
  • Mental health deterioration
  • Persistent symptoms in late pregnancy or 6 weeks pp
  • Panic attacks , obsessive thoughts
  • Morbid fears
  • Profound low mood or ideas
  • Personal or family history of serious affective disorder
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15
Q

referrals

A
  • Explain importance
  • Check that the woman has been seen
  • Remember referral is not treatment
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16
Q

FGM

A
  • Traditional practice that occurs in more than 40 countries
  • 130-140 million women and girls who have undergone some form of FGM
17
Q

classifications type 1

A

Excision of the prepuce, with or without excision of part or the entire clitoris

18
Q

classifications type 2

A

Excision of the clitoris with partial to total excision of the labia minora

19
Q

classifications type 3

A

Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening

20
Q

classifications type 4

A

Unclassified includes pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterisation by burning of the clitoris and surrounding tissue; scraping of the tissue surrounding the vagina

21
Q

Clitoridectomy

A

excision of the clitoris

22
Q

de-infibulation

A

surgical procedure to open up the closed vagina of type 3

23
Q

excision

A

removal of the clitoral hood, with or without removal of part or all of the clitoris

24
Q

FGM

A

comprises all procedures involving partial or total removal of the external genitalia or other injury to the female genital organs for non-medical reasons

25
Q

re-infibulation

A

re-suturing of FGM type 3 to re-close the vagina again after childbirth

26
Q

sunna

A

traditional name – removal of the prepuce of the clitoris only

27
Q

legal implications (legislation)

A

The crimes (femal genital mutilation) amendment act 1994 (NSW)

28
Q

legal implications FGM A person cannot:

A
  • Excise, infibulate or mutilate the whole or any part of the labia minora or labia majora or clitoris of another person
  • Aid, abet, counsel or procure a person to perform any of those acts on another person.
29
Q

legal implications FGM this means that it is against the law for non-therapeutic purposes to:

A
  • Circumcise a woman, girl or female baby.
  • Remove or cut out any part of the female genital area (‘excise’).
  • Stitch up (close) the labia majora or labia minora of the female genitalia (infibulation). Whilst it is undesirable and should under no circumstances be supported or recommended its absolute illegality is not entirely clear as legislation varies between jurisdictions.
  • Cut the clitoris or part of the clitoris.
  • Damage the female genital area in other ways.
30
Q

referral for antenatal de-fibulation

A
  • Recommended 20-28 weeks
  • Difficulty with catheterisation and fetal blood sampling if not done
31
Q

implications for birth FGM

A
  • VE
  • Difficulty in applying FSE
  • Difficulty in performing fetal blood sampling
  • Catheterisation
  • Prolonged second stage of labour
  • Increased risk of perineal lacerations/tears
  • Increased need for episi
  • Haemorrhage
  • LSCS
32
Q

MANAGEMENT OF A TRAUMA EVENT IE CRASH

A

stabilize mum,
once stable consider fetal welfare, CTG
ANti D if neg blood gorup

Complex care 2 (9 decks)

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