OB (1/10)

Question 1

what are the different hormones involved in changes to mom with pregnancy

Answer 1

1. relaxin
2. progesterone
3. cortisone
4. estrogen
5. endorphins
6. prostaglandins

Question 2

during pregnancy the heart moves _______ and to the _____________

Answer 2

up; left

Question 3

what is normal CO during pregnancy

Answer 3

6-12 L/min

Question 4

during pregnancy CO increases by ___________%

Answer 4

50

Question 5

HR during pregnancy increases by about _____%

Answer 5

25

Question 5

BP during pregnancy may decrease except with _________________

Answer 5

htn

Question 5

SVR is decreased by _________ % during pregnancy

Answer 5

20

Question 6

what hormones are responsible for the decrease in SVR during pregnancy

Answer 6

1. prostacyclines
2. estrogen
3. progesterone

Question 7

during pregnancy what CV parameters increase?

Answer 7

1. CO
2. HR
3. contractility
4. blood volume
5. SV

Question 8

T/F: pregnancy causes a high vascular resistance system

Answer 8

false; low vascular resistance system

Question 9

why does SVR decrease during pregnancy

Answer 9

due to low vascular resistance system 2/2 vasodilation that gets blood to the utuerus for adequate blood flow.

Question 10

normal blood volume of 150 lb, non-pregnant pt = ___________

blood volume in this pt who is pregnant at term will ___________ by 1-1.5L

Answer 10

4.7; increase

Question 11

T/F: hgb decreases with increased blood volume in pregnancy

Answer 11

false; RBC/hgb increases by 30% but the plasma volume increases by 50% and that why you may see dilutional anemia

Question 12

CO during pregnancy starts to increase at ____________ weeks

Answer 12

5

Question 13

when is CO the greatest during pregnancy

Answer 13

right at delivery, CO increases up to 80%

Question 14

CO reaches 50% increase mark in the ___________ trimester, and is due to increased _________ stimulated by __________

Answer 14

2nd; SV; estrogen

Question 15

LV mass of the heart increases by ______% between the 1st and 3rd trimesters

Answer 15

23

Question 16

there is a ______________ shift in the oxyhgb dissocation curve with pregnancy

Answer 16

right

Question 17

during labor, CO increases by _____% in the first stage of labor; _____% in the late first stage of labor, and ____% in the second stage of labor

Answer 17

10; 25; 40

Question 18

T/F: giving a pregnant pt an epidural will suppress the SNS stimulation and increase in CO during labor

Answer 18

true

Question 19

during a uterine contraction __________ mL of blood is displaced from the intervillous space of the placenta to maternal central circulation = _______________

Answer 19

300-500; autotransfusion

Question 20

a woman is in labor laying in the supine position, you come in and she is c/o N/V & dizziness, she looks pale, diaphoretic, and pallor, & hypotensive what do you think is going on/what is the intervention?

Answer 20

aortal/inferior vena caval compression; compression of vessels –> transient decrease in CO from decrease in venous return

fix: left uterine displacement (placing wedge under the right hip)

Question 21

when is a mom particularly sensitive to aortal/inferior vena caval compression when close to labor?

Answer 21

after epidural block

Question 22

pregnant mom goes into cardiac arrest while on the OR table; baby is still utero what position change should you do while doing compressions

Answer 22

left uterine displacement (wedge under right hip)

Question 23

mom is term and is sitting up in the bed; what vessel is a risk of occlusion

Answer 23

femoral

Question 24

if mom is term and sitting up --> s/sx of hypotension, diaphoresis, N/V how do you intervene

Answer 24

she is possibly occluded femorally, put head down and do left uterine displacement

Question 25

TV & Mv during pregnancy increases by _______%

Answer 25

45

Question 26

what hormone causes an increase in minute ventilation during pregnancy

Answer 26

progesterone

Question 27

FRC is _________ by 20% during pregnancy

Answer 27

decreased

Question 28

O2 consumption increases by _________% during pregnancy

Answer 28

50

Question 29

why do pregnant women drop their O2 saturation so fast during pregnancy?

Answer 29

decrease FRC and increased O2 consumption

Question 30

progesterone causes what respiratory changes during pregnancy

Answer 30

1. bronchodilation 2. increased minute ventilation

Question 31

hypoxic ventilatory response during pregnancy is _______x the normal level

Answer 31

2 (this is a protective mechanism in the pregnant pt)

Question 32

what respiratory parameters are increased during pregnancy

Answer 32

1. inspiratory reserve volume 2. Tidal volume 3. inspiratory capacity 4. dead space 5. minute ventilation 6. alveolar ventilation

Question 33

what respiratory parameters decrease during pregnancy

Answer 33

1. expiratory reserve volume 2. residual volume 3. functional residual capacity 4. total lung capacity

Question 34

T/F: the pregnant pt in surgery, the EtCO2 is assumed to be about 5 < than PaCO2

Answer 34

false; during pregnancy EtCO2 is assumed to = PaCO2

Question 35

what parameter during surgery of the pregnant pt predicts the degree of maternal hyperventilation and an be used to avoid uterine vasoconstriction induced by hypocarbia

Answer 35

EtCO2

Question 36

if you have to intubate a pregnant woman at term, what are the risks

Answer 36

1. trauma 2. bleeding 3. obstruction 4. difficult DL (d/t arytenoid and VC edema)

Question 37

T/F: you should avoid nasal airways in the pregnant pt at term

Answer 37

true - increased risk of bleeding

Question 38

pregnant women are in a mild state of _________________ (respiratory or metabolic acidosis or alkalosis)

Answer 38

respiratory alkalosis (d/t increased Mv --> more CO2 blown off by mom)

Question 39

what hormone drives the change in CO2 in the pregnant pt

Answer 39

progesterone

Question 40

changes to Mv in stages of labor: 1st stage = ___________ 2nd stage = ____________

Answer 40

1. 1st stage = 70-140% increase Mv 2. second stage of labor Mv increases 120-200%

Question 41

during labor PaO2 may ___________ by _______ mmHg

Answer 41

decrease; 10 - 15

Question 42

in the first stage of labor O2 consumption increases by _____% and increases by _____% in the second stage of labor

Answer 42

40; 75

Question 43

T/F: during labor maternal aerobic requirement for Oxygen > oxygen consumption

Answer 43

true

Question 44

what helps with the respiratory changes (increased Mv, decreased PaO2, increased O2 consumption) during labor?

Answer 44

epidural and adequate pain control

Question 45

FRC ___________ after delivery, but remains ___________ pre-pregnancy level for _______ weeks

Answer 45

increases; lower; 1-2

Question 46

O2 consumption, Tv, and Mv remain elevated after birth for ___________ weeks

Answer 46

6-8

Question 47

what two factors cause physiologic anemia for pregnancy

Answer 47

1. maternal plasma volume increases 50% by 34 weeks 2. increase in maternal plasma volume exceeds RBC volume increase

Question 48

plasma volume increases from 49 mL/kg up to __________ mL/kg during pregnancy

Answer 48

67