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Flashcards in OB Deck (68):
1

Respiratory Changes:
would you anticipate the PaO2 to be higher in the pregnant or non pregnant state

Pregnant

2

Respiratory Changes:
Would you anticipate the PaCO2 to be higher in the pregnant or non-pregnant state

Non-Pregnant

3

Respiratory Changes:
the increase in O2 consumption produces a 70% increase in _____ _____ at term

Alveolar ventilation

4

Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the ____ will increase by 40%

tidal volume

5

Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the Tidal volume will increase by 40% and the _____ increases by 15%

respiratory rate 

6

Respiratory Changes:
the increase in O2 consumption produces a 70% increase in alveolar ventilation at term. the Tidal volume will increase by 40% and the respiratory rate  increases by 15% relenting the increase in what?

alveolar ventilation

7

Respiratory Changes:
the increase in alveolar ventilation and decrease in FRC enhance maternal uptake of what?

inhaled anesthestics

8

Respiratory Changes:

increased AV + decreased FRC = what w/ MAC

Decreased MAC

9

Changes in lung parameters: increase/ decrease/ NC:

Inspriatory reserve volume (IRV)

increase ( 5%)

10

Changes in lung parameters: increase/ decrease/ NC:

 

TV 

increase (45%)

11

Changes in lung parameters: increase/ decrease/ NC:

Expiratory reserve volume (ERV)

decrease (25%)

12

Changes in lung parameters: increase/ decrease/ NC:

 

Residual volume (RV)

decrease (15%)

13

Changes in lung parameters: increase/ decrease/ NC:

Inspiratory capacity (IC)

increase (15%)

IC = IRV + TV 

if IRV and TV increase obviously IC must increase

 

14

Changes in lung parameters: increase/ decrease/ NC:

FRC

decrease (20%)

FRC = ERV + RV

If ERV an dRV both decrease then obviously FRC must also decrease

15

Changes in lung parameters: increase/ decrease/ NC:

Vital Capacity (VC)

no change

VC= IRV + ERV + TV

16

Changes in lung parameters: increase/ decrease/ NC:

TLC

decrease (5%)

17

Changes in lung parameters: increase/ decrease/ NC:

Closing volume and Capacity

no change

18

Changes in lung parameters: increase/ decrease/ NC:

 

Deadspace

increase (45%)

19

Changes in lung parameters: increase/ decrease/ NC:

 

respiratory rate 

NC to INcrease (15%)

20

Changes in lung parameters: increase/ decrease/ NC:

Minute ventilation

increase (45%)

21

Changes in lung parameters: increase/ decrease/ NC:

alveolar ventilation

increase (45%)

22

Changes in lung parameters: increase/ decrease/ NC:

oxygen consumption

Increase (20%)

23

Respiratory changes: Anesthestic significance

why is airway management more challenging? (3 things)

 

  • weight and breast engorgement hinder laryngosocpy
  • Swollen mucose bleeds easily: avoid intranasal manipulation
  • use smaller ETT (swollen airway)

 

24

Respiratory changes: Anesthestic significance

 

what is their response to anesthestics?(4 things)

 

  • MAC decreased
  • Decreased FRC results in faster indution
  • Increased MV = faster induction
  • Rapid overdose with loss of airway reflexes

25

Respiratory changes: Anesthestic significance

3 reasons the prego is at greater risk for hypoxemia

  • Decreased FRC ( less O2 reserve)
  • Increased O2 consumption
  • Rapid airway obstruction

26

Respiratory changes: Anesthestic significance

excessive mechanical hyperventilation (ET CO2 < 24 mmHg) may do what to things

decrease maternal CO

decrease uterine blood flow 

27

Respiratory changes: Anesthestic significance

Maternal and fetal hypoxemia are associated with pain-induced hyper-hypoventilation and can be avoided how?

with analgesics

28

Cardiovascular Changes:
Does BLOOD VOLUME increase/ decrease/ No change?

 

Increase (35%)

29

Cardiovascular Changes:
Does PLASMA VOLUME increase/ decrease/ No change?

Increase (45%)

30

if blood volume increases why is the prego anemic?

b/c plasma volume increases more 

31

Cardiovascular Changes:
Does RBC VOLUME increase/ decrease/ No change?

increases (20%)

32

Cardiovascular Changes:
Does CO increase/ decrease/ No change?

increases (40%)

33

Cardiovascular Changes:
Does STROKE VOLUME increase/ decrease/ No change?

Increases (30%)

34

Cardiovascular Changes:
Does HEART RATE  increase/ decrease/ No change?

Increases (15%)

35

Cardiovascular Changes:
Does MAP increase/ decrease/ No change?

Decrease (15 mmHg)

36

Cardiovascular Changes:
Does SYSTOLIC BP increase/ decrease/ No change?

Decreses (0-15mmHg)

37

Cardiovascular Changes:
Does DIASTOLIC BP increase/ decrease/ No change?

Decreases (10-20mmHg)

38

Cardiovascular Changes:
Does CVP increase/ decrease/ No change?

No change

39

CV changes: Anesthetic Significance:

venodilation may increase the incidence of accidental what?

epudural vein punture

40

CV changes: Anesthetic Significance:

a healthy partutient will tolerate upto ____ mLs if blood loss, thus transfusions are rarely needed

1500mL's

41

CV changes: Anesthetic Significance:

the drug ___ with a free water IV infusion may lead to fluid overload?

oxytocin

42

CV changes: Anesthetic Significance:

High hgb level (<14) indicated low volume status caused by what ?

pre-eclampsia

HTN

inapropriate diuretics

43

CV changes: Anesthetic Significance:

____ reduces cardiac work during labor and may be benificial is some cardiac disease states

Epidural

44

CV changes: Anesthetic Significance:

maternal SBP of <___ to ____ during regional block should be of concern b it may associated w proportional decrease in uterine blood flow>

<90-95mmHg

45

Placenta Previa:

the first episode of bleeding is typically when? and there are NO contractions with bleeding

 

preterm

 

46

Placenta Previa:

onset of bleeding is not related to any particular event. ther is NO abdominal pain, painless vaginal bleeding during the ____ or _____ trimester

2nd or 3rd trimesters

47

Placenta Previa:

____ lying placenta previa increases the risk of excessive bleeding w/ C-section

anterior

48

Placenta Previa:

_____ and _____ are the treatment especially if the fetus is less than 37 weeks gestation

bedrest and observation

49

Placenta Previa:

what confirms diagnosis

US

50

Placenta Previa:

management is based on what 2 things

amount of vaginal bleeding 

maturity if fetus

51

Placenta Previa:

_______remains the most common cause of neonatal morbidity and motality, especially if bleeding begins before 20 weeks

Prematurity

52

Placenta Previa:

the incidence of _____ of the fetus is greatest in women with placenta previa

asymetric intrauterine growth restriction

53

Placenta Previa:/

the urgency for C-section is based on what

Maternal hypotension

54

Placenta Previa:

 

can you use either regional or general anesthesia

yes

55

Placenta Previa:

what type

Marginal

56

Placenta Previa:

what type

partial

57

Placenta Previa:

what type

Complete

58

Placental Abruption

what is it

separation of the placenta from the decisuas basalis before delivery of the fetus

59

Placental Abruption:

may have acute bleeding from the exposed ______ vessels, this usually accounts for a lot of blood

decidual vessels

60

Placental Abruption:

_____ results from loss of area for maternal-fetal gas exchange

fetal distress

61

Placental Abruption:

Fetal distress signals what?

general C-section

62

Placental Abruption:

what is the classic presentation

painful vaginal bleeding

63

Placental Abruption:

what is teh definative treatment?

delivery of fetus and placenta

64

Placental Abruption:

any concerns with ____ or _____ = no epidural

volume 

coasgulation studies

65

Placental Abruption:

agressive volume resuscitation w/___ or ____

 colliod or crytalloid 

66

Placental Abruption:

what tyoe is this

 

Marginal

67

Placental Abruption:

What type is this

partial

68

Placental Abruption:

what type is this?

Complete