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OB Flashcards

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1
Q

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

A

Pregnant

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2
Q

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

A

Non-Pregnant

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3
Q

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

A

Alveolar ventilation

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4
Q

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

A

tidal volume

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5
Q

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%

A

respiratory rate

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6
Q

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?

A

alveolar ventilation

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7
Q

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

A

inhaled anesthestics

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8
Q

Respiratory Changes:

increased AV + decreased FRC = what w/ MAC

A

Decreased MAC

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9
Q

Changes in lung parameters: increase/ decrease/ NC:

Inspriatory reserve volume (IRV)

A

increase ( 5%)

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10
Q

Changes in lung parameters: increase/ decrease/ NC:

TV

A

increase (45%)

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11
Q

Changes in lung parameters: increase/ decrease/ NC:

Expiratory reserve volume (ERV)

A

decrease (25%)

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12
Q

Changes in lung parameters: increase/ decrease/ NC:

Residual volume (RV)

A

decrease (15%)

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13
Q

Changes in lung parameters: increase/ decrease/ NC:

Inspiratory capacity (IC)

A

increase (15%)

IC = IRV + TV

if IRV and TV increase obviously IC must increase

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14
Q

Changes in lung parameters: increase/ decrease/ NC:

FRC

A

decrease (20%)

FRC = ERV + RV

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

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15
Q

Changes in lung parameters: increase/ decrease/ NC:

Vital Capacity (VC)

A

no change

VC= IRV + ERV + TV

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16
Q

Changes in lung parameters: increase/ decrease/ NC:

TLC

A

decrease (5%)

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17
Q

Changes in lung parameters: increase/ decrease/ NC:

Closing volume and Capacity

A

no change

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18
Q

Changes in lung parameters: increase/ decrease/ NC:

Deadspace

A

increase (45%)

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19
Q

Changes in lung parameters: increase/ decrease/ NC:

respiratory rate

A

NC to INcrease (15%)

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20
Q

Changes in lung parameters: increase/ decrease/ NC:

Minute ventilation

A

increase (45%)

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21
Q

Changes in lung parameters: increase/ decrease/ NC:

alveolar ventilation

A

increase (45%)

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22
Q

Changes in lung parameters: increase/ decrease/ NC:

oxygen consumption

A

Increase (20%)

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23
Q

Respiratory changes: Anesthestic significance

why is airway management more challenging? (3 things)

A
  • weight and breast engorgement hinder laryngosocpy
  • Swollen mucose bleeds easily: avoid intranasal manipulation
  • use smaller ETT (swollen airway)
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24
Q

Respiratory changes: Anesthestic significance

what is their response to anesthestics?(4 things)

A
  • MAC decreased
  • Decreased FRC results in faster indution
  • Increased MV = faster induction
  • Rapid overdose with loss of airway reflexes
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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/c it may be 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 ## Footnote
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

Valley Need to knows (25 decks)

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