OB and Neonatal Care Flashcards Preview

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Flashcards in OB and Neonatal Care Deck (81)
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1
Q

Approximately how many cells does the embryo contain when it implants into the uterine wall?

A

32

2
Q

Function of placenta

A

Synthesis of glycogen and cholesterol.
Metabolizes fatty acid.
Transfer of certain antibodies.
Performs respiratory gas exchange, transport of nutrients, excretion of wastes, and heat transfer.
Produces necessary hormones and serves as a barrier against harmful substance in woman’s circulation.

3
Q

Premature rupture of membranes

A

Rupture of amniotic sac prior to the onset of labor.

Increasing risk of fetal infection or injury.

4
Q

What is considered preterm?

A

Less than 37 weeks

5
Q

Cardiovascular changes during pregnancy

A

HR elevates by 10-20 beats
CO increases by 30-50%
BP decreases by 10-15

6
Q

Blood changes during pregnancy

A

Blood volume increases by 50%
RBC increase by 30#
Elevated RBC increases the need for iron

7
Q

Respiratory changes during pregnancy

A

Respiratory minute volume increases by 40%

Increased CO2 during exhalation

8
Q

GI changes during pregnancy

A

Morning sickness
Heartburn
Peristalsis decreases resulting in constipation

9
Q

Musculoskeletal changes during pregnancy

A

Edema in LE

Approximately 27 lb weight gain

10
Q

Most common cause of vaginal bleeding during the first nd second trimester?

A

Spontaneous abortion

Miscarriage

11
Q

Causes of abortions.

A

Chronic illness in mother
Maternal exposure to toxic substances or illicit drugs
Fetal abnormalities
Abnormal attachment of placenta

12
Q

Threatened abortion

A

Abortion that is impending or potentially occurring

13
Q

Treatment for threatened abortion

A

Best rest to avoid activity or fluctuations in vital signs

14
Q

Imminent abortion

A

Impending or threatened spontaneous abortion that cannot be prevented

15
Q

Treatment for imminent abortion

A
Administering 250 mL bolus - repeat PRN
NRB at 15L
Emotional support
Rapid transport
Be alert for signs of shock
16
Q

Incomplete abortion

A

Part of the products of conception is expelled, but some remain in the uterus.

17
Q

s/s ectopic pregnancy

A

Sudden onset of lower abdominal pain and cramping

May or may not have vaginal bleeding

18
Q

abruptio placenta

A

Premature separation of normally planted placenta from the wall.

19
Q

s/s abruptio placenta

A

Sudden onset of severe abdominal pain
Decreased fetal movement
Decreased fetal hart tones
Minimal vaginal bleeding or none

20
Q

placenta previa

A

Placenta is implanted low in the uterus and partially or fully obscures cervical canal

21
Q

s/s placenta previa

A

Painless vaginal bleeding

22
Q

Chronic HTN in pregnancy can cause

A

Retard growth and development of the fetus
Impaired liver and renal function
Pulmonary edema
Progress to life-threatening tonic-clonic seizures

23
Q

Preeclampsia

A

HTN

24
Q

s/s preeclampsia

A
Severe headache
N/V
Agitation
Rapid weight gain
Visual disturbances
pulmonary embolus
SOB
AMS
Upper abd pain
Myoclonus
25
Q

Eclampsia

A

HTN

Seizure

26
Q

Postpartum eclampsia

A

24 hours - 4 weeks after birth

27
Q

Supine hypotensive syndrome

A

vena cava compression

28
Q

s/s supine hypotensive syndrome

A
Nausea
Dizziness
Tachycardia
Claustrophobia
SOB
Syncopal episodes
29
Q

Gestational diabetes mellitus

A

Inability to process carbohydrates during pregnancy

30
Q

Treatment for hyperemesis gravidarum

A
NRB 100%
Blood glucose levels
IV access
Saline bolus
Transport
31
Q

Deceleration forces may cause :

A

abruptio placenta

uterine rupture

32
Q

XABCDE

A
eXsanguinating hemorrhage
Airway
Breathing
Circulation
Disability
Exposure

Assessment for trauma in pregnancy

33
Q

Questions to ask during hx taking

A
If the patient is pregnant
G/P/A
Length of gestation
Estimated due date or date of confinement
Fetal movements present
Complications w/ past pregnancies
C-section
Under physician's care
Taking prenatal vitamins
Last OB visit
Contractions? How far apart?
34
Q

When would you consider delivering a newborn on scene?

A

Delivery is expected in minutes
Natural disaster, bad weather or other catastrophe making it impossible to reach the hospital
No transportation is available

35
Q

What BP would you consider preeclampsia?

A

140/90

36
Q

First stage of labor

A

Onset of contractions and ends when the cervix is fully dilated

37
Q

Second stage of labor

A

Full cervical effacement and dilation until fetus is delivered

38
Q

Third stage of labor

A

Delivery of newborn and ends with delivery of placenta

39
Q

Emergency situations after delivery

A

Placenta has not delivered after 30 minutes
More than 500 mL of bleeding occurs before delivery of placenta
Substantial bleeding occurs after the delivery of the placenta

40
Q

When is labor considered preterm?

A

20th week, but before 37th week

41
Q

When is a newborn considered a premi?

A

Born before 36 weeks or weighs less than 5 lbs

42
Q

Physical findings of uterine rupture.

A

Diaphoretic
Tachycardia
Falling BP
May or may not have substantial vaginal bleeding
Possible sign: palpate fetal body parts through abdominal wall

43
Q

Symptoms of uterine rupture

A
Weakness
Dizziness
Thirst
Strong, painful contractions that are now slackened off
Severe abdominal pain
44
Q

Factors increasing the chance of amniotic fluid embolism.

A
Maternal age greater than 35
Eclampsia
Abruptio placenta
Placenta previa
Uterine rupture
Fetal distress
45
Q

s/s amniotic fluid embolism

A
Sudden onset of respiratory distress
Hypotension
Cyanosis
Seizures
Cardiogenic shock
Unresponsiveness
Cardiac arrest
46
Q

Breech presentation

A

Buttocks or both feet

47
Q

Frank breech presentation

A

Hips flexed
Knees extended
Buttocks present

48
Q

Incomplete breech presentation

A

One or both hips and knees extended

One or both feet presenting

49
Q

Complete breech presentation

A

Hips and knees are flexed with buttocks presenting

50
Q

Two goals in the situation of a limb presentation

A

Prevent further trauma to newborn

Transport patient rapidly and safely

51
Q

What position should the mother be placed in during transport of a limp presentation?

A

On her back w/ head down and hips elevated

52
Q

McRoberts manuever

A

Used in cases of shoulder dystocia.

Have mother hyperflex her knees tightly to her abdomen. Apply suprapubic pressure and gently pull on fetus’s head

53
Q

What is the major concern after a newborn is born with a shoulder dystocia complication?

A

Damage to brachial nerve plexus

54
Q

Examples of potential embolic processes during pregnancy.

A

Amniotic embolism
Pregnancy-related venous thromboembolism
Air embolism

55
Q

Treatment for spina bifida?

A

Place a sterile, moist dressing over opening. Maintain body temperature.

56
Q

In which instances should you insert your fingers into your pregnant patient’s vagina?

A

Umbilical cord prolapses

Breech birth

57
Q

Causes of delayed transition in newborns

A
Hypoxia
Meconium staining
Blood aspiration
Acidosis
Hypothermia
Pneumonia
Hypotension
Sepsis
Birth asphyxia
Pulmonary hypoplasia
Respiratory distress  syndrome
58
Q

What does “Do What Probably Seems Simple” stand for?

A
Drying
Warming
Positioning
Suctioning
Stimulation
59
Q

When should you provided positive pressure ventilations on a newborn?

A

HR below 100

60
Q

Tactile stimulations acceptable and safe for newbown.

A

Slapping or flicking the soles of the feet

Gently rubbing the back, trunk, or extremities

61
Q

Appearance APGAR Score

A

Completely pink : 2
Body pink, extremities cyanotic : 1
Centrally cyanotic, pale : 0

62
Q

Pulse rate APGAR score

A

> 100 : 2
<100, >0 : 1
Absent : 0

63
Q

Grimace APGAR Score

A

Cries : 2
Grimaces : 1
No response: 0

64
Q

Activity APGAR Score

A

Active motion : 2
Some flexion of extremities : 1
Limp : 0

65
Q

Respiratory APGAR Score

A

Strong cry : 2
Slow and irregular : 1
Absent : 0

66
Q

Indications for artificial ventilation of newborn

A

Apnea
HR <100
Persistent despite breathing 100% oxygen

67
Q

When should you d/c chest compressions and continue ventilations during a neonatal resuscitation? When do you stop ventilations?

A

HR is above 60 but below 100.

Stop ventilations once HR is more than 100.

68
Q

When do you administer free-flow oxygen?

A

Central cyanosis present

69
Q

When do you perform positive pressure ventilations w/ 100% oxygen when newborn has central cyanosis?

A

If the newborn remains cyanotic after 30 minutes of free-flow oxygen

70
Q

Signs of respiratory distress that suggest a need for BVM?

A

Periodic breathing
Intercostal retractions
Nasal flaring
Grunting on expiration

71
Q

How much of the BVM bag are you going to compress?

A

1/10th

72
Q

Ventilation rate for newborn

A

40 to 60 breaths

73
Q

Count for ventilation of newborn

A

Breath-two-three, breath-two-three

74
Q

Delivery of compressions and ventilations ratio of neonate

A

3:1

75
Q

Apnea of prematurity is a result of _____.

A

Underdeveloped CNS

76
Q

Primary apnea vs secondary apnea

A

Primary: caused by oxygen deprivation
Secondary: period of gasping respirations, falling HR, and falling BP

77
Q

Tx for primary apnea

A

Attempt drying and stimulation

78
Q

Tx for secondary apnea

A

Positive pressure ventilation by BVM

79
Q

Where should you asses HR in newborn?

A

Auscultation

Palpating base of umbilical cord

80
Q

Blood glucose levels 12 hours after birth

A

30-45

81
Q

Tx of hypovolemia in newborn

A

Administer 10 mL/kg isotonic solution over 5-10 minutes