OB facts Flashcards
(211 cards)
1
Q
all pt’s are considered what????
A
full stomachs
2
Q
what type of induction should be done s needed
A
RSI
3
Q
Respiratory Changes:
the diaphragm is displaced 4cm where by the expanding uterus
A
cephalad
4
Q
Respiratory Changes:
the diaphragm being displaced 4 cm cephalic will cause what to FRC
A
decrease by 20%
5
Q
Respiratory Changes:
what happens to VC, TLC, and IC ?
A
nothing they are all unchanged
-Unchanged d/t compensatory increase in thoracic anteroposterior diameter
6
Q
Respiratory Changes:
as pregnancy increase thoracic breathing INcreases and _____ breathing decreases
A
Abdominal
7
Q
Respiratory Changes:
the ventilatory changes produce what acid base problem? yet the compensation by metabolic acidosis will keep pH normal
A
respiratory alkolosis (PaCO2 =30)
8
Q
Respiratory Changes:
would you anticipate the PaO2 to be higher in the pregnant or non pregnant state
A
Pregnant
9
Q
Respiratory Changes:
Would you anticipate the PaCO2 to be higher in the pregnant or non-pregnant state
A
non-pregnant
10
Q
Respiratory Changes:
the increase in O2 consumption produces a 70% increase in _____ _____ at term
A
alveolar ventilation
11
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
12
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
13
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
14
Q
Respiratory Changes:
the increase in alveolar ventilation and decrease in FRC enhance maternal uptake of what?
A
Inhaled anesthetics
15
Q
Respiratory Changes:
Increased AV + Decreased FRC = what to MAC
A
decreased MAC
16
Q
Respiratory Changes:
Airway edema and engorgement is most evident during what trimester
A
3rd
17
Q
Respiratory Changes:
Airway edema and engorgement is most evident in the 3rd trimester… what does this mean with our instrumentation?
A
Unexpected nose bleeds and airway bleeds can occur d/t careless instrumentation placement
oral airways, ETT, and NG tubes placed w/ caution
ETT need to be smaller (6/7 instead of 7/8)
18
Q
Respiratory Changes:
a decrease in FRC may cause what complication
A
rapid desaturation
19
Q
Respiratory Changes:
there is an increase in maternal O2 consumption and any episode of apnea will lead to what?
A
maternal hypoxia
20
Q
Respiratory Changes:
During labor hyperventilation may be due to pain or specific breathing technique. Assess for alkalemia bc hypocarbia will cause what? and will result in what?
A
uterine vasoconstriction
result in decreased placental perfusion
21
Q
Respiratory Changes:
with hyperventilation the alkalemia and hypocarbia will cause uterine vasoconstriction and results in decreased placental perfusion… is the fetus at risk?
A
yes
22
Q
Changes in lung parameters: increase/ decrease/ NC:
Inspiratory reserve volume (IRV)
A
increase (5%)
23
Q
Changes in lung parameters: increase/ decrease/ NC:
TV
A
Increase (45%)
24
Q
Changes in lung parameters: increase/ decrease/ NC:
Expiratory reserve volume (ERV)
A
decrease (25%)
25
```
Changes in lung parameters: increase/ decrease/ NC:
Residual Volume (RV)
```
decrease ( 15%)
26
```
Changes in lung parameters: increase/ decrease/ NC:
Inspiratory capacity (IC)
```
increase (15%)
IC = IRV + TV
(since both IRV and TV increase obviously this must increase also)
27
Changes in lung parameters: increase/ decrease/ NC:
| FRC
Decrease (20%)
FRC = ERV + RV
(since both ERV and RV decrease obviously this must also decrease)
28
```
Changes in lung parameters: increase/ decrease/ NC:
Vital Capacity (VC)
```
no change
| VC= IRV + ERV + TV
29
Changes in lung parameters: increase/ decrease/ NC:
| Total lung Capacity (TLC)
decrease (5%)
30
Changes in lung parameters: increase/ decrease/ NC:
| closing volume and capacity
no change
31
Changes in lung parameters: increase/ decrease/ NC:
| Dead space
increase (45%)
32
Changes in lung parameters: increase/ decrease/ NC:
| Respiratory rate
NC to Increase (15%)
33
Changes in lung parameters: increase/ decrease/ NC:
| minute ventilation
increase (45%)
34
Changes in lung parameters: increase/ decrease/ NC:
| Alveolar ventilation
Increase (45%)
35
Changes in lung parameters: increase/ decrease/ NC:
| oxygen consumption
increase (20%)
36
Blood Gases:
| PaCO2 what are the values for non pregnant? first? 2nd ? and 3rd trimester?
```
normal 35-45 (40) mmHg
1st 30 mmHg
2nd 30 mmHg
3rd 30 mmHg
(key is it is always lower PaCO2 hence the respiratory alkalosis that ensues w/ pregnancy)
```
37
Blood Gases:
| PaO2 what are the values for non pregnant? first? 2nd ? and 3rd trimester?
```
Normal 100 mmHg
1st 107 mmHg
2nd 105 mmHg
3rd 105 mmHg
(key is once pregnant the PaO2 is always higher then the non pregnant)
```
38
Blood Gases:
| pH what are the values for non pregnant? first? 2nd ? and 3rd trimester?
```
Normal 7.35-7.45 (7.40)
1st 7.44
2nd 7.44
3rd 7.33
(key is the body compensated with metabolic acidosis to keep pH WNL but slightly more alkolotic than normal)
```
39
Blood Gases:
| HCO3 what are the values for non pregnant? first? 2nd ? and 3rd trimester?
```
Normal 24
1st 21
2nd 20
3rd 20
(key is the pregnant pt is metabolic acidotic to compensate for the respiratory alkalosis)
```
40
Cardiovascular Changes:
| Does BLOOD VOLUME increase/ decrease/ No change?
increase (35%)
41
Cardiovascular Changes:
| Does PLASMA VOLUME increase/ decrease/ No change?
Increase (45%)
42
iCardiovascular Changes:
| If blood volume increase why are prigs anemic?
dilutional anemia
| plasma volume increases more
43
Cardiovascular Changes:
| Does RBC VOLUME increase/ decrease/ No change?
increase (20%)
44
Cardiovascular Changes:
| Does CARDIAC OUTPUT increase/ decrease/ No change?
increases (40%)
45
Cardiovascular Changes:
| Does STROKE VOLUME increase/ decrease/ No change?
increases (30%)
46
Cardiovascular Changes:
| Does HEART RATE increase/ decrease/ No change?
Increases (15%)
47
Cardiovascular Changes:
| Does MAP increase/ decrease/ No change?
decrease (15 mmHg)
48
Cardiovascular Changes:
| Does SYSTOLIC BP increase/ decrease/ No change?
decrease (0-15 mmHg)
49
Cardiovascular Changes:
| Does DIASTOLIC BP increase/ decrease/ No change?
Decreases (10-20 mmHg)
50
Cardiovascular Changes:
| Does CVP increase/ decrease/ No change?
No change
51
Cardiovascular Changes:
| CO increases 30-40% during the 1st trimester d/t ___ and ___ while stroke volume remains the same.
increase in HR
| decrease in Afterload
52
Cardiovascular Changes:
| when is CO the greatest
after delivery and next couple of weeks
53
Cardiovascular Changes:
CO during Labor
CO increases how much during latent phase
15%
54
Cardiovascular Changes:
CO during Labor
CO increases how much during the Active phase/
30%
55
Cardiovascular Changes:
CO during Labor
CO increases how much during the 2nd stage?
45%
| (15% increase each phase)
56
Cardiovascular Changes:
CO during Labor
CO increases how much in the postpartum phase?>
80%
57
Cardiovascular Changes:
After delivery blood volume increases when the uterus no longer obstructs the vena cava and aorta leading to ann increase in what?
Stroke Volume
58
Cardiovascular Changes:
Blood volume increases by 33-40% and the RBC increase 30 mL/kg and the plasma volume also increases 70 mL/kg the anemia is a result of what?
greater increase in plasma volume
59
Cardiovascular Changes:
| you can correct the dilution anemia how?
w/ iron and folic acid administration
60
tCardiovascular Changes:
| the increase in blood volume does not increase BP d/t what?
decreased peripheral vascular resistance
61
Cardiovascular Changes:
| Near term blood volume increases about 1000mL (40%) probally d/t what?
peripheral vasodilation
62
Cardiovascular Changes:
| CO to the uterine vasculature is apron ___-____ mL/min
700-800 mL/min
63
Cardiovascular Changes:
| the CO must keep maternal SBP greater then _____ to maintain maternal perfusion to vasculature
100mmHg
64
Cardiovascular Hemodynamics at term:
| Is there an INCREASE/ DECREASE/ NC in CO
increase (50%)
| CO = HR + SV
65
Cardiovascular Hemodynamics at term:
| Is there an INCREASE/ DECREASE/ NC in SV
increase (25%)
66
Cardiovascular Hemodynamics at term:
| Is there an INCREASE/ DECREASE/ NC in HR
increase (25%)
67
Cardiovascular Hemodynamics at term:
| Is there an INCREASE/ DECREASE/ NC in LVEDV
increase
68
Cardiovascular Hemodynamics at term:
| Is there an INCREASE/ DECREASE/ NC in EF
increased
| EF= SV / LVEDV
69
Cardiovascular hematologic changes at term:
| Is there an INCREASE/ DECREASE/ NC in Blood volume
increase (45%)
70
Cardiovascular hematologic changes at term:
| Is there an INCREASE/ DECREASE/ NC in Plasma volume
Increase (55%)
71
Cardiovascular hematologic changes at term:
| Is there an INCREASE/ DECREASE/ NC in RBC
Increase (30%)
72
Cardiovascular hematologic changes at term:
| Hgb Value
11.6 g/dL
73
Cardiovascular hematologic changes at term:
| HCT value
35.5%
74
Cardiovascular:
| what is maternal supine hypotensive syndrome
compression of inferior vena cava decreases venous return and this will result in a decreased stroke volume and hypotension. further compression will decrease uterine perfusion and may result in fetal distress
75
Cardiovascular:
| what is the maternal response to maternal supine hypotensive syndrome?
tachycardia and vasoconstriction of lower extremities.
76
Cardiovascular:
| how do you fix maternal supine hypotensive syndrome
LUD
| -tilt pt to left with right hip bump 15 degrees
77
CV changes: Anesthetic Significance:
| Ventilation may increase the incidence of accidental what
epidural vein punture
78
CV changes: Anesthetic Significance:
| the healthy parturient will tolerate up to _____mLs of blood loss thus transfusion is rarely needed
1500ml's
79
CV changes: Anesthetic Significance:
| The drug _____ with free water IV infusion may lead to fluid overload
oxytocin
80
CV changes: Anesthetic Significance:
| high Hgb level (>14) indicates low volume status caused by what?
pre-eclampsia
HTN
inappropriate diuretics
81
CV changes: Anesthetic Significance:
| _____ reduces cardiac work during labor and may be beneficial in some cardiac disease states
Epidural
82
CV changes: Anesthetic Significance:
| maternal SBP of
83
CV changes: Anesthetic Significance:
| Always avoid what?
Aortocaval compression
84
CV changes- Coagulation at term:
| Does the value Increase/ decrease/ NC for PT
Shorten
85
CV changes- Coagulation at term:
| Does the value Increase/ decrease/ NC for PTT
shorten
86
CV changes- Coagulation at term:
| Does the value Increase/ decrease/ NC for Platelet count
NC
87
Gastrointestinal Changes:
Prolonged gastric emptying time and a decrease in LES tine. The decreased GI motility, decreased food absorption, and LES pressure are all due to elevated levels of what hormone?
Progesterone
88
Gastrointestinal Changes:
elevated _____ produces by from the placenta increases intragastric pressures and decreases the normal oblique angle if the GE junction. thus the pt is more prone to Gastric reflux
Gastrin
89
Gastrointestinal Changes:
| these pts are ALWAYS considered _______ and a risk for aspiration
full stomach
90
Gastrointestinal Changes:
| Narcotics, valium, and atropine all ____ LES tone and increase gastric emptying time
decrease
91
Gastrointestinal Changes:
| what else is wrong with narcotics and valium
fetal depression
92
Gastrointestinal Changes:
| what drug increases LES tone and increases gastric emptying
Metoclopramide
93
Gastrointestinal Changes:
| Secretion of gastric acid increases secondary to an increased _____ release
gastrin
94
Maternal Renal Changes:
| Normal decreases in BUN and serum creatinine are d/t what?
increases in renal blood flow and glomerular filtration
95
Maternal Renal Changes:
renal plasma flow and glomerular filtration rate increases by __-__% above normal by the fourth month of gestation and slowly return to normal during the 3rd trimester
50-60%
96
factors Causing decreased uterine blood flow:
| what are 2 main causes for decreased uterine blood flow
Decreased perfusion pressure
| uncreased uterine vascular resistance
97
factors Causing decreased uterine blood flow:
| what are 2 things that cause decreased perfusion pressure
Decreased uterine arterial pressure
| Increased uterine venous pressure
98
factors Causing decreased uterine blood flow:
| what are 4 causes of decreaased uterine arterial pressure?
supine position
hemorrhage/hypovolemia
Drug induced hypotension
hypotension from sympathetic block
99
factors Causing decreased uterine blood flow:
| what are 4 causes of Increased uterine venous pressure
Vena caval contraction
Uterine contractions
Drug induced uterine hypertonus (oxytocin)
Skeletal muscle hypertonus (sz, valsalva)
100
factors Causing decreased uterine blood flow:
| name 2 things that can cause Increased uterine vascular resistance
endogenous vasoconstrictors
| Exogenous vasoconstrictors
101
factors Causing decreased uterine blood flow:
| name 2 typs of endogenous vasoconstrictors that cause increased uterine vascular resistance
cathecholamines (stress)
| Vasopressin (in response to hypovolemia)
102
factors Causing decreased uterine blood flow:
| name 3 types of exogenous vasoconstrictors that cause increased uterine vascular resistance
Epi
vasopressores (pheny, ephedrine)
LA (in high concentrations)
103
Drug passage across placenta:
| name 3 ways a drug crosses placenta
low molecular weight (
104
Drug passage across placenta:
| name 3 ways a drug will NOT cross the placenta
Large molecular weight > 500
Low lipid solubility
Ionized
105
placental blood flow:
| Blood is delivered to both the placenta and uterus how?
uterine artery
106
placental blood flow:
| in essence _______ is the ONLY factor that influences blood floe through the placenta
Mothers systemic arterial pressure
107
placental blood flow:
| Describe how maternal blood flow circulates through the placenta.
uterine arteries
intravenous space
fetal villi
uterine wall
108
placental blood flow:
fetal blood and maternal blood are separated by the placental membrane. how many microscopic tissue layers are found in the placental membrane?
3
109
General and regional Anesthesia during pregnancy:
| what happens to MAC
reduced 15-40%
110
General and regional Anesthesia during pregnancy:
| what happens to rate of induction w/ inhalation agents
increases (faster inductions)
111
General and regional Anesthesia during pregnancy:
| w/ induction agents what happens to 1/2 life of propofol
nothing unaltered
112
General and regional Anesthesia during pregnancy:
| what happens to 1/2 life of meprdine
nothing unaltered
113
General and regional Anesthesia during pregnancy:
| what happens to sensitivity to SCh
reduced sensitivity
114
General and regional Anesthesia during pregnancy:
| what happens to duration of SCh block
unchanged to slightly decreased
115
General and regional Anesthesia during pregnancy:
| what happened to NDMR sensitivity
increased w. roc and Vec
116
General and regional Anesthesia during pregnancy:
| what happens to elimination 1/2 time w/ roc and vec
shortened
117
General and regional Anesthesia during pregnancy:
| what happens to Atacurium
unaltered
118
General and regional Anesthesia during pregnancy:
| what happened to chronotropics
diminished response
119
general Anesthesia: implications of maternal physiologic changes:
4 things to remember with ETT intubation
Smaller tube
increased risk of trauma nasal
Increased risk of failed intubation
Increased risk if aspiration
120
general Anesthesia: implications of maternal physiologic changes:
3 things to remember about maternal oxygenation
increased physiologic shunt when supine
increased rate of denitrogenation
Increased rate of decline in PaO2 w/ apnea
121
general Anesthesia: implications of maternal physiologic changes:
what happens to MV
increased
122
Regional Anesthesia: implications of maternal physiologic changes:
5 technical things to consider
lumbar lordosis increased
Apex of thoracic hypnosis at higher level
Head down tilt when in lateral position
CSF return unaltered
Reduced sensitivity to "hanging drop" tech
123
Regional Anesthesia: implications of maternal physiologic changes:
what is a concern with hydration
increased fluid requirements to prevent hypotension
124
Regional Anesthesia: implications of maternal physiologic changes:
3 concerns with LA dosing
SA dose decreased 25%
| Epidural dose unaltered
125
Regional Anesthesia Effects on Uterine Blood flow:
| Increased uterine blood flow results from what 3 things
pain relief
Decreased sympathetic activity
Decreased maternal hyperventilation
126
Regional Anesthesia Effects on Uterine Blood flow:
| decreased uterine blood flow results from what 3 things
Hypotension
unintentional IV LA injection
Absorbed LA
127
Stages of Labor:
| how many stages are there
3
128
Stages of Labor:
| What is the first stage
onset of contractions to complete dilation of cervix
129
Stages of Labor:
| what is the second stage of labor
full cervical dilation (10cm) to delivery of infant
130
Stages of Labor:
| what is the 3rd stage
delivery of infant to delivery of placenta
131
Stages of Labor:
| what are the 2 phases of the first stage of labor
latent and active
132
Stages of Labor:
| what phase of stage 1 labor is little dilation of cervix, but it becomes softer
latent
133
Stages of Labor:
| what phase of stage 1 labor is regular cervical dilation in response to uterine contraction
active
134
Stages of Labor: Stage 1
| pain is initially at what dermatomes
T11-12
135
Stages of Labor: Stage 1
| pain is initially at T11-12 then progresses to ______ during active labor
T10-L1
136
Stages of Labor: Stage 2
| sensory innervation of the perineum is provided by the ____ nerve
pudendal nerve (S1-S4)
137
Stages of Labor: Stage 2
| the second stage of labor involves what dermatomes
T10-S4
138
Parenteral Agents for Parturient:
| what is the most commonly used opioid
Meperdine (demerol)
139
```
Parenteral Agents for Parturient:
what type of drug class is butorphenol and nalbupine
```
partial agonist
140
Parenteral Agents for Parturient:
| low doses of this drug is most helpful prior to delivery or as an adjunct to regional anesthesia
ketamine
141
```
Parenteral Agents for Parturient:
what drug class is not reccomended
```
NSAIDS
142
Parenteral Agents for Parturient:
| what are NSAIDS not recommended?
suppression of uterine contractions and promotes closure of fetal ductus arterious
143
Parenteral Agents for Parturient:
| what is the concern with Benzo's
Strong potential for neonatal depression
144
Regional:
| Spinal opioids are free of what
Preservatives
145
Regional:
| Spinal opioids are useful in what pts
high risk
146
Regional:
| do they impair mother from pushing?
nope
147
Regional:
| what are 3 disadvantages of spinal opioids
less complete analgesia
lack of perineal relaxation
Pruritus, N/V, sedation, and resp depresion
148
Regional:
| what is the most common side effect
hypotension
149
Regional:
| treatment for hypotension
ephedrine/ phenylephrine
LUD
IV bolus
150
Umbilical cord prolapse:
| may lead to what?
fetal hypoxia
151
Umbilical cord prolapse:
| how is it diagnosed
sudden fetal bradycardia
profound decals
physical exam
152
Umbilical cord prolapse:
| treatment?
immetiade steep trendelenburg
maual pushing the presenting fetus buck up into pelvis
immediate c-section
153
Signs of fetal distress
Repetative late decels
Loss of beat to beat variation
sustained FHR
154
Placenta Previa:
| For testing purposes think of what letter
```
"P"
Painless
Preterm bleeding
Planned c-section
Pass on Pushing
```
155
Placenta Previa:
| how many types are there
3
156
Placenta Previa:
| what ar the 3 types
marginal
Partial
total
157
Placenta Previa:
| describe marginal
Placenta lies close to, but does not cover cervical os
158
Placenta Previa:
| describe partial
placenta partially covered cervical os
159
Placenta Previa:
| describe total
placenta covers over cervical os
160
Placenta Previa:
| delivery for marginal
up to ob
161
Placenta Previa:
| delivery for partial and total
c-section
162
Placenta Previa:
| 1st episode of bleeding is typical when
preterm
163
Placenta Previa:
| are there contractions when bleeding
no
164
Placenta Previa:
| the onset of bleeding is not related to any articular event thus there is no what
No abdominal pain
| Painless vaginal bleeding
165
Placenta Previa:
| there is usually painless vaginal bleeding when
2nd and 3rd trimester
166
Placenta Previa:
| is more common in women who have had what?
previous placenta previa
167
Placenta Previa:
| what are 3 risk factors?
Multiparity
Advanced maternal age
Large placenta that is disturbed
168
Placenta Previa:
| ____ lying placenta previa increases the risk of bleeding for c-section
anterior
169
Placenta Previa:
| what is the treatment especially in the fetus is less than 37 weeks gestation and bleeding is mild to moderate
bedrest and observation
170
Placenta Previa:
| is fetal distress or demise common with first episode of bleeding?
no uncommon
171
Placenta Previa:
| what is common and may require blood component therapy
coagulopathy
172
Placenta Previa:
| is regional anesthesia appropriate is fluid resuscitation is complete?
yes
173
Placenta Previa:
the goal is to delay delivery until the fetus is mature, the management is terminated and a c-section is performed if what things occur?
```
Active labor persist
Documented lung maturity
gestational age reaches 37 weeks
excessive bleeding
another OB complication occurs
```
174
Placenta Previa:
| r/t anesthetic management what should we be ready for
massive blood loss
175
Placental Abruption:
| what is it
separation of placenta from the decimal basalis
176
Placental Abruption:
| what are the 3 types
marginal
Partial
Complete
177
Placental Abruption:
| what are risk factors
```
HTN
Advanced age
parity
tobacco use
Cocaine use
trauma
PRM
hx of previous Placental Abruption
```
(basically anything that is bad for the vasculature)
178
Placental Abruption:
| what problem is seen with FHR
Late decels
179
Placental Abruption:
| fetal distress automaticaly signal what
c-section
180
Placental Abruption:
| what is the classic presentation
PAINFUL vaginal bleeding
uterine tenderness
increased uterine activity
Atypical presentation
181
Placental Abruption:
| large bleeding is expected.. the uterus can hold up to how much blood
2500 mL
182
Placental Abruption:
| what are the major complications from it
```
DIC
Hemorrhagic shock
ARF
coagulopathy
fetal distress
```
183
Placental Abruption:
| management
```
FHR monitorig
Large bore IVs
type and cross
H/H, coags
LUD
```
184
Placental Abruption:
| is regional anesthesia ok
not usually indicated d/t coagulopathy and uncertain uteroplacental blood flow
185
Placental Abruption:
| C-section- is problematic what type of anesthesia is prefered
General
186
Abnormal Placental Implantation:
| what are the 3 types?
placenta accreta
Placenta increta
Placenta percreta
187
Abnormal Placental Implantation:
| what one is the adherence of the placenta to the myometrium without invasion of or passage through the uterine muscle
Placenta Accreta vera
188
Abnormal Placental Implantation:
| what one is when the placenta invades and is confined to the myometrium
Placenta increta
189
Abnormal Placental Implantation:
| what one is when the placenta invades and penetrates the myometrium, the uterine series, or other pelvic structures?
placenta percreta
190
Abnormal Placental Implantation:
| what are 3 risk factors for developing it
placenta previa
previous c-section
uterine trauma
191
Abnormal Placental Implantation:
| it is the most common indication for what procedure
hysterectomy
192
DIC labs:
Indicate increased or decreased
Plasma fibrinogen
decreased
193
DIC labs:
Indicate increased or decreased
Platelet count
Decreased
194
DIC labs:
Indicate increased or decreased
Thrombin time
increased
195
DIC labs:
Indicate increased or decreased
Prothrombin time
Increased
196
DIC labs:
Indicate increased or decreased
Partial thromboplastin time
Increased
197
DIC labs:
Indicate increased or decreased
What is an easy way to remember all these
if its a count it's decreased
| If its a time its increased
198
what is a syndrome of HTN, proteinuria, and generalized edema after the 20th week of gestation and usually abating within 48 hours of delivery
Pre-Eclampsia
199
Pre-Eclampsia:
| what is the cure?
delivery of baby
200
what is the occurrence of convulsions superimposed on Pre-Eclampsia:
eclampsia
201
Eclampsia/ Pre-eclampsia:
| what is the drug of choice
magnesium sulfate (4-6 mEq/L)
202
Eclampsia/ Pre-eclampsia:
| what does Mag sulfate do
attenuates smooth muscle contraction with calcium at the cell membrane level and preventing an increase in free intracellular Ca++
203
Eclampsia/ Pre-eclampsia:
| principle SE of Mag sulfate
Hypotension
204
Magnesium Sulfate:
| is invers to what ion
Ca++
205
Magnesium Sulfate:
| normal plasma level
1.5-2.0
206
Magnesium Sulfate:
| what is therapeutic range
4-8 mEq/L
| 4x's the normal range
207
Magnesium Sulfate:
| what level has EKG changes
5-10
208
Magnesium Sulfate:
| what level has loss of DTR
10
209
Magnesium Sulfate:
| what level has SA node and AV node block and respiratory paralysis
15
210
Magnesium Sulfate:
| what level will cause cardiac arrest
25
211
What is normal FHR
125-150
