Randy's Lecture Mod 6 Exam Flashcards by Ricky Clarke

A 24 y/o patient, the fundus of the uterus is at the level of the umbilicus

how far along is this person?

20-22 weeks pregnant.

Fundus at umbilicus corresponds to weeks of pregnancy.

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If you find a leg protruding from the vagina what is the treatment?

Rapid Transport

Paramedics should provide immediate transport to the hospital for possible breech birth

needs c-section

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You’re assisting with a vaginal delivery mouth and nose have been suctioned and what do you need to do to deliver the upper shoulder

Guide head and shoulder down

Support the baby’s head and neck, apply gentle traction to the baby’s body, and rotate the baby to free the shoulder.

McRoberts maneuver knees to chest

suprapubic pressure, which involves applying pressure to the mother’s abdomen just above the pubic bone

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You’re evaluating a newborn after birth moving all their extremities has a strong respiratory effort what is the APGAR score?

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A condition that is a leading cause of infertility results when the lining of the inside of the uterus outside the uterus

EndometriOsis

It occurs when the tissue similar to the lining of the uterus grows OUTSIDE the uterus, causing pain and infertility.

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What is the difference between
ovarian cyst and endometriOSIS and endometRITIS

Ovarian cyst - fluid-filled sac in ovary.

Endometriosis - tissue outside uterus.

Endometritis - inflammation of the inner lining of the uterus (bacterial infection)

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28-year-old patient combining of sudden onset of severe abdominal pain relates to her shoulder

what could this be?

Ectopic Pregnancy

Note: a uterine rupture likely to NOT have severe ab pain and vaginal bleeding

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What do you do for a Uterine inversion?

What causes it?

Manage SHOCK, transport patient immediately, keep uterus moist.

excessive traction on the umbilical cord, fundal pressure

IV, O2, Fluids, keep warm, monitor

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What two conditions on which treatment includes a pre-hospital provider placing a gloved hand into a vagina?

prolapsed cord and breech

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What is the function of the placenta?

Oxygen & Nutrients to the fetus
Remove waste
Produce hormones
Barrier against infections

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What interventions come first in neonatal resuscitation

VENTILATIONS
providing warmth, suctioning the mouth and nose, and drying the infant thoroughly.

and providing positive pressure ventilation (BVM) if the infant is not breathing spontaneously (without oxygen first)

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Products of conception are expelled but some remain in the uterus

what is this called?

Incomplete abortion

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Fetal circulation

Blood to newborn lungs

The fetus receives oxygen and nutrients from the mother’s bloodstream via the placenta and returns deoxygenated blood to the placenta for elimination of waste products. Fetal circulation is unique in that oxygenated blood bypasses the lungs and enters the fetal heart via the inferior vena cava, while the right ventricle pumps deoxygenated blood to the placenta via the ductus arteriosus and ductus venosus.

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What is the correct positive pressure rate for apneic newborn

40-60 breaths per min

1 breath every 1-2 seconds

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How do you treat a prolapsed cord?

Position the mother with her ELEVATED HIPS
relieve pressure on the cord by pushing presenting part up,
and administer high-flow oxygen.

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How do you treat a nucal cord?

If tight and causing fetal distress, clamp and cut the cord immediately.

If loose continue.

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What are the signs of placenta previa

PAINLESS vaginal bleeding in the third trimester,
soft and non-tender uterus, and
ABSENCE of contractions.

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Mittelschmerz refers to what

Abdominal pain occurring during the menstrual cycle

Caused by the release of an egg from the ovary.

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30-year-old with g - 1 p - 0 bright red vaginal bleeding severe abdominal pain for an half hour tells you she’s 35 weeks pregnant (cocaine use)

what is the possible condition

ABRUPTIO placenta.

because of the bright red blood
ab pain
and 35 weeks pregnant
(third trimester)

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What situations is a newborn most likely to suffer damage to the brachial nerve plexus

During a difficult delivery

SHOULDER DISTOSIA
Large baby
Prolonged labor
Maternal obesity

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What are the risk factors predisposing a woman to have a large fetus

GEST DIABETIES

Maternal Obesity
Several pregnancies
Male baby
Maternal age
Genetics (tall)

What are life-threatening causes of vaginal bleedings in the first trimester

ECTOPIC pregnancy,
threatened miscarriage
molar pregnancy
ruptured ectopic pregnancy

Leading cause of infections in newborns in their first week of life?

Group B Streptococcus (GBS) bacteria.

Factors associated with Eminent delivery?

BOWEL MOVEMENT

Closer intense contractions
Dilation and Effacement
Rupture of amniotic sac
Pelvic Pressure
Mucus plug

Note: Effacement means that the cervix stretches and gets thinner. Dilatation means that the cervix opens

List the signs of placental separation

Gush of blood Lengthening umbilical cord Rise in fundus Sense of release Increase in contractions (usually after baby born)

what is the most common cause of Amenorrhea?

Pregnancy

Which OB complications are considered life threatening? (4)

PID - Pelvic inflam disease Uterine rupture Ectopic pregnancy Ovarian Cysts

What is the Appropriate prehospital care of postpartum bleeding?

O2, IV Fundal Massage Oxytocin 10 units

A newborn has adequate respirations and heart rate but her hands and feet are cyanotic that's called? what is the treatment?

acrosynosis keep warm and dry stimulate

A Pregnant woman should be transported with wedge on her right hip left tilt to decrease the risk of ?

Supine hypotensive syndrome

Presence of meconium in the amniotic fluid can increase the risk of ?

respiratory distress syndrome and meconium aspiration syndrome

What is the expected due date for a woman with regular 28-day Cycles whose last menstrual period was normal and began on April 14th 2021

January 19th, 2022. (or 20th?) Add 280 days (or 40 weeks) to the first day of the last menstrual period (April 14th, 2021).

24-year-old sexual assault patient very quiet withdrawing. Fairly upset you see a small amount of blood on her shorts near the groin area and the initial priority of the patient is

Ensure her safety, Treat immediate life threats. provide emotional support. Assess physical injuries, genital/bleeding STD/ Forensic Exam

what are 6 gynecological causes of abdominal pain

Ovarian Cysts Ectopic Pregnancy PID - Pelvic inflam disease EndometriOsis - outside Menstrual Cramps Uterine Fibroids - growths that appear in the uterus. (not lymphoma)

What defines secondary apnea in a newborn

baby initially had good respirations but then stops breathing for more than 20 seconds or has a heart rate less than 100 beats per minute despite attempts at stimulation.

You have a full term neonate 15 days old 3 Kg blood glucose level of 30 what should you administer

you should administer 2 mL/kg of 10% dextrose solution IV or IO. (6mL)

A BLS crew is delivering a baby determine the neonates what

APGAR Term, tone, breathing, cry Check for the presence of amniotic fluid and meconium staining. Clear the airway of any mucus or meconium using a bulb syringe. Dry the neonate and place him or her on a warm, dry surface. Clamp and cut the umbilical cord. Assess the neonate's breathing and heart rate. If the neonate is not breathing or has a heart rate below 100 bpm, begin resuscitation efforts.

What factors increase the risk that a neonate will require resuscitation

Prematurity (born before 37 weeks of gestation) Low birth weight (less than 2,500 grams) Meconium-stained amniotic fluid Maternal drug use during pregnancy Maternal hypertension Placental insufficiency or abruption Prolonged rupture of membranes (more than 18 hours) Multiple gestation (twins, triplets, etc.) Fetal distress during labor Congenital abnormalities.

35 week pregnant 33-year-old patient fell down a flight of stairs and complaining of severe neck and back pain full spinal mobilization what is the problem with laying this patient on their back?

TILT BACKBOARD THE LEFT Supine hypotensive syndrome

What stage of labor is this: when she has a strong urge to move her bowels (BOWEL MOVEMENT) the cervix is fully effaced and partially dilated

the second stage of labor

Define the uterine fundus

It is the top portion or the highest point of the uterus, located above the entrance of the fallopian tubes. It is the rounded part of the uterus that can be palpated or felt through the abdominal wall during a physical exam or during pregnancy.

Abortion is defined as the expulsion of the fetus from any cause before how many weeks of gestation?

Before 20 weeks

What is this?

A-fib (test might RVR) the heart's upper chambers (the atria) beat chaotically and irregularly — out of sync with the lower chambers (the ventricles) of the heart.

29-year-old patient one week postpartum from a C-section complains of shortness of breath. What could be the cause?

Pulmonary Embolism Women who have had a C-section are at an increased risk of developing a blood clot.

oxytocin is administered when and why?

To treat postpartum hemorrhage.

What are the adverse effects of mag sulfate?

Hyporeflexia - slow reflexes Drowsy Respiratory Depression

nitroglycerin what does it do?

decreases peripheral vascular resistance decreases left ventricular preload. (DECREASE PRELOAD) improves myocardial oxygen supply.

what is Depakote is used for

for Seizures, bipolar disorder

Two indications for glucagon Administration

hypoglycemia and beta blocker toxicity

What class of meds is typically used to control the heart rate in patients with afib or a flutter in the pre-hospital environment

Cal Channel Blocker

23 year old patient opens her eyes when you speak to her is disoriented and pulls her hand away