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Special Populations 2 Flashcards

(71 cards)

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1
Q

Gyn Questions

A

When was your last period How long is your period normally Anything different Type of bleeding Clots Discharge Smell Pregnancy On birth control Any trauma What is normal for pt How many pads have you gone through in 24 hours

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2
Q

Basic Gyn Tx

A

Support pt

Position of comfort

O2 if SpO2 low

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3
Q

Hypermenorrhea/Menorrhagia

A

abnormally heavy bleeding

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4
Q

Polymenorrhea

A

period more frequent than 24 days

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5
Q

Dysmenorrhea

A

painful menses

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6
Q

Metorrhagia

A

spotting that occurs bw periods

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7
Q

Vaginal bleeding <20 weeks

A

likely spontaneous miscarriage

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8
Q

Vaginal bleeding >20 weeks

A

Abruptio placenta Placenta Previa

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9
Q

Ectopic pregnancy S/S

A

Unilower abdominal px

Gradually worsens over few days

Rebound tenderness

diffuse px

may have cullen or grey turner sign

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10
Q

Ectopic pregnancy tx

A

ABCs Cardiac monitor IV Fluids px management warm and tx for shock

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11
Q

PID S/S

A

diffuse lower abdominal px

shuffling gait

fever

chills

discharge

px on urination

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12
Q

Sexual assault tx

A

focus on what hurts and what pt needs tx don’t ask for retelling ask for gender preference in provider don’t examine vagina tx px and anxiety document well

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13
Q

Fetal Circulation

A
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14
Q

Ductus Arteriosus

A

allows blood to pass from pulmonary artery directly into aorta t

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15
Q

Gravida

A

number of times pregnant

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16
Q

Parida

A

number of births

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17
Q

Nulligravida

A

never been pregnant

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18
Q

Nulliparious

A

never given birth

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19
Q

Primigravida

A

female who is pregnant first time

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20
Q

Multigravida

A

female who has been pregnant multiple times

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21
Q

Multiparity

A

given birth multiple times

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22
Q

Grand multiparity

A

female who has given birth more than 5 times

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23
Q

Hyperemesis gravidarum tx

A

ABCs

Position of comfort

EKG

500mL NS if hypotensive

Zofran and maybe benadryl

check BGL

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24
Q

PreEclampsia S/S

A

edema hands, feet, face

seizures

SBP >160

DBP >105

20th week of pregnancy or greater

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25
PreEclampsia Tx
O2 Position of comfort 4-6g of Mag over 15mins Maintenance infusion of 1-2g if seizure persists, 4mg of lorazepam Contact Med control for Labetalol
26
Abruptio Placenta S/S
dark red blood lots of px external blunt trauma most common cause can be deep in shock with minimal bleeding
27
Abruptio Placenta Tx
ABC Shock tx O2 fluids if hypotensive
28
Placenta Previa S/S
bright red blood more minimal px may be unknown if not receiving prenatal care bleeding begins towards end of pregnancy
29
Placenta Previa Tx
ABCs tx for shock O2 IV fluids for hypotension breathe slow and deep through contractions txp in knee to chest position pelvis should be highest point rapid txp
30
Labor Stages
Stage 1: fully dilated cervix and full effacement signals end of first stage Stage 2: delivery of child is end of second stage Stage 3: concludes with delivery of placenta
31
Labor steps
Mama in semi fowlers with knees drawn up PPE Once baby crowns, apply gentle pressure to head After head delivers, apply downward pressure, check for cord After first shoulder delivers, apply upward pressure Be prepared to catch after shoulder delivery Dry baby and suction mouth/nose place baby on mama keep back super warm APGAR score at 1, 5 minutes
32
APGAR
33
Contractions seem to be getting weaker, differential diagnosis?
Uterine rupture
34
Pre term labor window
20-37 weeks
35
Prolapsed Cord tx
mama in knee to chest position pelvis high keep baby off cord rapid txp
36
Nuchal cord
loosen cord if possible if not possible, clamp in two places and cut in middle
37
Breech tx
lift ankles towards abdomen if it doesn't free head, place fingers on either side of face and press up to allow for baby to breathe
38
Uterine inversion tx
O2 at least one line fluid titrated for BP Oxytocin withheld Mag sulf can be useful
39
Postpartum hemorrhage definition
in under 24 hours \>500mL in vaginal birth \>1000mL in C section
40
Postpartum hemorrhage tx
fundal massage breastfeed 10 unit of oxytocin in 1000 NS over 20-30mins two large bore IVs do not pack vagina
41
Important pregnant trauma question
have you felt the baby move since incident
42
Baby born, first steps
warm dry position suction stimulate feet if no response to this after 30s, oxygenate
43
central cyanosis with HR \>100
blow by O2 if baby pinks up, stop O2
44
HR \<100 nasal flaring grunting retractions head bobbing see saw respiration
ventilate at rate of 40-60 bpm \*if no improvement in 30s, intubate and CPR
45
Congenital Diaphragmatic Hernia tx
intubation over BVM NG or OG tube rapid txp
46
Pneumo tx in infant
insert 22g in 2nd intercostal intubate
47
Umbilical Catherization Steps
1. Clean umbilical cord outward 3cm 2. Attach 3-5ml prefilled syringe with 3 way stop cock that is attached to 3.5-5 Fr catheter and flush saline through 3. Cut cord bw infant and first cord clamp 4. Insert cather into umbilical vein 5. advance catheter about 2-4cm into vein until blood aspirated 6. do not advance beyond 5cm 7. flush catheter and tape into place
48
Inverted Triangle of Newborn Resuscitation
Warm, Dry, Suction, Stimulate Oxygen BVM, ETT Chest compressions Medications
49
Acidosis tx in Newborns
If ventilation, oxygenation, chest compressions not resolving bradycardia, acidosis may be cause. Do not use sodium bicarb. Focus on volume expansion to clear metabolic acids.
50
Seizure cause in Infants under 3 days old
hypoxic encephalopathy hypoglycemia other metabolic disturbances
51
Seizure cause in Infants over 3 days old
meningitis epilepsy intracranial bleeding birth defects drug withdrawal
52
Esophageal atresia
failure of esophagus to develop properly and connect to stomach frothing, vomiting, choking during feeding
53
Infantile Hypertrophic Pyloric Stenosis
stomach is unable to empty normally into small intestine causes projectile vomiting infants can be dehydrated and hypoglycemic as a result
54
Intestinal Atresia or Stenosis
narrowing and malformation of upper intestine projectile vomiting with green tinge baby avoids eating and has distended stomach reduced bowel movements
55
Malrotation
intestines fail to coil properly bloody vomit vomit may smell of feces
56
Meningitis
projectile vomiting nuchal stiffness fever bulging fontanelles
57
Vomiting tx in infants
ABCs IV access BGL be prepared to suction look for dehydration fluid bolus of 10ml/kg x3 antiemetics not indicated
58
Premature Infant tx
ABCs keep warm keep dry blow by O2 get to hospital
59
Jaundice tx
IV fluids can dilute bilirubin txp to hospital
60
Hypothermia consequences in infants
increased metabolism hypoglycemia bradypnea bradycardia metabolic acidosis
61
Acrocyanosis
cyanosis of hands and feet
62
Ventricular Septal Defect
malformation of septum causing blood flow bw ventricles leads to pulmonary HTN leads to decreased SBP
63
Pulmonary Stenosis
- pulmonary valve is damaged and doesn't open fully - right ventricle hypertrophies as result of needing more pressure to move blood through valve to lungs - pt often presents with JVD and cyanosis, especially during feeding
64
Tetralogy of Fallot
- combines Pulmonary stenosis, RVH, VSD, and overriding aorta - aorta receives some deoxy blood from right ventricle - results in baby who is mostly cyanotic during day but especially while crying eating or active - have tet spells where become centrally blue and may pass out if working to breathe too hard
65
Atrial Septal defect
failure of foramen ovale to close so blood shifts bw atria pt can become cyanotic as result
66
Patent Ductus Areriosus
failure of ductus arteriosus to close blood shunted away from lungs if SpO2 doesn't increase with O2, this may be issue can lead to CHF in infant
67
Truncus Arteriosus
cdxn where pulmonary artery and aorta are single vessel often have CHF due to massive blood flow to lungs
68
Tricuspid Atresia
lacks a tricuspid valve frequently fatal significantly decreased blood flow to lungs
69
Transposition of the Great Vessels
- pulmonary artery is connected to left ventricle - aorta is connected to right ventricle - this systemic hypoxia can allow ductus arteriosus and foramen ovale to remain open
70
71
Stages of Uterine Prolapse

NMETC (11 decks)

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