a bulge in the wall of the aorta, possibly causing a rupture which will cause massive bleeding in the abdominal cavity
List the s/s of an abdominal aortic aneurysm
some are asymptomatic
writhing abdominal pain, may radiate to the lower back, hip, or chest
pulsating mass in the abdomen
unequal femoral pulses
if internal bleed is allowed to continue, will cause: hypovolemic shock, hypertension, tachycardia, cyanosis, and altered LOC
Define an ectopic pregnancy
implatation of placenta that occurs outside of the uterus (90% being in the fallopian tubes)
List the s/s of a GI bleed
hematemesis (vomiting up blood; from upper GI bleed)
melena (passing of dark, tarry stools; from lower GI bleed)
esophageal varices (abnormal, enlarged veins in the lower part of the esophagus) or Mallory-weiss tear (tear occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach)
Define and list the s/s of kidney stones
calcium crystals in the kidneys
mimics an MI
pain comes in waves
List the s/s of an ectopic pregnancy
triad = female of childbearing age, abdominal pain, s/s of shock
vaginal spotting, intense painful cramping
abdominal pain with shoulder pain (indicating severe bleed)
What are the ALS upgrades for abdominal/back pain?
upper abdominal pain, age greater than 35
lower abdominal pain in women age 12-50 with dizziness, snycope, or heavy vaginal bleeding
abdominal/back pain with syncope/near syncope, age greater than 50
acutely distended, rigid, or tender abdomen
unequal or absent femoral pulses
What is the uterus?
large female reproductive organ in lower abdomen where the fetus grows
What is the vagina?
lower part of the birth canal
What is a fetus?
developing unborn baby
What is a placenta?
fetal organ that provides perfusion from the uterus; filters; feeds the baby
What is the umbilical chord?
connects fetus to the placenta
What is the amniotic sac?
sac that surrounds the fetus in utero
What is the perineum?
skin area between vagina and anus
What are the preterm emergencies?
emergencies that happen before 36 weeks such as...
Define and list s/s of a miscarriage
loss of fetus up to 20 weeks (most occuring within 12 wks of pregnancy from a fetal abnormality)
usually preceded by spotting and intense cramping
products of conception often naturally expelled and if not, dilation and curettage (D&C) are likely (widening of the cervix and scooping out what was left after the miscarriage)
fetal loss in the 2nd trimester may occur when the cervix is weak and opens too early
Define and list the s/s of placenta previa
when the placenta forms over part of or the entire cervix
bright red bleed in 2nd or 3rd trimester
Define and list s/s of placental abruption
premature separation of placenta from uterus in the 2nd or 3rd trimester, usually from trauma
abdominal pain with bleeding that is usually dark red
If ectopic pregnancy is high on your index of suspicion, what are the questions you should ask?
last menstral cycle?
is that length of time normal?
Until proven otherwise, an ectopic pregnancy should be assumed in who?
any female of childbearing age with s/s of shock
What is the treatment for a preterm bleed?
general pt care procedures
place pad between legs (to catch blood and measure the amount)
do not pack the vagina (....phrasing....)
do not allow the pt to insert a tampon
What are the ALS upgrades in pregnancy?
160/90 (pregnancy induced hypertension)
lower abdominal pain in women age 12-50 with: dizziness, syncope/near syncope, or heavy vaginal bleeding
s/s of shock
At what point does preeclampsia become eclampsia?
when seizures begin
When deciding to do an vaginal exam, what are the 4 things you should consider?
history - 36-40wks
contraction less than 2 mins apart, lasting at least one minute
What are the signs of imminent delivery?
gestation of 36 wks or more
contractions less than 2 mins apart, lasting at least one minute
crowning is present
mother feels strong urge to push
mother feels need to move her bowels
What is the minimum BSI needed for child birth?
gloves, goggles, splash protection (dexter mask)
What is meconium and why can it be a cause for concern?
baby's first bowel movement
if it occurs in utero, baby will aspirate it causing pneumonia
Once the umbilical cord is cut, what should you do next?
Do What Probably Seems Simple
D - dry
W - warm
P - position
S - suction
S - stimulate
What is a nuchal cord and how do you remedy it?
when the umbilical cord is wrapped around the baby's neck
pull cord toward baby's face over the top of the head
if the cord cannot be removed, clamp it and cut in place
Why is it best for mom to start breastfeeding right after delivery?