OB part I

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OB part I
2013-07-24 19:22:13
aa emory

APIII, test 3
Show Answers:

  1. Respiratory changes during pregnancy?
    • FRC decrease
    • Min Ventilation and RR increase
  2. _________ ___________, aka spuine hypotensive syndrome, causes aortoilliac compression in ___ of women, and vena cava compression in ____.  solution: _ _______ _____________.
    • aortocaval compression
    • 20%
    • 100%
    • L uterine displacement
  3. T or F, nasal instrumentation should be avoided in pregnant women and airway edema may will lead to a less than optimal laryngeal view?
  4. define gravida:
    # times pt has been pregnant
  5. Name the four parts of Parity:
    • full term births
    • pre-term births
    • losses
    • living children
  6. Pregnancy causes an increase in total blood volume by ___, heart rate by ___, SV by ___ and CO by ____.  A ________ is seen in peripheral vascular resistance.
    • 40%
    • 15-20%
    • 25%
    • 50%
    • decrease
  7. how much can CO increase just after delivery?
  8. GI changes during pregnancy (6)
    • all labor treated as full stomach
    • stomach displacement by uterus causes reflux
    • gastrin from placenta makes stomach more acidic
    • All women undergiong surgery should have antacid (non particulate)
    • use a cuff OETT slightly smaller than normal
    • Aspiration is major risk for this population
  9. Describe relative anemia seen during pregnancy. What is a normal pregant H/H?  what other blood component is decreased with pregnancy?
    • plasma and total blood volume increase about 40%, red cell mass only increases about 20%.
    • hgb 11-12, Hct 35%
    • platelet count
  10. pregnancy causes a _______________ state, Why?  Creates higher risk for what two things?
    • hypercoagulable
    • increased coag factors and anticlotting factors.
    • DIC, DVT's
  11. How much MVO2 increase with pregnancy?
  12. pa___ is decreased with pregnancy.
  13. What is the reason for gestational diabetes, and worsened diabetes?
    placental hormones cause tendency for hyperglycemia. 
  14. What leads to changes in response to drugs during pregnancy?
    • decreased plasma cholinesterase, plasma protein concentration, MAC
    • increase neuraxial spread of LA's
  15. When is MAC decreased with pregnancy?
    8-12 weeks
  16. safest, most effective intervention for labor pain?
    lumbar epidural
  17. stages of labor:
    • 1- dilation of cervix to 10 cm
    • 2- fetus moving from cervix, out
    • 3- placental delivery
    • 4- time until physiologically normal (2-6 weeks)
  18. What three things are needed before performing an epidural?
    • history
    • exam
    • labs
  19. when performing epidural, what should be noted about ligaments in a gravid pt?
  20. What is a normal fetal heart rate?
    110-160 bpm
  21. When fetal tracings be evaluated?
    • decelerations in relation to contractions
    • accelerations- good if related to stimulus.  bad if constant tachy
    • variability- fine and coarse
  22. early decelerations are related to....?
    head compression as fetus moves toward delivery
  23. variable decelerations are related to....?
    uterine cord prolapse
  24. Late decelerations are related to....?
    fetal asphyxia following contractions
  25. What level block is needed for a c-section?
    t4, more dense than for labor alone
  26. mortality rate in c-section __ times greater with GA than with _________.
    • 17
    • neuraxial
  27. what induction drugs are not transferred to the fetus, in the case of GA?
  28. spinal anesthesia contraindicated with what disease?
    multiple sclerosis
  29. volatile anesthetics contribute to what?
    uterine atony