Obstetrics

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Author:
readyreg29
ID:
272614
Filename:
Obstetrics
Updated:
2014-05-09 10:03:59
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Obstetrics
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Description:
MEDIC 2013
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  1. You are the medic
    Pregnant Patient
    Primary / Immediate concerns
    • Overall presentation
    • Any obvious life threats
    • Responsiveness
    • Breathing difficulty
    • Injurys
    • Appearance: pale, cyanotic, red, gray 
    • Alert & Oriented or confused
  2. You are the medic
    Pregnancy questions
    • Are there any chief complaints (OPQRST)
    • How many weeks pregnant
    • Prenatal care?
    • Any expectant problems
  3. Pregnancy trimesters
    • 1st: 0-3 months (12 weeks)
    • 2nd: 4-6 months (13-24 weeks)
    • 3rd: 7-9 months (25-36 weeks)
  4. The most significant pregnancy physiologic changes occur in the:
    Uterus
  5. Refers to the number of times a woman has been pregnant, regardless of outcome (abortion, stillborn, live birth)
    Gravida (Gravidity)

    *gettin it
  6. Refers to delivery of an infant who is alive
    Para (Parity)

    * payin for it
  7. The average labor time in 1st time mothers
    16 hours
  8. APGAR scoring 
    parameters
    • Heart rate
    • Respiratory effort
    • Muscle tone
    • Reflex irritability
    • Color
    •     ** Check blood sugar
    • Scoring: 0-2
  9. APGAR scoring should be conducted:
    • 60 seconds
    • &
    • 5 minutes
    • After birth
  10. Drugs given in the field for pregnancy-related problems
    • Magnesium Sulfate
    • Calcium Chloride
    • Terbutaline
    • Valium
    • Diphenhydramine
    • Oxytocin
  11. Oocyte
    An egg produced from the female ovary
  12. The term for an oocyte once it has been fertilized and multiplies into cells
    Blastocyst
  13. The condition in which the placenta is implanted low in the uterus and, as it grows, it partially obscures the cervical canal
    Placenta previa
  14. A musclar, inverted pear-shaped organ that lies between the urinary bladder and the rectum; where the fetus will develop and acts of labor takes place
    Uterus
  15. The narrowest portion of the uterus that opens into the vagina
    Cervix
  16. The fetus in the earliest stages after fertilization
    Embryo
  17. Seizures that result from severe hypertension in a pregnant woman
    Eclampsia
  18. The developing, unborn infant inside the uterus
    Fetus
  19. Preeclampsia involves gradual onset of:
    • Hypertension
    • Headache
    • Visual changes
    • Swelling hands & feet
  20. Functions of the placenta:
    • Respiratory gas exchange
    • Transport of nutrients
    • Excretion of wastes
    • Transfer of heat
    • Hormone production
    • Formation of a barrier
  21. What hormones stimulates the process of ovulation?
    Luteinizing hormone (LH)
  22. Which of the following hormones signals the body that pregnancy has begun?
    Estrogen Human chorionic gonadotropin hormone (HCG)
  23. The distance from the top of the uterus to the pubic bone measured in centimeters. After the first 12 weeks of pregnancy. The measurement often matches the number of weeks you've been pregnant
    Fundal height
  24. The most common symptoms of preeclampsia
    • Peripheral edema (swelling of lower limbs)
    • Gradual onset of hypertension
    • Protein in the urine
  25. Class of drugs used to delay preterm labor
    • Tocolytics
    • Magnesium Sulfate (4-6g over 15-20mins)
  26. Basic prehospital steps in pregnancy management:
    • Recumbent lying on left side
    • 100% O2 NRM
    • Rapid transport (notify facility)
    • Large bore IV (consider additional line)
    • ECG
    • Loose trauma pads over vagina
    • Consider medications (mag, oxy)
  27. Drug used in case of uterine rupture
    Oxytocin (10-20 USP)
  28. A pregnant woman has a grand mal seizure:
    What steps do you take
    • Protect patient from injury
    • Ensure open airway
    • O2
    • Patch for Magnesium sulfate (2-4gm IV)
  29. Management of a pregnant pt. involved in an MVA
    • C-spine
    • Long board application (tilt to left side)
    • Ensure airway (prep for vomit)
    • O2
    • IV w/ NS
    • ECG
    • Maintain vitals
  30. A 20-year-old woman in her 1st pregnancy. She says her water broke about 6 hours ago. Contractions are about 2 minutes apart, and she feels the need to move her bowels. You are 20 minutes from the hospital.
    Transport or Deliver?
    • Deliver
    • * amniotic sac rupture (6 hours) may indicate fetal infection
  31. 32-year-old multipara (gravida 10, para 8) who has been in labor about 5 hours. Her contractions are 3 minutes apart. She says she think the baby's coming. You are 10 minutes from the hospital.
    Transport or Deliver?
    • Deliver
    • * Multipara uterine rupture & postpartum hemorrhage
  32. A 25-year-old nullipara (gravida 1, para 0) who has been in labor for 9 hours. Her contractions are 4 to 5 minutes apart. You are 20 minutes from the hospital.
    Transport or Deliver?
    Transport
  33. a 30-year-old gravita 4, para 3 who has been in labor for 6 hours. She had 2 of her 3 children by cesarean section. Her contractions are 2 minutes apart and she is crowning. You are 5 minutes from the hospital.
    Transport or Deliver?
    • Deliver
    • * risks: uterine rupture

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