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A & P of OB

Princinples II CARDIAC

QuestionAnswer
PARTURIENT PATIENTS ARE RARLY IN OPTIMAL CONDITION. ALWAYS ALWAYS A FULL STOMACH.
PHYSIOLOGICAL CHANGES CARDIOVASCULA, PULMONARY, NERVOUS, RENAL, HEPATIC, GI AND WEIGHT GAIN 17%
HOW MUCH WEIGHT GAIN FOR A PREGNANT WOMAN 17%. APPROX. 12KG. 1-2 1ST TRIMESTER, 5-6KG 2ND TRIMESTER AND THEN 5-6 KG 3RD TRIMESTER.
WHAT ARE THE TWO BASIC REASONS FOR CARDIOVASCULAR CHANGES DEVELOPING FETUS. LABOR AND DELIVERY EVENTS WITH MOM.
WHY DOES THIS CHANGES OCCUR (PHYSIOLOGICAL CHANGES) THESE CHANGES OCCUR BECAUSE OF INCREASE IN INTRAVASCULAR FLUID AND CO, AND DECREASE IN SVR.
SOME OTHER CARDIOVASCULAR CHANGES ARE INTRAVASCULAR FLUID VOLUME/CONSTITUENTS.; CO AND PERIPHERAL CIRCULATION.
IVF / CONSTITUENTS ARE BEGINS AT 1ST TRIMESTER AND BY TERM IT IS 1500ML
PLASMA VOLUME INCREASES BY APPROX. 45%
ERYTHROCYTES VOLUME INCREASES BY ABOUT 20 %
PLASMA PROTEIN (ALBUMIN) CONCENTRATION-DECREASES (TRUE OR FALSE) TRUE
WHY IS PLASMA PROTEIN REDUCED IT IS REDUCED DUE TO DILUTION RESULTING IN HIGHER FREE BLOOD LEVELS OF HIGHLY PROTEIN-BOUND DRUGS.
WHAT IS EBL FOR VAGINAL DELIVERY 300-500ML
EBL FOR C/S 800-1000ML
HOW MUCH CARDIAC OUT IN THE 10TH WEEK GESTATION ABOUT 10 %
HOW MUCH CO IN 3RD TRIMESTER ABOUT 30 - 40 %
HOW MUCH POST DELIVERY AS HIGH AS 60-80%. (MAY GO UP TO 180%).
WHAT HAPPEN TO SV, HR, PLACENTAL AND OVARIAN STERIODS INCREASED. SV BY 30%; HR 15-25%
WHAT HAPPEN TO PERIPHERAL CIRCULATION. DECREASED. SVR BY 20% (CO) AND PVR DECREASES BY 35%
IS THERE ANY CHANGES IN SBP NO CHANGES
IS THERE ANY CHANGES IN DBP YES, DECREASES BY UP TO 15%
IS THE ANY CHANGES IN CVP NO CHANGES
HOW MUCH DOES FEMORAL VENOUS INCREASED BY 15% (IVC)
IS THE MEAN ARTERIAL PRESSURE DECREASED YES.
WHAT IS SUPINE HYPOTENSION SYNDROME IT IS CHARACTERIZED BY HYPOTENSION IS ASSOCIATED WITH PALLOR,DIAPHORESS, N/V, AND CHANGES IN CEREBRATION. THE CAUSES OF THE SYNDROME APPEARS TO BE COMPLETE OR NEAR COMPLETE OCCLUSION OF THE INFERIOR VENA CAVA BY THE GRAVID UTERUS IN A SUPINE POSITION.
WHAT HAPPEN WHEN THE IVC IS COMPRESS THERE IS DECREASE CO; DECLINE IN SYSTEMIC BP
WHAT IS AORTOCAVAL COMPRESSION THIS IS SYSTEMIC HYPOTHENSION(DECREASE SBP); AND DECREASE INUTERINE AND PLACENTAL BLOOD FLOW.
IN THE SUPINE POSITION, UNDO PRESSURE FROM THE WT OF THE BABY COMPRESSING THE GREAT VESSELS BY LUD. LEFT UTRINE DISPLACEMENT. THIS CAN HELP TO ALLEVIATE THE SYMTOMS
HOW MUCH OF A DEGREE WITH LUD ABOUT 15 DEGREE RIGHT HIP ELEVATION WITH LUD
PREVENTION IS THE PREFERRED TREATMENT (TRUE OR FORCE) TRUE.
WHAT IS THE SUPINE HYPOTHENSION MECHANISM (COMPENSATORY RESPONSES) COMPENSATORY RESPONSES- PARAVERTEBRA VENOUSPLEXUSES => AZYGOS VEIN => SVC. REFLEX INCREASES IN PERIPHERAL SNS. >> INCREASE IN SVR, MAINTAINS SBP DESPITE DECREASE CO.
WHAT IS THE SUPINE HYPOTENSION MECHANISM (UNCOMPENSATED RESPONSE) DECREASE SBP < 100MMHG. >>FETAL ACIDOSIS >>BRADYCARDIA
WHAT IS THE TREATMENT FOR SUPINE HYPOTENSION LATERAL POSITION. -LEFT UTERINE DISPLACEMENT -RIGHT HIP ELEVATION 15 DEGREE.
WHAT ARE THE CONSIDERATIONS RELATED TO CARDIOVASCULAR CHANGES COMPENSATORY INCREASES IN SVR R/T SUPINE HYPOTENSION SYNDROME. NORMAL RESPONSES IN ALL PATIENTS.
WHAT ARE SYMPATHETIC RESPONSE TO REGIONAL ANESTHESIA VASODILATION; HYPOTENSION; AND DECREASED UTERINE AND PLACENTAL BLOEED FLOW. (FETAL ACIDOSIS).
Created by: eonaodow