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A & P of OB
Princinples II CARDIAC
| Question | Answer |
|---|---|
| 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
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