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Paramedic Prep - 2

Paramedic Prep - OB

Ovaries: surge/release of LH (Luteinizing Hormone) & FHS (Follicle Stim Hormone) causes eggsto be released, known as? ovulation
Ovulation to menstruation ALWAYS takes how many days? 14
Menstruation to ovulation takes around how many days? 14-17 (when pregnancy can occur)
What at the distal ends of the fallopian tubes "grab" the ovum & carry it down the tubes? Fimbrae
What happens if an egg isn't fertilized? menstruation (blood, mucous, cellular debris d/c from endometrium)
Where will fertilization usually occur? distal 3rd of fallopian tube
Ovum becomes a ? blastocyst
Blastocyst becomes a ? developing fetus (baby)
What is a hollow muscular-pear shaped organ, approx 3" long & held in place by ligaments? uterus
During pregnancy, how much blood does the uterus carry? 5,000 ml (1/6 of TBV)
What is located at the opening, seperating the uterus from the vagina? cervix
What acs as a mucus plug that prevents disease/bacteria, etc. from entering the mom? cervix
What is a.k.a. the organ of pregnancy & is a blood filled structure that is attached to the uterine wall? placenta
What are 6 functions of the placenta? 1)transfers heat to baby 2)exchanges O2 for CO2 3)delivers glucose, K, Sa, & Chloride 4)Removes wastes, urea, uric acid, & creatine 5)Secretes estrogen & progesterone 6)protective barrier against harmful substances
Can narcotics, steroids, & antibiotics cross the placental membrane? yes
What is the baby's lifeline that connects the baby and placenta? umbilical cord
Umbilical cord contains how many arteries and veins? - 2 arteries - 1 vein
The 2 arteries in the umbilical cord do what? trans deoxygenated blood
The vein in the umbilical cord does what? trans oxygenated blood
What is the thinned walled, bag of H2O & its main function is to protect the fetus? amniotic sac
What is ovulation? egg d/c from ovary (need LH & FHS)
What is fertilization? sperm in contact with egg
What is implantation? in uterine wall
What is para? # of live births
What is gravida? # of pregnancies
How long is each trimester? 13 wks (for a total of 37-40 wks for delivery of baby)
What is a lunar month? 28 days
How many lunar months are in a pregnancy? 10
What is antepartum? prior to birthing
What is postpartum? after the baby is delivered
What is the Tx for a pregnant trauma pt? 1)full c-spine precautions 2)high flow O2 3)Tilt spine board 15 degrees to left (using pilow) 4)Fluid replacement wit IV 5)Monitor fetus (listen to fetal heart tones/is baby kicking more or less?)
Risk factors for gestational or superimposed diabetes? - obesity - >30 y/o - family hx - prior pregnancy with baby >9 lb or still born
Which is more common in pregnancy, diabetes or HTN? HTN
HTN in pregnancy commonly occurs in females with? 1)1st pregnancy, but decreases in future ones 2)previous PIH (hx of HTN during preg) 3)diabetes or kidney disease 4) >40 y/o 5)carrying multiple fetuses
HTN in preg usually occurs during which trimester? 3rd
If the preg pt has HTN due to stress, what is typical tx? placed on bedrest & meds (as last resort)
What is the termination of pregnancy prior to viability? abortion
What is a.k.a. a spontaneous abortion? miscarriage
When does miscarriage commonly occur? 1st trimester
What are s/s of miscarriage? -cramping -bleeding -passage of tissue (product of conception)
What is an ectopic pregnancy? When the fertilized ovum is implanted anywhere other than the uterus (commonly in fallopian tube)
Is an ectopic pregnancy life threatening? Yes
What are s/s of ectopic pregnancy? -severe abd pain (in lower quadrants) -may not know they are preg -shocky -distended abd
What is tx for ectopic pregnancy? -O2 -IV -Rapid trans to hosp with immed. surgical capibilites
What is the premature separation of the placenta from the uterine wall? abrutio placenta
When does abruptio placenta occur? usually in 3rd trimester (CAUSED BY TRAUMA)
S/S of abruptio placenta? - SUDDEN ONSET OF SHARP LOWER ABD. PAIN - may have lower back pain - mod to heavy bleeding that you usually can't see - a lot of fetal mvmt - rhythmic contractions
What occurs when the placenta is implanted in lower uterine segment, & it partially or completely covers OS? placenta previa
S/S of placenta previa? - YOU WILL SEE A LOT OF VAGINAL BLEEDING (bright red) - little or no pain
Tx for placenta previa? - O2 - IV - Rapid trans
What are the risk factors for pre-eclampsia or eclampsia? - hx of HTN - renal disease - diabetes - 1st preg - mult. births
What is the difference between pre-eclampsia & eclampsia? seizures occur in eclampsia
S/S of pre-eclampsia? - HTN, >140/90 - Edema in hands, feet & face - sugar in urine - H/A & sensitivity to light
Tx of pre-eclampsia or eclampsia? - O2 - IV - rapid trans (usually to trauma ctr b/c of surgeon) - versed if still seizing
What is caused by fetus compression on the inferior vena cava, decreasing blood return to the heart? supine hypotension syndrome
Is supine hypotension syndrome a self limiting issue? yes
S/S of supine hypotension syndrome? - within 3-7 min - Mom may feel dizzy, or not feel good - Cold, sweaty
Tx for supine hypotension syndrome? - lay pt on L side, will resolve - if it doesn't: O2, IV for vol. replacement), trans
What are like labor contractions but referred to as false labor? braxton-hicks contractions
What is the most common cause of braxton-hicks contractions? dehydration
S/S of braxton hicks contractions? - last approx. 30-60 sec - painless - unpredictable - non-rhythmic - will ease up & then go away
3 most important qs to determine immenint delivery? 1) duration of contractions (how often) 2) length between contractions (how far apart) 3) need to bare down?
Special Qs for labor: 1) duration of contractions (how often) 2) length between contractions (how far apart) 3) need to bare down? 4) How many babies? 5) Color of fluid? 6) due date? 7) Doctor care/prenatal care? 8) Expected complications?
How many stages of labor? 3; some say 4
1st stage of labor: -beginning of contractions to full cervical dilation -contractions will occur @ reg intervals -will be painful & getting worse -last approx. 30-60 sec & coming sooner -thinning of the cervix -crowning
2nd stage of labor: baby enters birth canal & is born
3rd stage of labor: the delivery of the placenta
4th stage of labor: -1st hr postpartum -500cc Ebl is norm -may bleed upto 3-6 wks
When is APGAR taken? @ 1 min and then 5 min after birth
What does APGAR stand for? Appearance, Pulse, Grimace, Activity, Respirations
What initial APGAR is considered good? >8
What initial APGAR is considered NOT good & something we'll start "working on?" <7
What do you want to document in regards to cutting the cord? - Date - Time - How far you cut it - Who cut it - Location where it was cut? (location during route of trans, etc)
Top line of newborn resuscitation triangle:"Do What Probably Seems Stupid" Dry, Warm, Posistion, Suction, Stimulate
2nd line from top of newborn resuscitation triangle: O2
3rd line from top of newborn resuscitation triangle: establish effective ventilation: -BVM -ET tube
4th line from top of newborn resuscitation triangle: chest compresions
bottom line of newborn resuscitation triangle: meds
What is the mmHg for newborn suction? 90-110 mmHG
What do you do if newborn's pulse is <100? BVM for 30 sec., then re-evaluate
What if infant's initial pulse is <60? start CPR immediately!
What is breech birth? When something other than head comes out first (usually butt or extremity)
What is prolapsed cord? When the umbilical cord comes out 1st
Tx for breech or prolapsed cord: - head down, butt up (knee chest position) - insert gloved hand & make "V" to keep baby's face away from vaginal wall - keep cord moist with wet sterile dressings - Rapid trans - O2 - IV - Do not pull or tug on aything!
What happens if cord is around baby's neck while dlivering? Slip over head with 2 fingers, if you can't, clamp & cut cord
What is shoulder dystocia? infant's shoulders are larger than it's head
What is cephalpelvic disproportion? infant's head is too big to pass through pelvis
What is meconium staining? fetus passes feces in the amniotic sac
Name 3 post partum emergencies: 1)PE 2)Uterine rupture 3)Uterine inversion
Created by: Wisniewski