6-26-10 OB Mid Sess 1 Barry
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| show | 12 kg (or 17%)
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| show | 1 kg
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| How many kgs of weight gain does the amniotic fluid account for at term | show 🗑
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| How many kgs of weight gain does the interstitial fluid account for at term | show 🗑
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| show | 2 kg
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| How many kgs of weight gain does the new fat and protein account for at term | show 🗑
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| show | 4 kg
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| show | Diaphram elevation, reduced functional residual capacity, capillary engorgement, progesterone induced tracheal and bronchial dilation
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| What major anatomical changes happen during pregnancy with: Cardiovascular (2 things) | show 🗑
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| What major anatomical changes happen during pregnancy with: Gastrointestinal (2 things) | show 🗑
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| What major anatomical changes happen during pregnancy with: Urogenital (4 things) | show 🗑
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| show | Aorticcaval compression and lower body venous stasis
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| T/F: As gestation continues onward from 12 weeks to delivery the following all increase - Alveolar ventilation, minute ventilation, tidal volume, and respiratory rate | show 🗑
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| show | Residual volume, expiratory reserve volume, functional residual volume, total lung capacity, sodium bicarbonate, arterial PCO2, chest wall compliance (alone), total compliance, pulmonary resistance, and airway resistance
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| show | to the Right
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| In there HYPO or HYPER ventilation DURINIG labor | show 🗑
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| show | UP = RR, TV, MV, DOWN = PaCO2, PaO2 (note: PaO2 rises during preg but decrease with labor)
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| What is a normal BiCarb level for 3rd trimester | show 🗑
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| List from least to most - the time it takes to desaturate: Normal adult, Obese adult (>127kg), normal child, and Mod. ill adult | show 🗑
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| Maternal hyperventilation cause what fetal effects (4 of them) | show 🗑
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| Cardiac output increases in pregnancy related to | show 🗑
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| show | Decreases
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| Why does SVR decrease during pregnancy (4 of them) | show 🗑
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| What % of blood volume change occurs in pregnancy | show 🗑
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| show | They all decrease by 15% each
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| show | non = 4000ml, preg = 5700 (400ml more RBC and 1300ml more of plasma)
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| Since blood plasma increases by up to 50% and RBCs increases to 45 %, what is happening to the viscosity - what is that called | show 🗑
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| show | RBCs continue to increase while plasma starts to decrease
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| show | 12 g%
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| Since RBCs #s are increasing rapidly, are they microcytic or macrocytic | show 🗑
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| Average mls blood loss for C section | show 🗑
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| Average mls blood loss for vaginal delivery | show 🗑
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| When in 2nd stage (lithotomy position) and contracting, what happens to CO and stroke volume | show 🗑
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| What ECGs changes happen during pregnancy | show 🗑
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| What are the two most common ectopies in pregnancy | show 🗑
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| What are the causes for PACs and PVCs (aka most common ectopies)in pregnancy (4 of them) | show 🗑
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| What is the most significant change that happens during pregnancy | show 🗑
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| What happens to CVP and CO when supine (in %) | show 🗑
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| show | The vessle are compressed between the fetus and the bodies of the vertabraes
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| show | 1)Inferior vena cava compression (after 24 wks causes alternative circulation (= Azygos vein/Paravertebral system) and Compensatory increase in sympathetic tone and HR) and 2) Second component includes: Aortoiliac obstruction, Arterial side compression..
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| show | Aortiliac obstruction, Arterial side compression, No maternal symptoms, Placental blood flow decreases, and femoral flow vs brachial flow (?)
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| Of a 30-60-90 degree triangle wedge jammed under mom to prevent aortocaval compression, which angle always touches the bed | show 🗑
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| show | It exaggerates it (so decrease regional dose)
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| show | Venous engorgement
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| The hypercoagulable state of blood during pregnancy is related to ALL Blood Factors except which two (per slide 65..66 says diff) | show 🗑
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| In pregnancy is fibrinolysis increased or decreased | show 🗑
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| show | Pulmonary Aspiration Pneumonitis
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| show | Witholding food during labor (holding on to fork and knife during contractions not wise), Greater use of regional anesthesia, Administration of antacids, Emptying of stomach prior to general anesthesia, competent general anesthesia administration
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| Shirley/Roberts defined what risk | show 🗑
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| In 1980 when Roberts offered Shirley an antacid with particulates what was her responce | show 🗑
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| When do GI physiologic and anatomic changes start to take place in pregnancy | show 🗑
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| When do GI physiologic and anatomic changes start to return to normal from pregnancy | show 🗑
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| show | Hold her with both hand and groan aloud, don't take her swimming, and don't push on her --Treat her like a full stomach
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| show | Delayed gastric emptying (increased gastric content)and increased acidity (lower pH)
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| What extrogenous nursing actions contribute to delayed gastric emptying | show 🗑
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| Does pain decrease gastric emptying | show 🗑
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| Why can't an anatomical displaced, 8 wk gestational lower esophagus pass the CRNA board exam | show 🗑
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| What do opioids do to hypoxemia/hypercarbia responces | show 🗑
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| show | Ranitidine (Zantac), Metoclopromide (Reglan), and Oral sodium citrate (0.3 M Bicitra)
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| show | All are appropriate except nasal intubation
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| show | Hydronephrosis - ureters and renal pelvis dilate starting at 12 wks
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| What happens to renal blood flow and glomerular filtration during pregnancy | show 🗑
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| An increase in total body sodium and water are because of | show 🗑
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| show | Pre-eclampsia
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| show | Increase
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| What happens to hepatic blood flow | show 🗑
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| show | Decrease (most in postpartum)
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| show | Steve must have fell out - slide 82 didn't specify
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| show | Increase
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| show | The slide (83) has sux, chloroprocaine, and etomidate (ester metabolism ?)
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| What causes increased neural sensitivity to local anesthetics | show 🗑
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| show | Engorgement of epidural veins
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| show | Small MACs - decrease by a quarter - 40 cents (decrease by 25-40%)
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| What does the black shaded area represent on slide 85 | show 🗑
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| What does the MAC of inhalation agents, epidural doses, and spinal doses have in common regarding pregnancy | show 🗑
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| show | CNS Toxcity
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| show | 700ml/min
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| T/F: Uterine blood flow is autoregulated | show 🗑
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| Uterine blood flow can decrease because of which one: Arterial or venous | show 🗑
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| show | 1100 grams
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| How much blood does a near term uterus receive a minute (ml/min) | show 🗑
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| show | 70 grams
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| show | 50 ml/mi
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| How many times more blood flow does a pregnant uterus receive over non-pregnant | show 🗑
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| show | Almost 20 times as much (1100g vs 70g)
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| The ovarian, uterine, and vaginal arteries all come from what artery | show 🗑
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| show | The uterine artery (the uterine artey comes directly off of the hypogastric artery)
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| show | Uterine artery than hypogastric artery
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| show | External iliac artery is being stolen from
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| show | Uterine contractions, hypertonus, hypotension, hypertension, vasoconstriction (endogenous and exogenous - most sympathomimetics alpha adrenergic)
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| show | Not in the pregnant uterus, but yes in the non-pregnant uterous (pregnancy releases a uterine artery vasodilator)
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| show | Estrogen produces the endothelium's ability to synthesize the vasodilator nitric oxide (this does not take place in the peripheral vessels)
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| A lower pH in the fetus after using ephedrine and not phenylephrin is because of | show 🗑
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| Name the cavities and tissue layers from the fetus to the outer wall of the uterus | show 🗑
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| Name three major functions of the placenta | show 🗑
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| Name four types fo transport mechanisms through a membrane | show 🗑
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| show | All of them - plus physiochemical properties of the drug
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| show | Lipid solubility, ionization, molecular weight, concentration gradient, surface area, membrane thickness, protein binding, injection related to contraction time and metabolism
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