6-26-10 OB Mid Sess 2
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| show | ACOG 1993
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| What are the other names for "Phase 0" | show 🗑
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| What are the other names for "Phase 1" | show 🗑
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| show | Stimulation (also Maximum Slope)
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| show | Involution (also Deceleration)
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| How many "Phases" of labor are there | show 🗑
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| In relation to "Phases", when does the Gravida become a Parturient (the Parturation takes place) | show 🗑
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| show | The more oxytocin produced creates more prostaglandins which creates even more oxytocin which creates even more prostaglandins (which increase the strength of contraction
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| What happens in the "First Stage" of vaginal delivery | show 🗑
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| show | Infants head enters this brutal world
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| What happens in the "Third Stage" of vaginal delivery | show 🗑
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| show | POWERS (uterine contractions and in 2nd stage, voluntary expulsive efforts), PASSAGEWAY (bony pelvis and the soft tissues contained therein), PASSENGER (the fetus: Lie, presentation, position)
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| What does PROM stand for | show 🗑
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| 3 classifications (times) of PROM | show 🗑
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| What is it called during delivery when the fetus's anterior shoulder is trapped above the pubic symphysis | show 🗑
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| show | Dick-Reed
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| "poena magna" is from who and means what | show 🗑
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| show | Hardy and Javert
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| The McGill Pain Rating Index is scale from 0 to what number | show 🗑
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| What are the two main Components to Labor Pain | show 🗑
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| show | C-fibers
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| show | First Stage
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| show | A delta fibers
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| show | Late First Stage and all of Second Stage
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| What nerve plexus innervates the ovaries | show 🗑
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| What is the major labor pain pathway called | show 🗑
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| show | Pressure on nerve endings on body and fundus of uterus, Contraction of an ischemic myometrium and cervix, vasoconstriction, inflammatory changes, dilation of the cervix and lower uterine segment
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| show | First Stage
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| show | TRACTION (on the pelvic peritoneum and uterine ligaments), TENSION (on bladder, rectum, ligaments, fascia, and muscles in pelvis), PRESSURE (on lumbosacral plexus)
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| Factors that influence severity of pain | show 🗑
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| show | Dick-Read
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| Known for "lamaze Method" and Psychoprophylaxis | show 🗑
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| show | Leboyer
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| show | A directive statement wishing not to have an epidural even though they change their mind once they start having pain
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| What happens with MAOI and Demerol | show 🗑
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| Why is the timing of demerol and birth time important | show 🗑
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| show | Pudendal, Paracervical, Caudal, Lumbar sympathetic block, infiltration
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| show | Frankenhauser's Plexus (goes straight to fetus)
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| show | Reflex bradycardia, Fetal CNS and myocardial depression, Increase uterine activity, and uterine artery vasoconstriction
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| show | -at the corner of "Vagina" and "Cervix"
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| Indications for general anesthesia during vaginal delivery (7 of them) | show 🗑
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| Contraindications for neuroaxial blockade (6 of them) | show 🗑
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| show | Maternal effects, fetal effects, prolonged labor, c/s rate, motor block, bedrest, and complications
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| Direct effects of epidural analgesia on labor | show 🗑
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| show | Decreased uteroplacental perfussion (@ 20 min mark), alteration in oxytocin metabolism, and impaired reflex activity
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| How does labor analgesia cause fetal bradycardia (2 reasons) | show 🗑
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| Treatment for fetal bradycardia (7 things) | show 🗑
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| show | Lumbar epidural (local anesthesia only), Caudal block, Saddle block (spinal anesthesia), combined spinal-epidural (trial of forceps/possible C/S)
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| show | Fetal status not jeopardized, engagement of fetal head, stable orthostatic vital signs, able to perform bilateral straight leg lift against resistance, able to step up on stool, no gait problems, never walk alone, and fetal monitoring Q 15 min
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| show | 20-30 minutes
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| Pre hydration starting amount for epidural/spinal should be ?ml/kg | show 🗑
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| What risk increases when inserting an epidural needle during a contraction | show 🗑
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| What should you do different on an obese pt with regards to taping an epidural | show 🗑
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| show | About 6 inches (can't wait to put this information to work)
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| show | Bicarb
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| What position should your epidural cath be in before applying tegaderm | show 🗑
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| show | Cephlad - r/t nerve roots (caudal leds to follow nerve roots and go outward)
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| show | Never good
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| show | Air emboli and/or spotty block
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| show | 4-6 cm
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| show | Check temp by dripping on gloved hand, glucose test, and thiopental-bicarb test (CSF stays clear, Local precipitates in high pH)
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| What are the S/S (first to last) of local anesthetic toxicity during epidural/spinal | show 🗑
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| show | Lidocaine 45mg and Epinephrine 15mcg
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| Series of T/F: #1 Before each injection of an epidural local you should lower the catheter below injection site and check for blood or CSF return | show 🗑
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| Series of T/F: #2 Before each injection of an epidural local you should aspirate before injecting each dose of local anesthetic | show 🗑
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| show | True
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| show | True
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| show | True
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| Series of T/F: #6 Before each injection of an epidural local you should maintain verbal contact with your patient | show 🗑
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| T/F: Give your test dose during a uterine contraction | show 🗑
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| show | Atropine
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| To stop convulsions from LA toxicity use (3 things) | show 🗑
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| In LA toxicity support blood pressure with | show 🗑
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| T/F: Mepivicaine is used in OB epidurals | show 🗑
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| show | Mepivicaine is fastest, pka = 7.6--- bupivicaine pka = 8.1
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| T/F: Lipid solubility = potency | show 🗑
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| T/F: Protein binding = duration | show 🗑
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| T/F: pKa = Onset speed | show 🗑
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| show | puritis
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| Intrathecal fentanyl dose | show 🗑
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