NREMT® Paramedic > EMT-P (6) Special Populations > Obstetrical Emergencies > Flashcards

Obstetrical Emergencies Flashcards

Explore the Obstetrical patient and the prehospital emergencies that exist (88 cards)

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1
Q

List down the female reproductive organs.

A
  • Ovaries
  • Fallopian tubes
  • Vagina
  • Uterus
  • Mammary glands
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2
Q

Fill in the blank:

Each follicle contains an ____.

A

oocyte (egg)

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3
Q

Define:

Follicle-Stimulating Hormone

(FSH)

A

Stimulates growth of the ovaries before it releases an egg.

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4
Q

Define:

Luteinizing Hormone

A

Stimulates the process of ovulation.

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5
Q

Fill in the blank:

The release of an egg is called a(n) ____.

A

ovulation

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6
Q

What do the uterus and placenta produce at the end of pregnancy?

A

Prostaglandins

It signals the uterus to contract.

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7
Q

What are fallopian tubes?

A

Tubes that the ovum passes through.

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8
Q

Fill in the blank:

A muscular organ that lies between the urinary bladder and the rectum is called the ______.

A

uterus

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9
Q

What is the pH inside the vaginal cavity?

A

low

It helps rid the vaginal cavity of invaders, such as sperm and bacteria.

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10
Q

Define:

episiotomy

A

Incision of the perineum.

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11
Q

At what week of pregnancy does the heart beat?

A

Third week after conception.

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12
Q

At what week of pregnancy does the placenta begin to form?

A

By the fourth week, it becomes more fully formed and functional.

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13
Q

What is the function of the placenta?

A
  • Respiratory gas exchange.
  • Transport nutrients.
  • Excretion of waste.
  • Transfer of heat.
  • Hormone production
  • A barrier is formed.
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14
Q

How many veins and arteries are in the umbilical cord?

A
  • two arteries
  • single vein

Remember: ___V___ ← The “V” touches once and has two branches above it.

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15
Q

How does the blood flow in the umbilical vein?

A

It carries oxygenated blood from the placenta to the fetus.

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16
Q

How does the blood flow in umbilical arteries?

A

It carries deoxygenated blood from the fetus to the placenta.

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17
Q

How does a baby receive oxygen while still in the utero?

A

Through the placenta.

Blood bypasses the lungs.

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18
Q

What is the function of the amniotic fluid?

A

It provides a weightless environment.

Approximately 1L of fluid in utero.

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19
Q

What happens during the 4th-8th week of embryonic development?

A

Development phase - major organs and body systems start to form.

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20
Q

Fill in the blank:

The normal gestational period is around ____ weeks.

A

38

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21
Q

What is the purpose of measuring the fundus?

A

It helps to estimate the gestational age and monitor the progress of the pregnancy.

Length in centimeters = weeks in gestation.
E.g. 28cm = 28 weeks

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22
Q

What hormone causes GI tract relaxation and constipation in women during pregnancy?

A

Progesterone

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23
Q

Define:

linea nigra

A

Dark line of pigment down the middle of the stomach of a pregnant patient.

This is normal.

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24
Q

How much does pregnancy increase blood volume?

A

40 - 50%

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25
# Define: gravidity
The number of times a person has been **pregnant**.
26
# Define: para
The number of **live births**.
27
How much do **white blood cells** increase during pregnancy?
Elevated, often up to 15,000–18,000/mm³
28
How does the **anatomical position** of the **heart** change during pregnancy?
Displaced **upward** and to the **left**.
29
1. How does blood pressure change **during** pregnancy? 2. What happens to the BP after the **36th week**?
1. Decreases by **5-10 mmHg** 2. Returns to baseline or increases
30
# Define: Lithotomy position
Laying in **supine** with the **knees spread apart**.
31
How does the **diaphragm** change **anatomically** during pregnancy?
It **moves up** to 1 - 1.5''.
32
# Define: postpartum
after delivery
33
What is the **function** of the hormone **relaxin**?
It **relaxes** the tissue, joints, and ligaments to prepare for birth. ## Footnote Relaxin - relaxes
34
# Define: Primigravida
first pregnancy
35
# Define: Primipara
single delivery/birth
36
# Define: Multigravida
two or more pregnancies
37
# Define: Multipara
two or more deliveries/birth
38
# Define: Nullipara
never delivered
39
What are the **signs/symptoms** of **true labor**?
* Regularly spaced contractions. * Shortening intervals between contractions. * Increasing intensity. * Analgesics are ineffective. * Progressive cervical dilation.
40
What are the **signs/symptoms** of **imminent delivery**?
* multiple pregnancies/deliveries * crowning
41
# Define: Supine Hypotensive Syndrome
Laying in supine **compresses the inferior vena cava** and causes hypotension. ## Footnote Treatment: Left lateral positioning.
42
What is **pregnancy-induced hypertension**?
It **develops after the 20th week** of gestation and patient is typically normotensive.
43
# Define: preeclampsia
* peripheral edema * hypertension * proteinuria
44
# Define: eclampsia
**Seizure activity** from hypertension.
45
What is considered **hypertension** in pregnancy?
A **systolic** of _160-180 mmHg_ and a **diastolic** of _105 mmHg_.
46
# Treatment: obstetrical seizures
* Administer magnesium sulfate. * Consider benzodiazepines (cross placental barrier). * Supplement oxygen.
47
Name typical causes of **respiratory disorders** during pregnancy
* **dyspnea** - due to physical changes. * **asthma** - typically occurs during the first pregnancy. * **pneumonia**
48
# Define: Hyperemesis Gravidarum
**Chronic nausea/vomiting** during pregnancy.
49
# Treatment: Hyperemesis Gravidarum
1. 100% oxygen NRB 2. Fluid bolus of 250ml 3. Diphenhydramine 10-50mg IV/IM 4. BGL 5. Orthostatic vitals
50
How much does **urine output increase** during pregnancy?
25 - 50%
51
# Define: Rh Sensitization
It can **produce maternal antibody isoimmunization** and the fetus can be *attacked* by the mother's immune system. ## Footnote Fetus is **Rh+**, mom is **Rh-**
52
How can **HIV** be contracted by the fetus if the mother is HIV**+**?
* breastfeeding * during pregnancy * delivery
53
What is **TORCH syndrome**?
* **T**oxoplasmosis * **O**ther Agents * **R**ubella * **C**ytomegalovirus * **H**erpes simplex ## Footnote Infections that can occur in the fetus due to agents passed by the mom.
54
What causes **toxoplasmosis** in a fetus?
**Parasites** from contaminated food that the mom ingested.
55
What is **rubella?**
viral infection ## Footnote Otherwise known as the "German measles."
56
What are the complications of a fetus contracting **cytomegalovirus**?
Encounter problems with **lungs, blood, liver and nutrition**. ## Footnote Part of the herpesvirus family.
57
# Define: abortion
Expulsion of fetus at **< 20 weeks**.
58
# Define: threatened abortion
Abortion trying to take place characterized by **bleeding**.
59
# Define: imminent abortion
**Spontaneous abortion** that cannot be prevented.
60
# Define: incomplete abortion
Some parts of the fetus are **remain inside** the mother's uterus.
61
# Define: complete abortion
When **all parts** have been cleared.
62
# Define: ectopic pregnancy
Fertilized ovum becomes implanted other than in the uterus, typically in the fallopian tubes. ## Footnote Women of reproductive age with abdominal pain and risk factors should consider ectopic pregnancy.
63
# Define: placental abruption
**Early separation of placenta** from uterine wall. ## Footnote The most common cause is due to hypertension.
64
# Assessment: placental abruption
* vaginal bleeding * bright red blood * pain
65
# Define: placenta previa
**Placenta is located over or near the cervical opening** and may be delivered before the baby.
66
# Assessment: placenta previa
* dark blood * painless bleeding
67
# Treatment: placenta previa
* Position in the left lateral recumbent. * 100% oxygen via NRB at 15L per minute. * IV fluids * Place loose trauma pads over vagina to manage bleeding.
68
# Describe: **First stage** of labor
**Onset of contractions** and end when the cervix is **fully dilated**.
69
# Describe: **Second stage** of labor
Begins with **crowning** and ends with **delivery** of the baby.
70
# Describe: **Third stage** of labor
**Placenta is cleared** from the uterus.
71
List the common **birthing positions**.
* standing birth * Semi-Fowlers position * kneeling birth * side-lying position
72
How do you assist with the **delivery of the placenta**?
* Explain to bear down with following contractions. * Place placenta in plastic bag. * Examine for tears and apply pressure with pads.
73
# Treatment: postpartum hemorrhage
* fundal massage * pitocin
74
What is a **magnesium sulfate**?
Smooth muscle relaxer
75
What is a **calcium chloride/gluconate**?
Increases contractility ## Footnote Antidote for Magnesium Sulfate toxicity.
76
What is **Terbutaline** and what is its use?
* **tocolytic**: smooth muscle relaxer * **used for preterm labor**: in attempt to slow down labor
77
# Dose and Mechanism of action. oxytocin
* It causes uterine contractions to reduce postpartum bleeding. * 3–10 units IM
78
# Define: Preterm Labor
Labor between **20-37th week** gestation.
79
# Define: Post-term Labor
Delivery **after 42 weeks**.
80
What is an **amniotic fluid embolism**?
**Amniotic fluid** enters the woman's _pulmonary_ and _circulatory system_.
81
# Define: hydraminos
**Too much** amniotic fluid.
82
# Define: Cephalopelvic Disproportion
A condition where the **baby’s head is too large** to pass through the maternal pelvis.
83
What is **cephalic presentation**?
Baby is positioned **head first**.
84
What is **breech presentation**? ## Footnote Describe **management** for delivery.
Baby is positioned to be delivered **buttocks or feet first** instead of head first. ## Footnote _Management:_ * Flex knees _(McRoberts Manuever)_. * Give gentle traction to deliver legs. * Let legs hang for gravity to assist in delivery. * Support body and head.
85
What is **shoulder dystocia**? ## Footnote Describe **management** for delivery.
The baby's **shoulders get stuck** inside the mother's pelvis during delivery. ## Footnote _Management:_ * McRoberts maneuver * Apply suprapubic pressure * Corkscrew Maneuver
86
# Treatment: nuchal cord
* Slip finger and remove cord over fetus head. * Cut if too tight.
87
# Treatment: prolapsed umbilical cord
* **Push**: presenting part back into vagina until no longer presses on cord. * **Cover**: exposed portion of cord with dressings moistened in saline.
88
# Define: pregnant trauma
If trauma occurs and the **mother is bleeding**, blood will shunt from the fetus and be used for the mother. When signs of shock are present, fetal mortality is between **70 - 80%**. ## Footnote The normal fetal heart rate is 120–180 bpm. If transported supine, elevate the right hip to 6 inches. If a recumbant position is not necessary, elevate the backboard underneath.
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