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Obstetric Emergencies Flashcards

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1
Q

What is the primary focus of Obstetrics in emergency care?

A
  • Recognition and management of normal delivery
  • Vaginal bleeding in the pregnant patient
  • Anatomy and physiology of normal pregnancy
  • Pathophysiology of complications of pregnancy

These competencies are essential for providing care to pregnant patients.

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2
Q

List the management aspects of obstetrics.

A
  • Normal delivery
  • Abnormal delivery
  • Nuchal cord
  • Prolapsed cord
  • Breech delivery
  • Third trimester bleeding
  • Placenta previa
  • Abruptio placenta
  • Spontaneous abortion/miscarriage
  • Ectopic pregnancy
  • Preeclampsia/eclampsia

These are critical conditions that require specific management strategies.

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3
Q

What are the key components of Neonatal Care?

A
  • Assessment of newborn care
  • Neonatal resuscitation

These components are vital for ensuring the health of newborns.

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4
Q

True or false: Most deliveries occur in a hospital.

A

TRUE

However, some pregnant women may not be able to reach a hospital in time.

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5
Q

What are the two glands located on each side of the uterus called?

A

Ovaries

Ovaries are similar in function to male testes and contain follicles with eggs.

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6
Q

Where does fertilization usually occur?

A

In the fallopian tube

The fertilized egg then travels to the uterus for implantation.

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7
Q

What is the role of the uterus during pregnancy?

A
  • Encloses and protects the fetus
  • Produces contractions during labor
  • Helps push the fetus through the birth canal

The uterus is a muscular organ essential for childbirth.

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8
Q

What is the placenta’s function?

A
  • Attaches to the uterine wall
  • Connects to the fetus by the umbilical cord
  • Keeps maternal and fetal blood separate while allowing nutrient exchange

The placenta is crucial for fetal development.

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9
Q

Fill in the blank: The amniotic sac contains about _______ mL of amniotic fluid.

A

500 to 1,000

This fluid helps insulate and protect the fetus.

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10
Q

What are some normal changes in pregnancy?

A
  • Increased hormone levels
  • Uterus displacement
  • Increased blood volume
  • Changes in respiratory capacity
  • Increased heart rate

These changes prepare the body for childbirth.

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11
Q

What is gestational diabetes?

A

Diabetes that develops during pregnancy

It usually resolves after delivery.

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12
Q

What is preeclampsia?

A

Pregnancy-induced hypertension

It can develop after the 20th week of gestation and has specific signs and symptoms.

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13
Q

What are the signs of eclampsia?

A
  • Seizures
  • Severe hypertension
  • Severe headache
  • Visual abnormalities
  • Swelling in hands and feet
  • Anxiety

Eclampsia is a serious condition requiring immediate medical attention.

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14
Q

What may internal bleeding indicate during pregnancy?

A

Ectopic pregnancy

This occurs when an embryo develops outside the uterus, often in a fallopian tube.

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15
Q

What is the risk associated with abruptio placenta?

A

Premature separation of the placenta from the uterus

This can lead to serious complications during pregnancy.

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16
Q

What are the potential effects of substance abuse on the fetus?

A
  • Prematurity
  • Low birth weight
  • Severe respiratory distress
  • Death

Fetal alcohol syndrome is a specific condition resulting from maternal alcohol abuse.

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17
Q

What should be assessed in a pregnant trauma patient?

A
  • Airway
  • Breathing
  • Circulation
  • Positioning on the left side

These assessments are crucial for the safety of both the mother and fetus.

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18
Q

What is the importance of cultural sensitivity in obstetric care?

A

It affects care choices during pregnancy and childbirth

Some cultures may have specific preferences regarding healthcare providers.

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19
Q

What is a common concern for teenage pregnancy?

A

Lack of awareness or denial of pregnancy

Respecting privacy is crucial when assessing pregnant teenagers.

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20
Q

What is the SAMPLE history in patient assessment?

A
  • Signs and symptoms
  • Allergies
  • Medications
  • Past medical history
  • Last oral intake
  • Events leading up to the incident

This history is essential for understanding the patient’s condition.

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21
Q

What is the first step in obtaining an obstetric history?

A

Her expected due date

This is crucial for assessing the pregnancy timeline.

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22
Q

What does SAMPLE stand for in obtaining a history?

A
  • Signs and symptoms
  • Allergies
  • Medications
  • Past medical history
  • Last oral intake
  • Events leading up to the present illness/injury

This acronym helps in gathering pertinent medical history.

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23
Q

What should be assessed during the secondary assessment of a pregnant patient?

A
  • Major body systems
  • Chief complaint
  • Fetal movement
  • Contractions and possible delivery

Focus on the patient’s condition and any signs of labor.

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24
Q

True or false: Hypertension in a pregnant patient may indicate more serious problems.

A

TRUE

Even mild hypertension can be a sign of complications.

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25
What are the **three stages of labor**?
* First Stage * Second Stage * Third Stage ## Footnote Each stage has distinct characteristics and processes.
26
The **first stage of labor** begins with the onset of contractions and ends when the cervix is __________.
fully dilated ## Footnote This stage is usually the longest, averaging 16 hours.
27
What is **lightening** in the context of labor?
The head of the fetus descends into the woman’s pelvis ## Footnote This positioning occurs as the body prepares for delivery.
28
What indicates that the **second stage of labor** has begun?
The fetus begins to encounter the birth canal ## Footnote This stage ends when the newborn is born.
29
What is the primary focus during the **third stage of labor**?
Delivery of the placenta ## Footnote The placenta must completely separate from the uterine wall.
30
When should you consider **delivery at the scene**?
* Delivery is imminent * Environmental factors prevent reaching the hospital ## Footnote Assess the situation carefully to ensure safety.
31
What questions should you ask to determine if **delivery is imminent**?
* How long have you been pregnant? * When are you due? * Is this your first baby? * Are you having contractions? * Have you had spotting or bleeding? ## Footnote These questions help assess the urgency of the situation.
32
What should you do if the patient feels the need to **push**?
Prepare for delivery ## Footnote Visually inspect for crowning and do not touch the vaginal area unless necessary.
33
What is the role of the **OB kit** during delivery?
Contains sterile supplies for childbirth ## Footnote Ensure your emergency vehicle is equipped with this kit.
34
What is the **golden minute** after birth?
The first minute after birth for initial newborn care ## Footnote Actions include airway positioning, suctioning, drying, warming, and tactile stimulation.
35
What does the **Apgar score** assess?
* Appearance * Pulse * Grimace or irritability * Activity or muscle tone * Respirations ## Footnote This scoring system evaluates the newborn's health at 1 and 5 minutes after birth.
36
What is a **breech presentation**?
When the buttocks are delivered first ## Footnote Breech deliveries usually take longer and require special care.
37
What should you do if a **limb presentation** occurs?
Provide prompt transport for hospital delivery ## Footnote This is a life-threatening situation requiring immediate medical attention.
38
What is **spina bifida**?
Developmental defect where a portion of the spinal cord protrudes outside of the vertebrae ## Footnote Cover the area with a sterile, moist dressing and maintain body temperature.
39
What typically happens after the **first birth** in a multiple gestation?
Contractions will begin again about 10 minutes later ## Footnote Delivery of twins is usually not difficult.
40
What is **Spina Bifida**?
Developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae ## Footnote Cover the open area of the spinal cord with a sterile, moist dressing.
41
What is important to maintain when applying moist dressings for Spina Bifida?
Maintenance of body temperature ## Footnote This is crucial to prevent complications.
42
Twins occur once in every _______ births.
30 ## Footnote Twins are typically smaller than single fetuses.
43
About how long after the first twin is born do contractions begin again?
10 minutes ## Footnote The second twin is usually born within 45 minutes of the first.
44
What should you record for each twin during delivery?
The time of birth ## Footnote This is important for medical records.
45
A newborn is considered **premature** if they are born before ____ weeks.
37 ## Footnote Any newborn weighing less than 5 lb at birth is also considered premature.
46
What are some characteristics of a **premature newborn**?
* Smaller and thinner * Head is proportionately larger * Vernix caseosa is absent or minimal * Less body hair ## Footnote Premature newborns require special care to survive.
47
What is the risk associated with **postterm pregnancy**?
* Increased chance of injury to the fetus * Increased likelihood of cesarean section * Risk for perineal tears and infection ## Footnote Fetuses can be larger, sometimes weighing 10 lb or more.
48
What should you do if bleeding continues after delivery of the placenta?
Continue to massage the uterus ## Footnote Check your technique and hand placement if bleeding continues.
49
Postpartum patients are at an increased risk of _______.
an embolism ## Footnote Most commonly a pulmonary embolism.
50
The first stage of labor ends when the **presenting part** of the baby is visible.
True ## Footnote This indicates that the cervix is fully dilated.
51
What is **preeclampsia** characterized by?
* Headache * Visual disturbances * Edema of the hands and feet * High blood pressure ## Footnote It usually develops after the 20th week of gestation.
52
To prevent **supine hypotensive syndrome**, how should a pregnant patient be positioned?
On her left side ## Footnote This stops the weight of the fetus from compressing the inferior vena cava.
53
Immediately after delivery of the infant’s head, you should check the position of the _______.
umbilical cord ## Footnote This ensures it is not wrapped around the baby’s neck.
54
If the umbilical cord is wrapped around the baby's neck, you should make one attempt to _______.
slide the cord over the head ## Footnote If this is not possible, the cord should be clamped and cut.
55
The need for and extent of **newborn resuscitation** is based on:
respiratory effort, heart rate, and color ## Footnote The Apgar score is not used to determine if resuscitation is needed.
56
A newborn is considered to be 'term' if it is born after ____ weeks and before ____ weeks.
37; 42 ## Footnote An infant born before 37 weeks is considered premature.
57
What is the MOST effective way to prevent **cardiopulmonary arrest** in a newborn?
ensure adequate oxygenation and ventilation ## Footnote This is critical as respiratory arrest is often the cause.
58
If you visualize an arm protruding from a woman's vagina during labor, you should _______.
cover the arm with a sterile towel and transport immediately ## Footnote Limb presentations do not deliver in the field.
59
What is the **gestation range** for a term infant?
between 37 and 42 weeks ## Footnote An infant born before 37 weeks is considered premature, while an infant born after 42 weeks is considered past due.
60
An infant who is born before **37 weeks’ gestation** is considered _______.
premature ## Footnote Premature infants may weigh less than 5 lb, regardless of gestational age.
61
An infant born after **42 weeks** is considered _______.
past due ## Footnote This indicates that the infant has exceeded the typical gestation period.
62
A newborn is considered to be 'term' if it is born after ____ weeks and before ____ weeks.
37, 42 ## Footnote This classification helps in assessing the health and development of the newborn.
63
True or false: A newborn is considered premature if born after **37 weeks**.
FALSE ## Footnote A newborn is considered premature if born before 37 weeks.
64
True or false: A newborn is considered past due if born after **42 weeks**.
TRUE ## Footnote This classification indicates that the infant has exceeded the normal gestation period.
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