Obstetrical Anesthesia Flashcards Preview

Board Review CRNA (Sweat Book) > Obstetrical Anesthesia > Flashcards

Flashcards in Obstetrical Anesthesia Deck (105)
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1

RSI, application of cricoid pressure, and a cuffed ETT is needed for pregnant women receiving general anesthesia after the __________.

first trimester

2

What are 3 lung capacities that do not change during pregnancy?

vital capacity, total lung capacity, and inspiratory capacity

3

Would you expect PaO2 to be higher in pregnant or non-pregnant state?

pregnant
*CO2 would be higher in the non-pregnant state

4

What happens to the diaphragm in pregnancy?

displaced cephalad about 4 cm by the expanding uterus

5

An increase in oxygen consumption produces a ______% increase in alveolar ventilation at term.

70

6

Why do pregnant pt's desat quickly?

they have a decreased FRC and increased alveolar ventilation resulting in faster desaturation
*an increased maternal oxygen consumption and any episodes of apnea will lead to maternal hypoxia

7

When is airway edema most evident?

airway edema d\t engorgement is most evident during the third trimester

8

What central hemodynamics increase at term?

increase:
+50% in CO
+25% in SV
+25% in HR
LVEDV
EF

9

What central hemodynamics decrease at term?

decrease:
-20% in SVR

10

What happens to CVP in the parturient at term?

no change

11

What happens to LVESV in the parturient at term?

no change

12

What happens to PCWP in the parturient at term?

no change

13

What happens to pulmonary artery diastolic pressure in the parturient at term?

no change

14

What two changes result in a dilutional anemia in the parturient at term?

a +45 % increase in blood volume, but another +55% in plasma volume

15

What is a typical H&H in the parturient at term?

11.6/35.5%

16

What is maternal supine hypotensive syndrome?

compression of IVC decreases venous return and this will result in decreased SV and hypotension

17

What is another name for maternal supine hypotensive syndrome?

aortocaval syndrome

18

How can you treat maternal supine hypotensive syndrome?

LUD--> left side with wedge under right hip 15%

19

Blood flow to uterine vasculature is approximately _______.

700-800ml/minute
must keep maternal SBP >100mmHg to ensure perfusion

20

Why does the increase in blood volume not cause an increase in BP?

due to a decrease in peripheral vascular resistance

21

A healthy parturient will tolerate up to _____ml of blood loss.

1500mL

22

A high Hgb of >14 can indicate a low volume state caused by ________. (3)

1) preeclampsia
2) HTN
3) inappropriate diuretics

23

Why do women with cardiac and pulmonary disease remain at risk after delivery?

b\c CO remains high in the first few hours following postpartum (80%)

24

Cardiac output during labor:
Latent Phase - increases ________%

15%

25

Cardiac output during labor:
Active Phase - increases ________%

30%

26

Cardiac output during labor:
Second Stage - increases ________%

45%

27

Cardiac output during labor:
Postpartum - increases ________%

80%

28

Always avoid aortocaval compression: _______% of supine parturients with a T4 sympathectomy develop significant hypotension.

70-80%

29

What clotting factors increase at term?

1, 7, 8, 9, 10, 12

30

What clotting factors decrease at term?

11, 13 (thromboplastin and fibrin stabilizing factor)