Flashcards in Week 4 OB Complications & VBAC - Exam 2 Deck (135)
how do we distinguish placental previa vs. placental abruption
lack of abdominal pain and or absence of abnormal uterine tone is previa
if patient has an abnormal placental attachment- what may occur if the placenta is removed forcefully
** scenario discussed in class**
You have a pregnant patient you've given sux to for c/s but on laryngoscopy you are not able to intubate. pt and baby are stable and you are able to bag/mask adequately.
what would you do?
- wake patient to discuss awake/ fiberoptic (best option since they aren’t in distress)
The most common postpartum headaches are (2)
Tension-type and migraine headaches
________ is the most common indication for a cesarean hysterectomy.
Treatment of magnesium toxicity
o D/C magnesium
o Intubation and ventilation
o IV calcium gluconate (calcium antagonizes effects of magnesium)
leading causes of maternal death (associated with PIH)
- Pulmonary edema/cerebral hemorrhages (
________ ______ is associated with more rapid oxygen desaturation during apnea during the induction of general anesthesia.
The administration of CPAP in patients breathing spontaneously or the administration of PEEP in patients undergoing mechanical ventilation restores
functional residual capacity,
reduces pulmonary shunting, and
The administration of corticosteroids for aspiration pneumonitis recommended?
The most effective way to decrease the risk for aspiration is to?
-Comprehensive airway evaluation,
-prophylactic administration of nonparticulate antacids, and
-use of regional anesthesia decrease the risk of aspiration.
The mother undergoing elective cesarean delivery should fast from solid food. Preoperative antacid prophylaxis may include?
“Before surgical procedures (e.g., cesarean delivery and postpartum tubal ligation), consider timely administration of nonparticulate antacids, H2-receptor antagonist, and/or metoclopramide for aspiration prophylaxis.”
Preoperative prophylaxis before emergency cesarean delivery under general anesthesia should include?
General anesthesia may be unavoidable occasionally, therefore, awake intubation may be indicated in women in whom airway difficulties are anticipated.
The hallmark of aspiration pneumonitis is?
Bronchospasm and disruption of surfactant
likely account for the slight decrease in PaO2 and increase shunting that are observed. The anesthesia provider witnesses regurgitation of gastric contents into the hypopharynx. Patients who aspirate while breathing spontaneously have a brief period of breath-holding followed by tachypnea, tachycardia, and a slight respiratory acidosis.
Is the oral intake of clear fluids allowed during labor?
No, a healthy patient undergoing elective C/S may drink modest amounts of clear liquids 2 hrs before induction of anesthesia. Patients with addition risk factors for aspiration may have further restrictions – determined case by case.
Does eating during labor results in larger residual gastric volumes?
Yes. A reduction in gastric content acidity and volume is believed to decrease risk for damage to the respiratory epithelium if aspiration should occur. Fasting periods for solids 6-8 hrs is recommended.
1. A patients BP is 80/40, HR is 120, RR 26, and are getting prepped for an emergency C/S. What should you do?
2. BP is 80/40 so will you use etomidate or propofol?
why do we avoid oral hypoglycemic agents during pregnancy?
can cause fetal hypoglycemia
The three most common symptoms preceding an eclamptic attack:
1. Headache, visual changes
2. RUQ/epigastric pain
3. Seizures; severe if not controlled with anticonvulsant therapy
HIV test to rule out?
hiv rule out test?
Western blot assay
positive results are then confirmed with
AIDS DX CD4 count:
CD4 < = 200
(N = 500-1500)
can include a flu-like illness within a month or two of exposure
Stage of HIV?
Seroconversion means the immune system is activated against the virus and antibodies can be detected in the blood
the individual usually remains free of major disease, even without treatment
stage of hiv?
It can last 6-8 years, during which HIV levels in the blood slowly rise
occurs when the immune system loses the fight against HIV
stage of HIV?
Symptoms worsen and opportunistic infectious develop
HIV - Four stages of infection:
1. Flu-like (acute)
2. Feeling fine (latent) – during latent phase virus replicates in lymph node
3. Falling count
4. Final crisis
Physical examination findings for HIV:
- Low grade fever, night sweat, weight loss
- Facial seborrhea
- Diffuse lymphadenopathy (like Mono)
- Oral candidiasis “thrush”
- Herpes zoster infection (reactiviation of shingles too)
Clinical features of HIV
- Persistent fevers and chill
- Drenching night sweats
- Fatigue, arthralgias (joint pain), myalgias (muscle pain)
- Unintentional weight loss “HIV wasting syndrome”
- Depression, apathy, as early signs of HIV-related encephalopathy