EMT Chapter 31 - Obstetrics and Neonatal Care

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Terms in this set (...)

The female reproductive system includes which organs?
It includes the fallopian tubes, uterus, cervix, vagina, and the breasts.
During the menstrual cycle how many follicles are successful at maturing and able to release an egg?
There will only be one follicle (out of 10 to 20 that attempt the process each month)
When does ovulation occur?
It occurs approximately 2 weeks prior to menstruation.
What is the endometrium?
It is when the lining of the inside of the uterus, begins to thicken and prepare for the potential fertilized egg to implant.
What happens if the egg is not fertilized within 36-48 hours after it has been released from the follicle?
It will simply die. Eventually, the lining that has thickened inside the uterus will be shed...It occurs around the 28th day of woman's cycle.
Where does fertilization of the egg usually occur?
Fertilization, when a sperm and egg meet, usually occurs when the egg is inside the fallopian tube.
What is an embryo?
It is the fertilized egg that is the early stages of the fetus.
What is the fetus?
It is the developing, unborn infant inside the uterus. (Grows for approximately 9 months/40 weeks)
What is the birth canal?
It is the vagina and cervix?
What is the cervix?
It is the narrowest portion of the uterus that opens into the vagina.
What is a bloody show?
It is a small amount of blood at the vagina that appears at the beginning of labor and may include a plug of pink-tinged mucus that is discharged when the cervix begins to dilate.
What is the length of the vagina?
It is about 8-12 cm in length (begins at the cervix & ends as an external opening)
How can you prevent the perineum from tearing?
By applying pressure to the baby's head to allow the tissues to stretch and to prevent a precipitous birth. An episiotomy may be performed by the physician (incision to the perineum).
What is the placenta?
It is the tissue attached to the uterine wall that nourishes the fetus through the umbilical cord.
What is the placental barrier?
It consists of two layers of cells, keeping the circulation of the woman and fetus separated but allowing nutrients, oxygen, waste, carbon dioxide, and many toxins and most medications to pass between the fetus and woman.
What is the umbilical cord?
It is the conduit connecting mother to infant via the placenta; contains two arteries and one vein.
The umbilical vein carries?
It carries oxygenated blood from the woman to the heart of the fetus.
The umbilical arteries carry?
They carry deoxygenated blood from the heart of the fetus to the woman.
What is the amniotic sac?
It is the fluid-filled, baglike membrane in which the fetus develops.
How much fluid is contained in the amniotic sac?
It contains about 500-1000 mL, which helps insulate and protect the fetus.
What systems are involved in changes dealing with pregnancy?
The primary systems are the respiratory, cardiovascular, and musculoskeletal systems.
How much of an increase in blood volume does a pregnancy bring?
Blood volume may eventually increase as much as 50% by the end of pregnancy.
As the pregnancy continues what happens to the respiratory system?
The respiratory rate increases, with decreasing minute volumes. The pregnancy also increases the patient's overall demand for oxygen as the metabolic demands increase.
What are the three stages of labor?
1)Dilation of the cervix
2)Delivery of the infant
3)Delivery of the placenta
What is a primigravida?
It is a woman who is experiencing her first pregnancy.
What is a multigravida?
It is a woman who has experienced previous pregnancies.
What are Braxton-Hicks contractions?
They are preterm or false labor contractions.
What is lightening?
It is a sensation felt by a pregnant patient when the fetus positions itself for delivery.
What is crowning?
It is the appearance of the infant's head at the vaginal opending during labor.
What is preeclampsia/pregnancy-induced hypertension?
It is a condition of late pregnancy that involves headache, visual changes, and swelling of the hands and feet.
What are the signs and symptoms of preeclampsia?
Headache, seeing spots, swelling in the hands and feet (edema), anxiety, and high blood pressure.
What is eclampsia?
It is seizures (convulsions) resulting from severe hypertension in a pregnant woman.
What is supine hypotensive syndrome?
It is low blood pressure resulting from compression of the inferior vena cava by the weight of the pregnant uterus when the mother is supine. (Prevent by transporting patient on her left side).
What is an ectopic pregnancy?
It is a pregnancy that develops outside the uterus, typically in a fallopian tube.
What is the leading cause of maternal death in the first trimester of pregnancy?
It is the internal hemorrhage into the abdomen following rupture of an ectopic pregnancy.
What is miscarriage?
It is the passage of the fetus and placenta before 20 weeks; spontaneous abortion.
What is an abruption placenta?
It is a premature separation of the placenta from the wall of the uterus.
What is placenta previa?
It is a condition in which the placenta develops over and covers the cervix.
Any bleeding from the vagina in a pregnant woman should be treated how?
As a serious sign and should be treated in the hospital promptly.
What is gestational diabetes?
It is diabetes that develops during pregnancy in women who did not have diabetes before pregnancy.
Pregnant women have an increased amount of overall what?
Increased amount of overall blood volume and an approximate 20% increase in their heart rate by the third trimester.
When your patient is pregnant, you have two patients to care for, who is the focus?
Your focus is on the assessment and the management of the woman.
What are the guidelines for treating a pregnant trauma patient?
1)Maintain an open airway - increased risk of vomiting
2)Administer high-flow O2 - patient also supplying O2 to fetus
3)Ensure adequate ventilations - listen to lung sounds
4)Assess circulation - maintain Index of S. for internal bleeding
5)Transport considerations - call ALS for MOIs or major trauma
What is meconium?
It is a dark green material in the amniotic fluid that can indicate distress or disease in the newborn; the meconium can be aspirated into the infant's lungs during delivery; aka infant's first bowel movement.
During the physical examination of a pregnant patient what should you focus on?
You should focus on the contractions and possible delivery.
In terms of litigation where does obstetrics fall?
It is among the most litigated specialties in medicine; therefore, scrupulous documentation is essential.
What are some questions to determine if delivery is imminent?
-How long have you been pregnant? -When are you due?
-Is this your first baby? -Are you have contractions, how long?
-Do you feel like you will have a bowel movement?
-Have you had any spotting or bleeding? -Has your water broken?
-Were any of you children delivered by cesarean?
What are some questions to ask to determine any potential complications?
-Have you had any problems in a previous pregnancy?
-Do you use drugs, drink, alcohol, or take any medications?
-Do you know if there is a chance for multiple births?
-Does your doctor expect any complications?
What is a nucal cord?
It is an umbilical cord that is wrapped around the infant's neck.
As soon as the infant is born, you should?
He or she needs to be dried off and wrapped immediately in a blanket or towel and placed on one side.
What is the fundus?
It is the dome-shaped top of the uterus.
What should you do to help control bleeding in mother who has just given birth?
After delivery massage the mother's abdomen in a firm, circular motion. The uterus will contract and become firmer.
During delivery of the placenta, the following are considered emergency situations:
1)More than 30 minutes elapse, and the placenta has not delivered.
2)There is more than 500 mL of bleeding before the placenta.
3)There is significant bleeding after delivery of the placenta.
When should you begin resuscitation efforts on an infant?
After 10-15 seconds, many infants require some form of stimulation that will encourage them to breath air.
If chest compressions are required for an infant, which technique should be used?
Use either the hand-encircling technique or the two-finger technique.
Because cardiac arrest in neonates is nearly always the result of ventilation compromise, a compression to ventilation ratio of what should be used?
A compression to ventilation ratio of 3:1 should be used, which yields 120 actions per minute (90 compressions & 30 vents)
If the newborn's cardiac arrest is believed to be of cardiac origin, what do you use?
Consider a higher ratio, 15:2 compressions vs. ventilations.
What is the Apgar score?
It is a scoring system for assessing the status of a newborn that assigns a number value to each of the five areas of assessment.
What are the five areas of assessment for the Apgar?
A - Appearance - color of the infants skin
P - Pulse - determine the beats/min
G - Grimmace/irritability - newborn's response to stimuli
A - Activity/muscle tone - newborns resistance to stretching
R - Respiration - how air is ventilated and used for the newborn
What is presentation?
It is the position in which an infant is born; the part of the infant that appears first.
What is vertex presentation?
It is a delivery in which the head comes out first.
What is breech presentation?
It is a delivery in which the buttocks come out first.
What is limb presentation?
It is a delivery in which the presenting part is a single arm, leg, or foot.
What is prolapse of the umbilical cord?
It is a situation in which the umbilical cord comes out of the vagina before the infant.
What is spina bifida?
It is a developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly even outside of the body, usually at the lower third off the spine in the lumbar area.
What is fetal alcohol syndrome?
It is a condition of infants who are born to women who consume alcohol during pregnancy; characterized by growth and physical problems, mental retardation, and a variety of congenital abnormalities.