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Terms in this set (30)
Many women complain of difficulty with nasal breathing
Level of diaphragm rises with increasing size of uterus
O2 consumption increases by 20%
BMR increases by 20%
From 5th month and on, what respiratory changes?
TLC, ERV, RV, and FRC decrease
Inspiratory capacity increases (due to increased TV)
IRV stays the same
(decreased FRC due to decrease ERV b/c of larger than normal TV)
Do pregant women rapidly desat?
yes due to decrease FRC and increased oxygen consumption
What relaxes bronchiolar smooth muscle to decrease airway resistance in pregnant women?
Post partum blood progesterone allows return to normal ventilation within
What changes the most in pregnant women?
Function of gastrin
induces copious secretions of water, electrolytes, and enzymes from the stomach, pancreas and small intestine
Which hormones increase in pregnancy?
gastrin and progesterone
Which hormones decrease in pregnancy?
What does motilin do?
accelerates gastric emptying, stimulates LES, and reduces intestinal transit time
What does progesterone do?
decreases LES pressure and increases GI transit time
Patient is considered full stomach after ____________ gestation
Which medication can cause extrapyramidal reactions?
MAC is decreased in pregnant pts at least __________ pregnant
True or false: pregnant pts have enhanced sensitivity to local anesthetics during regional anesthesia
Anesthesia for non-laboring parturient
delay surgery to second trimester
avoid any extra drugs
try to use local with minimal MAC
Anesthesia for early miscarriage
Most want to leave the hospital ASAP - use short acting drugs
Anesthesia for late miscarriage
many will get labor epidurals/spinals or increased IV narcotics
Anesthesia for labor
Epidural, spinal or CSE
LUD - left uterine displacement. Laying on IVC decreases blood return
Use O2 for baby's benefit
Sparing use of IV narcotics 2nd fetal transfer before clamping of the cord
Anesthesia for C section
only regional anesthesia
O2 until baby born and mom is stable
post-op pain with PCA, PCEA
Is GA for a C section a true RSI?
Most maternal mortality occurs secondary to
difficult/failed intubation with or without subsequent pulmonary aspiration of gastric contents
Situations tha tlead to the administration of GA from C-section
emergent delivery of fetus
contraindication to use of regional
failed regional and unexpected prolonged or difficult surgery
Studies have consistently shown that infants delivered under GA are more likely ot be
require more active resuscitation
however, with appropriate care, the infants are indistinguishable after first few minutes of life
Anesthesia for multiple gestation pregnancy
vaginal delivery in OR
be ready to convert to C section
6-6.5 ETT with stylet
MAC 3/ Mill 2 with stubby handle
Sux drawn up
Room should always be ready for emergency
Who is your first priority? mom or baby?
Which of the following lung volumes/capacities will increase during pregnancy?
Which of the following hormones acclerates gastric emptying?
Which of the following size ETT would be ideal to include in your airway setup for a parturient that is 5'9" and 90 kg?
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