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Principles II test III Obstetrics slides 9-15
She says I am the one, but the kid is not my son...
18
Nursing
Graduate
11/23/2009

Additional Nursing Flashcards

 


 

Cards

Term
How can you establish proper LUD positioning?
Definition

- tip the table to the left

- wedge and IV bag under right hip for a 15 degree tilt

-may have to manually move uterus

Term
Since pregnancy causes elevation of the diaphragm, (shifting the position of the heart) what are some cardiovascular changes you might observe?
Definition

- Left axis deviation

- T wave changes

- Systoloc murmur (not a big deal)

- Splitting of first heart sound S1

- S3 may be audible

-appearance of enlarged heart

- sm. pericardial effusion (asymptomatic)

 

*diastolic murmur in pregnancy is pathological*

Term
Due to pulmonary changes in pregnancy (edematous vocal cords and arytenoids), what ETT sizes would you use?
Definition

6.0-6.5

 

 

Term
What kind of handle would be used for shorties with short necks, large breasts, and increased weight?
Definition

a "Tim" handle

(stubby)

Term
How much does oxygen demand increase from baseline w/ pregnancy? During the 2nd stage of labor?
Definition

33%

 

100%

Term
At term, how much does minute ventilation increase?
Definition
50%
Term
An increase in minute ventilation is thought to be d/t an increase in what hormone?
Definition

progesterone

 

 

Term

In pregnancy, which way does the oxygen hemoglobin curve shift?

 

The P 50 value moves from _____ to _____.

Definition

Right


27 to 30 torr

Term
What is the PaCO2 at the beginning of pregnancy and end of the third trimester?
Definition
The PaCO2 rises to >100 torr initially d/t hyperventilation, but then drops below 100 torr as the preganancy progresses.
Term
Which way does 2,3 DPG shift the oxygen hemoglobin curve?
Definition

Right

 

it offsets the hemoglobin's affinity for O2 despite the overall alkalotic state.

Term
Is pregnancy an obstructive or restrictive dysfunction?
Definition
Restrictive
Term
FRC, expiratory reserve, and residual volume decrease d/t what?
Definition
The upward pressure on the diaphragm by the uterus.
Term
Decreased FRC means that patruients should not lie completely flat without what? After delivery, how long does it take for the baby-mama's FRC to return to normal?
Definition

supplemental O2!!

 

48 hours

Term
T or F: a reduction in FRC and a decreased minute ventilation increases the uptake of all inhalation anesthetics
Definition
False, bitches. Reduction in FRC and increase in minute ventilation will increase uptake of inhalation anesthetics.
Term
Is closing capacity increased or decreased in a supine preggers pt? Whats the difference in resting saturation between your baby-mama and your nonpregnant boo?
Definition

- Closing capacity is increased (resulting in airway closure and atelectasis before the TV has been fully exhaled)

 

- A sleeping patruient often has a lower resting saturation compared to nonpregnant person.

 

Term
T or F: MAC for volatiles increases during pregnancy
Definition

Nope, it decreases during pregnancy!

 

*this, again, might be d/t the effects of progesterone

Term

Engorgement of epidural veins leads to a __________ size of epidural space and __________ the CSF volume.  The ____________ volume of CSF facilitates the spread of the local anesthetics.

 

Definition

decreased

decreases

decreased

Term
What are the musculoskeletal effects of relaxin?
Definition

- soften the cervix

- inhibits uterine contractions

- relaxes pubic symphysis and pelvic joints

 

*ligamentous laxity of spine increases the risk of back injury and high incidence of back pain in pregnany

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