Shared Flashcard Set

Details

EMSTA Block 10
Covering Ch 9, & 39-42
125
Medical
Professional
01/26/2013

Additional Medical Flashcards

 


 

Cards

Term

When providing bag-mask ventilations to an infant, you need to be aware that....

Definition

an infant’s lungs are fragile. Ventilations that are too forceful can result in trauma from pressure, or barotrauma.

Term

Prior to birth, fetal circulation occurs through...

Definition

the placenta

Term

Just after birth, the ductus venosus constricts and closes.

As a consequence... 

Definition

the infant’s blood pressure changes, and the foramen ovale, an opening in the septum of the heart, closes

Term

Just after birth the ductus arteriosus constricts and closes, resulting in... 

Definition
  • circulation through the pulmonary system and the veins and arteries (rather than the placenta)
  • increased vascular resistance
  • decreased pulmonary resistance.
Term
Newborn (0 to 1 Month) Vital Signs
Definition

Pulse

90 to 180

 

Respirations

30 to 60

 

BP

50 to 70

Temp

 

98 to 100

Term
Infant (1 month to 1 Year) Vital Signs
Definition

Pulse

100 to 160

 

Respirations

25 to 50

 

Blood Pressure

70 to 95

 

Temp

96.8 to 99.6

 

Term
Toddler (1 to 3 years) Vital signs
Definition

Pulse

90 to 150

 

Respirations

20 to 30

 

Blood Pressure

80 to 100

 

Temp

96.8 to 99.6

Term
Pre-School Age (3 to 6 years) Vital Signs
Definition

Pulse

80 to 140

 

Respirations

20 to 25

 

Blood Pressure

80 to 100

 

Temp

98.6

Term
Schoo-Age (6 to 12 years) Vital Signs
Definition

Pulse

70 to 120

 

Respirations

15 to 20

 

Blood Pressure

80 to 110

 

Temp

98.6

Term
Adolescent (12-18 years) Vital Signs
Definition

Pulse

60 to 100

 

Respirations

12 to 16

 

Blood Pressure

90 to 110

 

Temp

98.6

Term
Early Adult (19 to 40 years) Vital Signs
Definition

Pulse

70

 

Respirations

12 to 20

 

Blood Pressure

90 to 140

 

Temp

98.6

Term
Middle Adult (41 to 60 years) Vital Signs
Definition

Pulse

70

 

Respirations

12 to 20

 

Blood Pressure

90 to 140

 

Temp

98.6

Term
Late Adult (61 and older) Vital Signs
Definition

Pulse

70

 

Respirations

12 to 20

 

Blood Pressure

90 to 140

 

Temp

98.6

Term
Mid-life Crisis
Definition
- a person who makes a dramatic gesture in a bid to reclaim his or her youth. The classic example is the 45-year-old father of three who buys a bright red, two-seat convertible sports car. 
Term
Terminal drop hypothesis
Definition

– the theory that a person’s mental function declines in the last 5 years of life.

Term
Each ovary contains about ___________.
Definition
200,000 follicles
Term
Each of the follicle contain an _________.
Definition
oocyte
Term

Oocyte

Definition
– an egg produced from the female ovary
Term

Artesia

Definition
– the process by which an oocyte dies
Term
Follicle-stimulating hormone
Definition
– FSH is a hormone produced by the anterior pituitary gland which is important in the menstrual cycle
Term
Gonadotropin-releasing factor (GnRF)
Definition
–  a chemical released by the hypothalamus that stimulates the release of follicle-stimulating hormone
Term

Luteinizing hormone (LH)

Definition
– a hormone released by the anterior pituitary gland that stimulates the process of ovulation
Term

Corpus luteum

Definition
– the remains of a follicle after an oocyte has been released, and which secretes progesterone
Term

Progesterone

Definition
– a hormone that influences the second phase of the menstrual cycle, when the oocyte is either fertilized or dies
Term

Secretory phase

Definition
– the second phase of the menstrual cycle
Term
Embryo
Definition
– the fetus in the earliest stages after fertilization
Term
The ______ is a muscular, inverted pear-shaped organ that lies between the urinary bladder and the rectum
Definition
uterus
Term

The dome-shaped top of the uterus is called the ______.

Definition
fundus
Term

Uterus

Definition

– a muscular inverted pear-shaped organ, that lies situated between the urinary bladder and the rectum

Term

Fundus 

Definition
– the dome-shaped top of the uterus
Term

Body 

Definition
– in context of the uterus, the portion below the fundus that begins to taper and narrow
Term

Cervix

Definition
– the narrowest portion of the uterus that opens into the vagina
Term

External Os

Definition
 – the junction where the uterus opens into the vagina
Term

Uterine cavity

Definition
 – the interior of the body of the uterus
Term

Cervical canal 

Definition
– the inferior of the cervix
Term

The interior of the vagina is acidic owing the breakdown of glycogen (found in large amounts in the vaginal mucosa), which creates...

Definition
... a low-pH environment that inhibits bacterial growth.
Term

The mammary gland (breasts) are _________________.

Definition
modified sweat glands
Term

Milk is carried to the surface of each breast through

Definition
lactiferous ducts that terminate in a nipple.
Term

Placenta

Definition

 – The tissue attached to the uterine wall that nourishes the fetus through the umbilical cord

Term

Blastocyst 

Definition

– the term for an oocyte once it has been fertilized and multiplies into cells.

Term

Human chorionic gonadotropin hormone

Definition
– a hormone that sends signals to the corpus leteum that pregnancy has initiated. 
Term

The placenta serves as ...

Definition
...an early liver, taking care of the synthesis of glycogen and cholesterol, metabolizes fatty acid, and produces antibodies that protect the fetus
Term

Gestational period is the time that is takes for the infant to develop in the utero. It normally takes ________, with significant developmental progress occurring each week. 

Definition
38 weeks
Term

Gravid

Definition
 - the total number of pregnancies, but not necessarily carried to term
Term

Para 

Definition
the number of pregnancies that resulted in delivery of an infant(s)
Term

primigravida

Definition
- a woman who is pregnant for the first time
Term

primipara

Definition
 - a woman who has had only one delivery
Term

multigravida

Definition
 - a woman who has had two or more pregnancies, irrespective of the outcome
Term

multipara 

Definition
- a woman who has had two or more deliveries. A woman who has had more than five deliveries is reffered to as a “grand multipara”
Term

Nullipara

Definition
- a woman who has never delivered
Term

During vaginal delivery, a woman may lose as much as ______ of blood (______  in case of cesarean section)

Definition

500 mL


1,000mL

Term

A pregnant woman’s heart rate gradually increases during pregnancy, by an average of _________________.

Definition
15 to 20 beats/min by term
Term

ECG changes that can occur during pregnancy include __________________, which is often considered normal.

Definition
ectopic beats and SVT
Term

Preeclampsia (also called toxemia of pregnancy) is a condition of late pregnancy that involves that involves gradual onset of....

Definition
....HTN, headache, visual changes, and swelling of the hands and feet.
Term

Preeclampsia manifests after the 20th week of gestation with the onset of a triad of symptoms such as....

Definition
  1. edema, usually of the face, ankles, and hands
  2. gradual onset of HTN
  3. and protein in the urine
Term

Cephalopelvic disproportion

Definition
- the head of the fetus is larger than the pelvis. In most cases, a cesarean section will be required to prevent maternal and fetal distress. May cause massive hemorrhage, along with other postpartum complications. 
Term

Abortion

Definition
– is defined as expulsion of the fetus, from any cause, before the 20th week of gestation
Term

Spontaneous abortion

Definition
– (miscarriage) occurs naturally, affecting about 1 of every 5 pregnancies
Term

Induced abortion 

Definition
– abortion brought on intentially
Term

Threatened abortion 

Definition
– an abortion attempting to take place
Term

Inevitable abortion

Definition
– a spontaneous abortion that cannot be prevented 
Term

Incomplete abortion

Definition
– occurs when part of the products of conception are expelled but some remain the uterus
Term

Complete abortion

Definition
– occurs when all of the products of conception have been expelled
Term

Missed abortion 

Definition
– the fetus dies during the first 20 weeks of gestation but remains in utero.
Term

Septic abortion

Definition

– was once the leading cause of maternal death worldwide.

- In medical literature, a common complication of childbirth was puerperal fever, which was caused by a streptococcal infection of the genital tract.

- Septic occurs when the uterus becomes infected, often by common vaginal bacterial flora, following any type of abortion. 

Term

Abruptio placenta

Definition
a premature separation of a normally implanted placenta from the wall of the uterus.
Term

Placenta previa

Definition
- The placenta is implanted low in the uterus and, as it grows, it partially or fully obscures the cervical canal. C/C is usually painless bright red vaginal bleeding
Term

Hyperemesis Gravidarum 

Definition
- a condition of persistent nausea and vomiting during pregnancy
Term

Complications of VBAC (vaginal birth after cesarean) can include _________________.

Definition
uterine rupture
Term

first stage of labor

Definition
  • Begins with the onset of labor pains–crampy abdominal pains that may radiate into the small of the back and reflect the contractions of the uterus.
  • Contractions happen in 5 to 15 minute intervals.
  • lasts until the cervix is fully dilated, an average of about 12 hours in a nullipara and anywhere up to 8 hours in a multipara.
Term

second stage of labor

Definition
  •  Begins as the baby’s head enters the birth canal. 
  • The woman’s contractions become more intense and more frequent, now occurring 2 to 3 minutes apart. 
  • Pulse rate increases and becomes sweaty. Bears down with contractions. 
  • The cervix becomes fully dilated and effaced, crowning occurs. 
  • The second stage is concludes when the baby is fully delivered.
Term

third stage of labor 

Definition
  • AKA the placental stage
  • The period from the delivery of the baby until the placenta has been fully expelled and the uterus has contracted. 
  • Uterine contraction is necessary to squeeze shut all of the tiny blood vessels left exposed when the placenta separates from the uterine wall.
Term

The average blood loss during the third stage of labor is normally about ______.

Definition
150 mL
Term

When blood loss exceeds ______ during the first 24 hours after giving birth, it is considered postpartum hemorrhage (bleeding after birth).

Definition
500 mL
Term

The first stool the infant passes is called _________, it is an odorless, greenish-black, and has a tar-like consistency

Definition
meconium
Term

Meconium aspiration syndrome can develop if ...

Definition
...the infant is allowed to take a breath before meconium is suctioned away
Term

An infant delivered at less than 37 completed weeks of gestation is considered ______.

Definition
preterm
Term

an infant born at 38 to 42 weeks of gestation is described as ____.

Definition
term
Term

an infant born at more than 42 weeks of gestation is described as __________________.

Definition
post-term (or post-dates)
Term

To ensure thermoregulation in a healthy newborn...

Definition
...put the baby directly on the mother’s chest after birth, drying, and then covering with a dry towel
Term

If the 5-minute Apgar score is __________, the newborn’s condition should be reassessed and a new score assigned every 5 minutes until 20 minutes after birth.

Definition
less than 7
Term

Fewer than ___ of deliveries involve bradycardia that requires treatment with chest compressions.

Definition
1%
Term

The most common etiology for bradycardia in a neonate is _______, which is readily reversed by effective ____.

Definition

hypoxia


PPV

Term

Bag-Mask Ventilation is indicated when an infant is apneic, has inadequate respiratory effort, or has a _________________________________________ after you clear the airway of secretions, relieve obstruction from the tongue, and dry and stimulate the infant. 

Definition
pulse rate less then 100 beats/min (bradycardia)
Term

Chest Compressions are indicated if ...

Definition
  • the pulse rate remains less than 60 beats/min despite positioning
  • clearing the airway
  • drying and stimulation
  • 30 seconds of effective PPV
Term

If  apnea is prolonged (more than 20 seconds), it can lead to _______ and bradycardia.

Definition
hypoxemia
Term

diffuse rhonchi, rales, and wheezing in an infant or toddler are typical signs of ....

Definition
....lower airway inflammation associated with bronchiolitis
Term

A child with epiglottitis looks sick and will be anxious, will sit upright in the sniffing position with the chin thrust forward to allow for maximal air entry, and may be ________ because of an inability to swallow secretions. 

Definition
drooling
Term
Expiratory wheezing alone may be heard in pt’s with mild to moderate asthma attacks, but wheezing may be heard on inspiration and expiration in pt’s with _________________
Definition
moderate to severe disease.
Term
______________________ is the most common cause of shock in infants and young children, with loss of volume occurring due to illness or trauma.
Definition
Hypovolemic Shock
Term
_________________________ decreased vascular tone develops, resulting in vasodilation and third spacing of fluids due to increased vascular permeability (leakage of plasma out of the blood vessels and into the surrounding tissues).
Definition
Distributive Shock
Term
__________________ is the result of pump failure: intravascular volume is normal, but myocardial function is poor.
Definition
Cardiogenic Shock
Term
Sudden Infant Death Syndrome
Definition
- the sudden and unexpected death of an infant younger than 1 year for whom a thorough autopsy fails to demonstrate an adequate cause of death.
Term
Apparent Life-Threatening Event (ALTE)
Definition
  • an episode during which an infant becomes pale or cyanotic
  • chokes, gags, or has an apniec spell
  • loses muscles tone
Term
The CHILD ABUSE mnemonic for Suspicion of Child Abuse
Definition

C - Consistency of the injury with the child's developmental age

H - History inconsistent with injury

I - Inappropiate parental concerns

L - Lack of supervision

D - Delay in seeking care

 

A - Affect ( of the parent or caregiver and the child relation to the caregiver)

B - Brusin of varying ages

U - Unusual injury patterns

S - Suspicious circumstances

E - Environment

Term

Bereavement 

Definition
– sadness over the loss of friends and loved ones. 
Term
The likelihood of death increases during the year following ...
Definition
...the death of one’s spouse
Term

As friends and family die, elderly persons tend to experience ...

Definition

... increasing loneliness and isolation.  These factors shown to have negative effects on health

Term

Changes in the Cardiovascular System for Geriatrics

Definition

  • the heart hypertrophies (enlarges) with age in response to the chronically increased afterload imposed by stiffened blood vessels. Bigger is not better. 
  • Arterioscleosis, the stiffening of vessel walls, contributes to systolic HTN in many older pt’s, which places an extra burden on the heart. 
  • number of pacemaker cells in the SA node decreases dramatically as a person ages, leading to bradycardia leading to decline in cardiac output.

 

Term

Aging brings a widespread decrease in bone mass in men and women, but especially among ___________ _____.

Definition
postmenopausal women
Term

Dementia

Definition
– a chronic deterioration of mental functions. Unlike delirium, dementia is a disease that produces irreversible brain failure.
Term

Delirium – An acute confusional state characterized by global impairment of thinking, perception, judgment, and memory. Also known as acute brain syndrome or acute confusional state) is a symptom, not a disease. This is a temporary usually reversible condition results in rapid changes in brain function

Definition
– An acute confusional state characterized by global impairment of thinking, perception, judgment, and memory. This is a temporary usually reversible condition results in rapid changes in brain function
Term

As _____________ with age, ____________ becomes more difficult

Definition

vision declines


reading small print

Term

Untreated and unrecognized ________ is associated with a higher suicide rate in the elderly population than in any other age group

Definition
depression
Term

Depression in elderly pt can ...

Definition
... mimic the effects of many other medical problems (such as dementia).
Term
The rate of completed suicide is ...
Definition
... disproportionately high in the geriatric population.
Term

At highest risk are ____________ who use ________ as their suicide method.

Definition

white men 85 years and older


firearms

Term

Pulseless Arrest for PEDS

 

Definition
  • Perform good BLS CPR, 
  • obtain IV/IO, 
  • monitor EKG
  • apply the pads
  • give Epi
  • pulse/rhythm check every two minutes 
  • Epi for astystole/PEA 
  • defib pulseless v-tach/v-fib
    • Small infants: anterior chest wall
    • Larger infants and children: anterior-posterior

 

Term

Wide Complex Tachycardia for PEDS

 

Definition

If the child is stable:

  • obtain vascular access
  • administer amiodorane (procainamide is an acceptable alternative). Do not give both.


If the pt is unstable:

  • then go to synchronized cardiversion. 
  • Prior sedation is ideal but not delay Rx to do so. 
  • If becomes unconscious, begin CPR.
Term

 Narrow Complex Tachycardia for PEDS

 

Definition

if stable;

  • vagal maneuvers
  • obtain IV access
  • consider Adenosine

 

For kids with poor perfusion;

  • synchronized cardioversion is recommended 
Term
Front-line Rx of distributive shock is ...
Definition
... fluid resuscitation because the child is in a state of relative hypovolemia.
Term
________________ is uncommon with pediatrics but may be seen with underlying congenital heart disease, myocarditis, or rhythm disturbances
Definition

Cardiogenic Shock

Term

The front-line Rx of distributive shock is ...

Definition
... fluid resuscitation because the child is in a state of relative hypovolemia.
Term
_________________ is the most common cause of shock in infants and young children
Definition
Hypovolemic Shock
Term
 ___________ is a late and ominous sign in a pediatric and requires urgent intervention to prevent cardiac arrest
Definition
Hypotension
Term
Minimal Systolic Blood Pressure by age
Definition
Infant (1 month to 1 year) - >70 mm Hg
1 year old - >80 mm Hg
Child (1-10 years) - 80 + (2 x age in years)
Child or adolescent > 10 years - >90 mm Hg
Term

Decompensated shock is defined as ...

Definition
... a BP less than 70 + (2 x age)
Term
clues that the PEDS pt needs hydration
Definition
  • Dry mucous membranes
  • tachycardia
  • a sunken fontanelle 
Term

Delivery with meconium-stained fluid

 

 

Definition
  • Determine whether the fluid is thin and green stained versus thick and particulate.

If the baby is crying and vigorous, 

  • employ standard interventions.

If the baby is depressed, 

  • do not dry or stimulate him or her.
  • Intubate the trachea.
  • Attach a meconium aspirator and suction catheter.
  • Suction the ET tube while withdrawing the tube from the trachea

After suctioning

  • Drying and stimulation
  • Oxygen and PPV may be necessary.
Term

Rx of cord prolapse, take the following steps:

Definition
  • Position the woman supine with her hips elevated on pillows
  • 100% o2 via NRB
  • instruct to pant with each contraction, which will prevent her from bearing down
  • with two fingers of a gloved hand, gently push the baby (not the cord) back up into the vagina until the presenting part no longer presses on the cord
  • cover the exposed portion of the cord with dressings moistened in normal saline
  • maintain that position throughout urgent transport to the hospital
Term

Premature babies cannot produce _________ very well and are at higher risk of resp distress

Definition
surfactant
Term

Extrinsic falls 

Definition
- accidental. Usually trip over a rug, or slip on ice
Term

Intrinsic falls

Definition
has a dizzy spell or a syncopal episode a falls due to that
Term

Risk factors for SIDS

Definition
  • Male
  • Premature
  •  Low birth weight
  • Sleeping in prone position, with soft bulky blankets, or on soft surfaces
  • Tobacco smoke
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