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33 Cards in this Set
- Front
- Back
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Spontaneous Abortion |
Before 20weeks or <500grams, because fetus cant survive extrauterine. Vaginal bleeding Rule out ectopic pregnancy |
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Nagels Rule |
LMP +9months +7days = EDC |
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Spontaneous Abortion : Pelvic exam/cervix assessment |
if cervix is dilated, will expel contents, miscarriage eminent. May need D+C.
Cervix tight with mild bleeding, 15-30% may not abort. |
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RhoGAM when |
Rh Immune globulin For all pregnant Rh negative pts |
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Placenta Previa |
"painless privates" generally. Placenta covers internal cervix, when cervix dilates stretches placenta decreases oxygen to fetus(placenta is organ for oxygenation for fetus) painless bright-red bleeding (placental abruption is very painful) |
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Placental Abruption |
Placenta seperates before delivery. Emergency OB condition Massive hemorrhage possible Can lead to DIC uterine pain/tenderness with bleeding |
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Kleihauer-Betke test and +indication |
Mother and baby blood is separated and should never mix. This test, assesses for mix of blood. If positive indicates mixing of blood and possible placental abruption. |
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Ectopic Pregnancy |
Implantation outside the uterus. Usually in R tube. Can cause internal hemorrhage, #1 cause of maternal death in pregnancy.
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Preeclampsia |
HTN 140/90 Due to placental dysfx. Causes decreased placental/fetal circulation. Usually only in 1st pregnancy.
Dx by : HTN, proteinuria, nondependent edema after 20th week |
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Eclampsia |
HTN 140/90 Due to placental dysfx Causes decreased placental/fetal circulation. Usually only in 1st pregnancy.
extension of preeclampsia, with convulsions, coma or both. Can occur early postpartum too. |
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HELLP |
Hemolysis, Elevated Liver enzymes, and Low Platelets
Severe form of preeclampsia. >20weeks. 20% may go into DIC |
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Treatment for HELLP |
Mag Sulfate Benzodiazepines for seizures resistant to Mag Hydralazine Labetalol Nipride |
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Hyperemesis Gravidarum |
Peak at 8-12 weeks Frequent sustained vomiting for 4-8 weeks.
Leads to : wt loss, dehydration, metabolic acidosis. Complications: GI bleeding, Mallory-Weiss tears(esophageal-gastric junction) |
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Post Partum Hemorrhage |
90% of cases due to uterine atony. late PPH (6-10days) : retained products
Atony - firmly massage uterine(fundal massage) Possible D+C for retained fragments Pitocin-incr uterine tone Methergine for persistent bleeding |
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Stages of Vaginal Delivery (3) |
1: contraction onset to cervical dilation 2: cervical dilation to infant delivery 3: infant delivery to placental delivery
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After delivery suction ____ then ____ |
After delivery suction Mouth then Nares
Suctioning nose first can cause gag reflex and aspiration of mouth contents |
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APGAR |
at 1and 5min
Appearance Pulse Grimace Activity Respiration |
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Neonatal Resuscitation |
Dry off, heat source, keep on back or side.
Absent slow or difficult respirations = suction trachea, Stimulate by flicking feet and rubbing back Resp slow or shallow = 100% blow by O2 Resp gasping or ineffective = positive pressure ambu 40-60/min HR <80 and not increasing with PPV = chest compressions. Consider intubation |
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Dysfunctional Uterine Bleeding : description, causes |
Steady painless bleeding w/o clots or tissue.
Causes : uterine fibroids, menstrual irregularities, trauma, infection, hormonal imbalances, CA. |
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Pelvic Inflammatory Disease : description, pathogens |
Infx of higher reproductive structures(anything above cervix). Damage to fallopian tubes over time.
Pathogens : Gonorrhea, C. Trachomatis. |
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PID : Treatment |
Rocephin Tx Gonorrhea Zithromax Tx Chlamydia Flagyl Tx Trichomoniasis |
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Urinary Tract Infection |
Symptomatic bacteria anywhere along the GU tract.
Pyelonephritis = upper UTI Cystitis = uncomplicated lower UTI |
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Urinary Tract Infection : diagnostics |
Nitrites(byproduct of bacterial metabolism), leukocytes and or blood. |
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Pyelonephritis : description |
Upper UTI involving renal tissues, d/t ascending lower UTI, 80-90% d/t Ecoli.
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Urinary Calculi : rule out what, what type of pain, what size will not pass |
Obstruction must be ruled out, an obstruction is an emergency.
Likely post-renal, intrarenal should not cause pain. Stone now in ureter.
colicky(sudden start and stop) pain.
greater than 6mm will not pass, urology consult. |
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Testicular Torsion |
Strangulation of testical d/t twisting. True urological emergency.
Detorsion within 6hrs = 80-100% salvage.
S/S = elevated testical, redness, bruising. Colicky pain. Rapid pain onset(epididymitis gradual)
Conscious sedation if urologist does detorsion. |
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Epididymitis |
Inflammation/infection. <35yo most likely STD. >35yo most likely E coli.
pain : gradual dull aching
Tx: scrotal support(jock strap, tighty whities) |
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Bladder Rupture |
80% bladder ruptures concurrent w pelvic fxs.
Feels like they have to void.
Blood at meatus. |
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Contraindication for foley in trauma pt (2) |
Blood at meatus.
Prostate high or to side indicating possible torn urethra. |
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Bartholins Cyst : description, type of pain, what age, Tx |
Labia minora 4 and 8 oclock. secretes mucus to keep surface moist. Cysts affect women of reproductive age.
Acute pain.
>40yo = possible carcinoma
I+D, irrigation, packing, "word" catheter for drainage. |
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Sexual Assault |
Physical force does not have to be present, injuries do not have to be present.
Reporting event is mandatory, even if victim does not wish to speak with law enforcement. |
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Trauma in Pregnancy |
Higher risk of aortic dissection.
Most common cause of fetal death is maternal death. |
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Changes in Pregnancy |
Cardiovascular : increased blood volume and CO. Anemia due to dilution of RBCs
Respiratory : breathing shallower(dec PCO2) and faster, partially compensated respiratory alkalosis.
GI : distended abdominal wall can mask intra-abdominal injury.
Indicated imaging tests Should Not be deferred d/t pregnancy. |
