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CRNA Board Review--OB
CRNA Board Review
28
Nursing
Graduate
12/28/2009

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Cards

Term
What happens to maternal FRC?
Definition
Decreases by 20%
Term
What happens to maternal TLC, VC, and IC?
Definition
They don't change due to compensatory increases in thoracic A-P diameter
Term
How much does O2 consumption increase by in the pregnant patient? Tidal volume? Respiratory rate?
Definition
Vo2--70%
TV--40%
RR-15%
Term
What does hypocarbia do to uterine blood flow?
Definition
Decreases it
Term
How is a pregnant ABG different?
Definition
pH about 7.45, low CO2, low HCO3 to compensate
Term
How does pregnancy affect MAC?
Definition
Decreases it 15-40%
Term
Is pregnant inhalational induction faster or slower?
Definition
Faster--due to decreased FRC and increased ventilation
Term
What happens to maternal cardiac output? Maternal BP?
Definition
CO increases, BP drops due to a decrease in SVR
Term
When is cardiac output the highest during pregnancy?
Definition
Immediately after delivery of the baby (stage 3)
Term
What happens to maternal BUN/Creatinine?
Definition
Lowers due to an increase in GFR/renal blood flow
Term
What vertebral levels are responsible for Stage 1 pain?
Definition
T10-L1
Term
What vertebral levels are responsible for second stage labor pain?
Definition
S2-S4
Term
Why are NSAIDS generally not used in OB?
Definition
It suppresses uterine contractions and can cause premature closure of the ductus arteriosis
Term
What is the overall incidence and mortality of placenta previa?
Definition
1%
Term
What is the classic sign indicating placenta previa?
Definition
Bright red painless bleeding---first episode is usually preterm
Term
What is the classic presentation of placental abruption?
Definition
Painful vaginal bleeding
Term
What is abruptio placenta associated with?
Definition
Cocaine, tobacco, old age
Term
What is placental abruption?
Definition
Separation of the placenta from the deciduas basalis before delivery of the fetus
Term
What is the fetal mortality rate for amniotic fluid embolism?
Definition
About 85%
Term
Describe the following lab values for a patient in DIC: Fibrinogen, platelets, PT, PTT, fibrin split products
Definition
Fibrinogen <150
Platelets <50
PT/PTT >100 seconds
Fibrin split products >200
Term
What are some of the beneficial effects of Mag in pre-eclampsia?
Definition
Anticonvulsant, vasodilator, increased uterine blood flow, tocolytic
Term
What are some of the negative effects of Mag?
Definition
Muscle weakness, prolonged muscle block
Term
What are early decels? What is another name for them?
Definition
Early decels are decels that mirror uterine contractions--due to head compression, normal---AKA Type I
Term
What are late decels? Whats the etiology? Whats another name?
Definition
Type II decels, caused by uteroplacental insufficiency (not normal)--they follow uterine contractions by about 10-30 seconds
Term
What are variable decels? What causes them?
Definition
Random decels usually caused by cord compression
Term
What is the therapeutic range of Mag in OB?
Definition
4-8
Term
What is normal plasma fibrinogen level during pregnancy?
Definition
400-650
Term
How much does plasma volume increase during pregnancy? Blood volume?
Definition
Plasma increases 40-50% while BV only increases 25-40%
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