Term
| How can you establish proper LUD positioning? |
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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 |
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Term
| Since pregnancy causes elevation of the diaphragm, (shifting the position of the heart) what are some cardiovascular changes you might observe? |
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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* |
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Term
| Due to pulmonary changes in pregnancy (edematous vocal cords and arytenoids), what ETT sizes would you use? |
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Definition
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Term
| What kind of handle would be used for shorties with short necks, large breasts, and increased weight? |
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Definition
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Term
| How much does oxygen demand increase from baseline w/ pregnancy? During the 2nd stage of labor? |
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Definition
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Term
| At term, how much does minute ventilation increase? |
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Definition
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Term
| An increase in minute ventilation is thought to be d/t an increase in what hormone? |
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Definition
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Term
In pregnancy, which way does the oxygen hemoglobin curve shift?
The P 50 value moves from _____ to _____. |
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Definition
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Term
| What is the PaCO2 at the beginning of pregnancy and end of the third trimester? |
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Definition
| The PaCO2 rises to >100 torr initially d/t hyperventilation, but then drops below 100 torr as the preganancy progresses. |
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Term
| Which way does 2,3 DPG shift the oxygen hemoglobin curve? |
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Definition
Right
it offsets the hemoglobin's affinity for O2 despite the overall alkalotic state. |
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Term
| Is pregnancy an obstructive or restrictive dysfunction? |
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Definition
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Term
| FRC, expiratory reserve, and residual volume decrease d/t what? |
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Definition
| The upward pressure on the diaphragm by the uterus. |
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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? |
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Definition
supplemental O2!!
48 hours |
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Term
| T or F: a reduction in FRC and a decreased minute ventilation increases the uptake of all inhalation anesthetics |
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Definition
| False, bitches. Reduction in FRC and increase in minute ventilation will increase uptake of inhalation anesthetics. |
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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? |
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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.
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Term
| T or F: MAC for volatiles increases during pregnancy |
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Definition
Nope, it decreases during pregnancy!
*this, again, might be d/t the effects of progesterone |
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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.
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Definition
decreased
decreases
decreased |
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Term
| What are the musculoskeletal effects of relaxin? |
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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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