Obstetrical Patient Management Flashcards

A 34-week pregnant patient is transported by air with a BP of 160/110 mmHg, 3+ proteinuria, and severe headache. Which medication is the FIRST-LINE treatment for severe-range hypertension in this setting?

Answer: Labetalol IV

Labetalol IV is the first-line agent for acute severe hypertension in pregnancy due to its rapid onset, predictable response, and safety profile.

During air transport, a 28-week gestation patient develops umbilical cord prolapse confirmed on exam. What is the PRIORITY nursing intervention?

Answer: Manually elevate the presenting part off the cord

Manual elevation of the presenting fetal part off the prolapsed cord relieves compression and preserves umbilical blood flow until emergency delivery.

A flight nurse is transporting a patient at 36 weeks gestation who suddenly develops severe abdominal pain, rigid uterus, and fetal bradycardia. These findings are MOST consistent with:

Answer: Placental abruption

Sudden severe abdominal pain, board-like uterine rigidity, and acute fetal distress are classic signs of placental abruption.

When managing a patient with eclampsia in a transport environment, magnesium sulfate toxicity is BEST assessed by monitoring which parameter?

Answer: Deep tendon reflexes (DTR)

Loss of deep tendon reflexes is the earliest clinical sign of magnesium toxicity, preceding respiratory depression and cardiac arrest.

A patient at 32 weeks gestation is being transported with suspected HELLP syndrome. Which lab finding is CHARACTERISTIC of this condition?

Answer: Thrombocytopenia and elevated liver enzymes

HELLP syndrome is defined by hemolysis, elevated liver enzymes, and low platelets (thrombocytopenia), distinguishing it from isolated preeclampsia.

During aeromedical transport, lateral uterine displacement in a third-trimester patient is performed to prevent:

Answer: Aortocaval compression syndrome

Left lateral uterine displacement prevents the gravid uterus from compressing the aorta and inferior vena cava, maintaining maternal cardiac output.

A term pregnant patient in active labor is transported and delivers the infant mid-flight. After delivery, the placenta delivers but the uterus remains atonic with heavy bleeding. The FIRST pharmacologic intervention should be:

Answer: Oxytocin 10–40 units in IV infusion

Oxytocin is the first-line uterotonic for postpartum hemorrhage due to uterine atony, administered as an IV infusion after placental delivery.