Pregnancy and Trauma (BLS) > Final Exam

You are treating a pregnant patient of 36 weeks gestation who has been involved in a high-speed motor vehicle collision. She presents with altered level of consciousness and mild combativeness during extrication and an obvious mid-shaft left femur fracture, but has palpable radial pulses and adequate respiratory effort. After a lengthy extrication, she is unresponsive with the following vital signs: BP 178/70, HR 52, RR 4, SpO2 84% on a non-rebreather mask. You first treatment priority is to:

establish a patent airway and begin positive pressure ventilation with high flow oxygen

Your patient is a pregnant female at 34 weeks gestation who was injured in a domestic assault. She was reportedly kicked in the side several times by her boyfriend, and she reports chest pain and severe difficulty breathing. She exhibits diminished breath sounds on the right side, with bruising and right lateral chest wall instability and paradoxical motion. Her vital signs are BP 108/62, HR 124, RR 30, SpO2 88% on room air. Your first treatment priority would be:

high-flow oxygen via positive pressure ventilation

During pregnancy, normal physiologic changes in circulating blood volume and heart rate in the expectant mother may:

mask early symptoms of hypovolemic shock as the mother's body uses the fetal blood supply to compensate for maternal blood loss

The general goal of treating the pregnant patient with multi-systems trauma and shock is:

maximizing oxygenation and perfusion in the mother, so that her compensatory mechanisms will be less likely to compromise perfusion of the fetus

A 20-week pregnant female slipped on a wet sidewalk at a water park and injured her right leg. She presents with obvious deformity and angulation to her right lower leg at approximately mid-shaft. The limb is cool and mottled below the injury, and has a very faint dorsalis pedis pulse. She is alert and oriented, denies loss of consciousness, and rates her pain as a 10/10. Her vital signs are BP 124/70, HR 112, RR 20, SpO2 96%. Your first treatment priority should be:

narcotic pain relief

Your patient is a pregnant female in her 38th week of gestation. She has sustained blunt chest and abdominal trauma due to a high-speed motor vehicle accident, and has an unstable pelvis. Her initial vital signs are BP 112/68, HR 104, RR 20. From your assessment of the patient and the mechanism of injury and your knowledge of the physiologic changes of pregnancy, you suspect:

she may already be in shock and compromising perfusion to her fetus

A female patient who is 36 weeks pregnant has been involved in a motor vehicle collision. She complains of difficulty breathing and left chest wall pain, and exhibits rib crepitus over her left lateral chest and diminished lung sounds on the left side. She is alert and oriented and has a patent airway. Her vital signs are BP 116/70, HR 100, RR 24 with an SpO2 reading of 92% on room air. Your first intervention for this patient should be:

supplemental oxygen administration titrated to an SpO2 of 95% or greater

By what percentage does the maternal blood volume increase by the end of pregnancy?

45%

Which condition would be MOST likely to result from blunt trauma to the abdomen in a pregnant patient in the second or third trimester?

Abruptio placentae

Of the following, which physiologic change of pregnancy is most likely to mask the clinical signs of shock?

Increased aldosterone production