While most perianesthesia nurses care for patients undergoing gynecologic procedures, care of patients for nonobstetric and obstetric procedures is less common. This chapter focuses on specific gynecologic and obstetric issues, beginning with a brief discussion on the menstrual cycle and other gynecologic issues. The primary focus of the chapter centers on operative procedures for gynecologic concerns and information useful to the perianesthesia nurse caring for the gynecologic patient. The final section of the chapter discusses the obstetric issues, including information on normal pregnancy, operative procedures for the pregnant patient, and issues associated with delivery of the parturient. Perianesthesia nurses whose primary role does not include caring for the pregnant patient will find the discussion helpful in increasing their knowledge and understanding of the patient who is pregnant.
1.What is a normal menstrual cycle?
2.What is an abnormal menstrual cycle?
3.Does the menstrual cycle and hormones influence anesthesia outcomes?
4.When should women start having pelvic examinations and Pap smears?
5.Who should be tested for pregnancy preoperatively?
6.Is informed consent for pregnancy testing necessary?
7.Who receives the results of the pregnancy test?
8.What is the definition of “external procedures”?
9.What are the potential complications and postoperative implications of these procedures?
10.What instructions will the patient and family need following “external procedures”?
11.What procedures are included in the transvaginal approach?
12.Why is a dilatation and curettage (D&C) done, and what is included in the procedure?
13.What are the most common cervical procedures?
14.Why is a conization of the cervix done?
15.What is a hysteroscopy, and why is it done?
16.How are uterine leiomyomas removed?
17.What is water intoxication (dilutional hyponatremia), which may be associated with hysteroscopy?
18.What is a tension-free vaginal tape procedure?
19.What are common operative treatments for infertility?
21.Any specific issues with postoperative care?
22.What are common complications after these laparoscopic procedures?
23.What are the procedures for tubal sterilization?
24.Vaginal, abdominal, or laparoscopic hysterectomy: What’s the difference between these procedures and the indications?
25.Why are pelvic and periaortic lymph node dissections performed?
26.In a pelvic exenteration, what organs are resected? What are the potential complications? What is included in postoperative care? What are the outcomes?
27.Why is the omentum removed?
28.What are the special considerations associated with vulvectomy?
29.What are the risks for deep vein thrombosis? What is recommended for prophylaxis?
Pregnancy-Related Questions
30.What are the normal physiologic changes of pregnancy that are of concern to anesthesia care providers?
31.How is an ectopic pregnancy identified and managed?
32.What medications typically used during the perioperative period are safe for the pregnant patient?
33.What is recommended for anesthesia and positioning for nonobstetric procedures on pregnant patients?
34.What is cerclage for insufficient or incompetent cervix?
35.Should fetal monitoring be intermittent or continuous for labor?
36.What are the signs of labor?
37.What is preeclampsia and eclampsia? Who is at risk of developing this disease of pregnancy?
38.What are the most common complications associated with operative delivery by cesarean section?
39.What is used for analgesia during labor and anesthesia for delivery?
41.What is assessed in the initial newborn examination?
42.What are the most common causes of abnormal bleeding during pregnancy and delivery?
43.What are the risks of trauma for the pregnant patient?
44.How does resuscitation during pregnancy differ from resuscitation of the nonpregnant patient?
45.What is included in postdelivery monitoring?
46.How frequently should the uterus be massaged after delivery?
47.What are the most commonly used drugs to reduce postpartum bleeding?
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