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I & M II > OB and Fetal Monitoring > Flashcards

OB and Fetal Monitoring Flashcards

1
Q

What’s this?

A

Three Stages of Woman

by Gustav Klimt

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2
Q

At what gestational age does CO reach its peak?

When does it normalize?

A

30 weeks

~44 weeks

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3
Q

When does MAP peak in the pregnant pt?

A

about 40 weeks

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4
Q

When does total peripheral resistance reach its nadir in the OB patient?

A

around 20 continuing to 35 weeks

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5
Q

What happens to SVR and PVR in a pregnant woman?

A

both decrease

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6
Q

What are the changes in % to:

platelets
erythrocytes
blood volume
plasma

A

0 %
20
35
45

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7
Q

What occurs to Hct and plasma volume in the pregnant pt?

A

Hct decreases and plasma volume increases

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8
Q

What occurs to MV, alveolar ventilation, TV, RR in the OB pt?

A

all increase

Alveolar (70%)
MV (50%)
TV
RR

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9
Q

What remains unchanged in the OB pt? (4)

A

pH
Vital capacity
Inspiratory lung capacity
Total lung capacity

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10
Q

What decreases in the OB pt?

A

FRC
Expiratory reserve volume
Residual volume

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11
Q

To prevent supine hypotensive syndrome, what do you do?

A

Right uterine displacement

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12
Q

What is normal FHR?

A

120 - 160

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13
Q

What defines fetal stress?

A

Decreased perfusion→hypoxia→low pH⇒low FHR

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14
Q

What is NST?

A

Nonstress Test

uses vibroacoustic stimulation
want to see variability and accelerations = (-) NST

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15
Q

What is a test that measures FHR over 10 minutes with 3 contractions?

A

Contraction Stress Test

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16
Q

What does the biophysical profile (BPP) measure?

A

Fetal breathing
Body movements
Tone
Amniotic fluid
HR
Reactivity

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17
Q

How common is fetal blood sampling?

A

Now uncommon

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18
Q

How is O2 sat measured on the fetus?

A

Fetal Oxygen Saturation (FSpO2) is measured on the scalp of the fetus.

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19
Q

What SaO2 is a concern for the well being of the fetus?

A

< 30%

20
Q

What is a normal pH for a fetus?

A

7.25 - 7.35

pH of umbilical = 7.26

21
Q

What is the blood gas SO2 for the fetus?

A

30 - 50%

22
Q

What is the normal PO2 and PCO2 for the fetus?

A

PO2 = 18 - 22 mmHg

PCO2 = 40 - 50 mmHg

23
Q

How can scalp pH be related to APGAR scores?

A

The higher the pH, the higher the Apgar score.

64.4% probability or correlation

24
Q

Label:

A
25
Q

What does increased SpO2 tell us?

A

increased pH, healthier baby

26
Q

What occurs during birth?

A

SpO2 decreases from stress, thus pH decreases.

27
Q

Which ECG electrode is the reference electrode?

Where is it placed?

What is the name of this electrode?

A

black one on left

uterine wall

Hon scalp ECG electrode

28
Q

Label

A

Top: fetal ECG

Bottom: ultrasound

29
Q

What is an external fetal monitoring system called?

A

Tocogram

30
Q

What are the classes of FHR variability? (4)

A

None

Reduced variability (0 - < 5 beats/min)

Normal variability (5 - 10 beats/min)

Increased variability (> 15 beats/min)

31
Q

What is this graph called?

What is enclosed in the red box?

A

Tocograph

Normal FHR pattern

32
Q

What are patterns of FHR changes? (4)

A

Accelerations (normal)
Early decelerations
Late decelerations
Variable decelerations

33
Q

Which FHR pattern is coincident with contraction?

A

Early decelerations possibly from compression of the head

34
Q

What FHR patterns will result in decreased uterine blood flow beyond the capacity of the fetus to extract sufficient oxygen?

A

Late decelerations

35
Q

What will occur to FHR with vagal firing in response to cord compression or sustained head compression?

A

Variable decelerations

36
Q

What’s depicted?

A

Normal fetal oxygenation

Accelerations with contractions

37
Q

What’s depicted?

A

Early deceleration, head compression

38
Q

What’s depicted?

A

Late deceleration, Uteroplacental insufficiency

39
Q

What’s depicted?

A

Variable deceleration, umbilical cord compression

40
Q

What’s depicted?

A

Early deceleration, head compression

41
Q

What’s depicted?

A

Late deceleration, hypoxia

42
Q

What is depicted?

A

Variable decelerations and absence of HR variability

43
Q

What does the lack of HR variability indicate?

A

decreased cerebral oxygenation

44
Q

What does APGAR represent?

What is it?

What is a good score?

A

Activity
Pulse
Grimace
Appearance of skin color
Respiration

Backronym named after Dr. Apgar.

10

45
Q

What emergency equipment is needed in the delivery room? (5)

A

Radiant warmer
Suction
Suction catheters
Infant aw materials including ambu
Meds: 1:10,000 epi, narcan, sodium bicarb, volume expanders

I & M II (21 decks)

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