Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

OB Exam > Fetal Heart Rate Assessment (Ch.9) > Flashcards

Fetal Heart Rate Assessment (Ch.9) Flashcards

(60 cards)

Start Studying
1
Q

What does assessing a fetal heart rate (FHR) tell the nurse?

A

-Fetal oxygenation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does acceleration mean?

A

Increase in FHR above baseline (>15 bpm over baseline for 15 seconds for 2 minutes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does deceleration mean?

A

Decrease from baseline

Can be periodic or intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a late deceleration?

A

Gradual decrease of FHR taking more than 30 seconds

  • Lowest point is at the peak of contraction
  • Always periodic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is prolonged deceleration?

A

Decrease FHR that is >15 bpm lasting > 2minutes but < 10 minutes
-Can be periodic or intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a normal heart rate?

A

110-160

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

FHR tachycardia

A

> 160 lasting 10 minutes or longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

FHR bradycardia

A

<110 bpm lasting 10 minutes or longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is contraindicated with internal fetal monitoring on quiz

A
  • Active genital herpes
  • Positive group B streptococcus
  • Placenta previa
  • Undiagnosed vaginal bleeding
  • Chorioamnionitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does internal electronic uterine monitor work?

A

Catheter is placed in the uterine cavity to directly measure uterine contractions
-Membranes must be ruptured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a tocodynamometer?

A

External electronic devices for monitoring and recording uterine contractions during labor
-Cannot measure intensity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some reasons you would use internal monitoring versus external?

A
  1. Maternal Obesity
  2. Lack of progress in labor
  3. Treat a worsening Category 2 tracing via amnioinfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you know if the strength of the uterine contraction is good?

A

At least 200 MVUs every 10 minutes for 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the top grid of monitor paper tell you?

A

FHR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does the lower grid of monitor paper tell you?

A

Uterine contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an issue with external monitoring?

A

It can pick up the maternal HR instead of the fetus and will show a low HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does the parasympathetic nervous system effect the baby?

A

Slows FHR and helps maintain variability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the FHR look like if they have a little hypoxia and are able to deal with it?

A

Variable decelerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What hormonal regulations occur when the fetus is hypoxic?

A

Release of epinephrine and nor-epinephrine that increase FHR and BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the three types of fetal responses that?

A

No hypoxia = Accelerations
Compensating = Variable deceleration
Decompensation = Late deceleration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a category 3 predictive of?

A

Abnormal fetal acid base balance and require promote evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q 
Which of the following FHR patterns indicated a normal FHR? 
A. Category 1
B. Category 2
C. Category 3 
D. None of the above
A

A. Category 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Intrauterine Resuscitation Interventions if goal is to Promote Fetal Oxygenation

A

~Administer oxygen at 10 L/min via nonrebreather face mask (DC ASAP based on fetal response)
~Lateral positioning (L or R side)
~IV Fluid bolus of ≤ 500 mL LR solution
~DC oxytocin, remove dinoprostone insert, or withhold next dose of misoprostol
~Alter pushing to every other contraction or temporarily stop pushing (during second stage of labor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Intrauterine Resuscitation Interventions if goal is to Reduce Uterine Activity

A

~DC oxytocin, remove dinoprostone insert, or withhold next dose of misoprostol
~IV Fluid bolus of ≤ 500 mL LR solution
~Lateral positioning (L or R side)
~If no response, consider administration of 0.25 mg SQ terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Intrauterine Resuscitation Interventions if goal is to Alleviate Umbilical Cord Compression
~Repositioning ~Amnioinfusion (during first-stage labor) ~Alter pushing to every other contraction or temporarily stop pushing (during second stage of labor) ~Umbilical cord prolapse, elevate the presenting fetal part while preparations are made for an expected birth
26
Intrauterine Resuscitation Interventions if goal is to Correct Maternal Hypotension
~Lateral positioning (L or R side) ~IV Fluid bolus of ≤ 500 mL LR solution ~If no response, consider ephedrine 5-10 mg IV push
27
What can Fetal tachycardia be a sign of?
Early fetal hypoxemia especially with decreased variability and deceleration
28
What are some maternal causes of fetal tachycardia?
``` ~Fever ~Infection (check allergies) ~Dehydration ~Epinephrine, Terbutaline ~Cocaine ```
29
What heart rate can cause fetal demise if it persists?
200-220
30
Nursing actions to fix fetal tachycardia
Treat underlying cause of tachycardia such as antibiotics for infection, antipyretics for fever, and fluids for dehydration ~Assess maternal VS (temp) ~Assess hydration by checking skin turgor, mucous membranes, urine specific gravity, I/O ~Decrease or DC Oxytocin
31
When is fetal bradycardia considered an emgergency?
Sudden profound bradycardia (less than 80 bpm)
32
Is fetal bradycardia of >80 with variability (fluctuations) considered good, okay, bad?
Okay needs to be monitored but not horrible
33
What type of fetal bradycardia is associated with current or impending fetal hypoxia?
Bradycardia with loss of variability or late deceleration
34
What are some maternal causes to fetal bradycardia?
~Supine position ~Dehydration ~Hypotension ~Placental abruption
35
What are some fetal causes to fetal bradycardia?
~Fetal response to hypoxia ~Baby is laying on umbilical cord ~Fetal head is compressed
36
If using external monitoring and the FHR indicates bradycardia, what do you need to check?
Check the mother's radial pulse because the EFM may be picking up the mother's heart rate
37
Nursing actions to fix fetal bradycardia
~Sterile vaginal exam to see fetal response to touching the head ~Vaginal exam for prolapsed cord ~Intrauterine Resuscitation Interventions
38
What is the most important predictor of adequate fetal oxygenation and fetal reserve during labor
Baseline variability
39
What is the gold standard for variability (fluctuations)?
Moderate (6-25 bpm) shows well-oxygenated fetus with normal acid-base balance
40
What are the different types of variability (fluctuations) ?
Absent: looks like flatline Minimal: undetectable below 5 bpm Moderate: Amplitude from 6-25 bpm Marked: Greater than 25 bpm
41
Maternal causes of minimal or absent variability (fluctuations)
~Supine hypotension ~Cord Compression ~Uterine tachysystole ~Drugs (illicit drugs, alcohol)
42
How do you confirm minimal or absent variability (fluctuations)?
Artificial rupture of membranes and more invasive internal monitoring with fetal spiral electrode
43
Nursing actions for minimal or absent variability (fluctuations)
Intrauterine Resuscitation Interventions
44
What are the four types of deceleration?
1. Early 2. Variable 3. Late 4. Prolonged
45
What are episodic changes?
Accelerations and deceleration patterns not associated with contraction *Most common is accelerations*
46
What are FHR accelerations predictive of?
Adequate oxygenation and require no interventions
47
What does early decelerations indicate?
Occur with contractions and is a normal response and require no intervention -Fetal head compression
48
What is the most common deceleration seen in labor?
Variable deceleration | -caused by umbilical cord compression
49
Characteristics of normal variable decelerations
1. Duration of less than 60 seconds 2. Rapid return to baseline 3. Normal baseline and variability
50
Define an "overshoot"
Accelerations at the beginning and end of decelerations
51
Treatment for abnormal variable decelerations
Intrauterine Resuscitation Interventions
52
What are late decelerations a sign of for the fetus?
Fetal intolerance to labor | -uteroplacental insufficiency
53
What is usually the problem with late decelerations?
Placenta
54
What three things do you look at for uterine activity?
1. Frequency (beginning of one to start of next) 2. Intensity (strength) 3. Duration (beginning to end of same contraction)
55
What is the normal amount of contractions in a 10 minutes averaged over 30 minute period?
5 or fewer
56
What is a big concern if the uterus is in tachysystole?
the uterus could rupture
57
Characteristics of tachysystole of the uterus
~More than 5 UC in 10 minutes
58
How do you treat tachysystole of the uterus?
DC medication that caused it and Intrauterine Resuscitation Interventions
59
What does magnesium sulfate do for preterm labor?
Decreases FHR variability and acceleration amplitude in preterm infants
60
What is the normal type of deceleration?
Early decelerations (FHR is responding to UC)

OB Exam (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions