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OB/PEDS: Midterm > Intrapartum Fetal Surveillance: > Flashcards

Intrapartum Fetal Surveillance: Flashcards

1
Q

What is a fetoscope used for?

A

auscultation and palpation
- midwife uses in community

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2
Q

What is a a Doppler ultrasound used for?

A

auscultate fetal heartbeat

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3
Q

Benefits of auscultation and palpation

A
  • Easy, inexpensive and less invasive
  • Results comparable to EFM in low risk women
  • Comfortable and allows freedom of movement
  • Can be used with hydrotherapy (water birth)
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4
Q

Limitations of auscultation and palpation

A
  • Inability to perform in some situations
  • No permanent record
  • FHR counting is intermittent not continuous
  • May not detect abnormal FHR at all, or in time for intervention- bc it’s intermittent
  • Not recommended for high risk pregnancy
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5
Q

What are the two monitors of a bedside electronic fetal monitor (EFM)?
Where do you place them for use?

A
  • tocometer: measures uterine contractions
    — Placed at the fundus, top of uterus
  • Ultrasound: placed on back of fetus, must know fetal positions
  • External monitor cannot determine the intensity of contraction
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6
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
LSA:

A

LUQ

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7
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
LOP

A

LLQ

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8
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
RSA:

A

RUQ

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9
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
LOA

A

LLQ

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10
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
ROP:

A

RLQ

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11
Q

FETAL POSITION; ABD QUAD FOR FHR PLACEMENT:
ROA:

A

RLQ

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12
Q

Benefits of Doppler and EFM:

A
  • Noninvasive
  • Ease-of-use
  • No risk to mother or fetus
  • Provides continuous FHR and UA readings
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13
Q

Limitation of Doppler and EFM

A
  • Limits mobility of mother
  • Does not assess strength or intensity of contractions
  • Limited effectiveness in obese or multifetal women
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14
Q

What needs to happen before using an:
Intrauterine pressure catheter (IUPC)

A
  • Mom needs to be dilated at least 2 cm
  • and her membranes need to be ruptured
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15
Q

FHR MONITOR STRIP:
Each box = how many secs?

A

10 secs

6 boxes = 1 min
Assending boxes= FHR

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16
Q

Normal baseline FHR:

A

110-160 bpm

17
Q

FHR Tachycardia:

A

> 160 bpm

18
Q

FHR Bradycardia:

A

<110 bpm

19
Q

What is Variability?

A

fluctuation in the FHR from the baseline FHR with irregular amplitude and frequency

  • Variability: is considered normal (reassuring HR)
20
Q

Minimal Variability

A

5 bpm or less

21
Q

Moderate variability

A

6-25 bpm

22
Q

Marked variability

A

25 bpm or greater

23
Q

What are accelerations?

A
  • 15 bpm above baseline for 15 seconds (normal)
  • Indicates adequate fetal oxygenation and fetal pH. - Reassuring.
24
Q

What are periodic accelerations?

A

linked with uterine contractions

25
Q

What are episodic accelerations?

A
  • fetal movement, vibroacoustic stimulation, scalp stimulation from vaginal exam
  • Are not directly linked to uterine activity
  • Caused by fetal or uterine stimulation
26
Q

Early decelerations:

A

Normal
- early in the cycle of contractions the FHR starts to go down.
- Cause: head compression
- FHR goes back up after contractions
- No intervention needed. Continue to monitor. This is a normal finding. This is a reassuring FHR

27
Q

Late deceleration:

A
  • bad/ not reassuring
  • FHR goes down after the contractions
28
Q

Late deceleration causes:

A
  • *Uteroplacental insufficiency
  • Maternal hypotension
  • Uterine hyperstimulation from Pitocin
  • Bleeding disorders
29
Q

Late deceleration nursing interventions

A
  • IV fluids to correct hypotension
  • Stop/slow Pitocin
  • Address bleeding issue. Perhaps give PRBC
  • Reposition mother on side (especially left side)
  • Administer 02
  • Prepare for C-section
30
Q

Variable decelerations:
Causes:

A
  • bad/not reassuring
    .
  • *Cord compression
  • Fetus on cord
  • Knot in cord
  • Nuchal cord
31
Q

Nuchal cord:

A
  • cord around baby’s neck
  • Often occurs after membranes rupture
32
Q

Variable decelerations Nursing interventions:

A
  • Change mothers position
    — Place mom in hands and knees, side lying, or Trendelenburg
  • Amnioinfusion
  • IVF
  • Oxygen
33
Q

Whartons Jelly

A

Gelatinous substance surrounding the umbilical cord that protects it from compression

34
Q

Variable deceleration=

A

Cord compression

35
Q

Early deceleration=

A

Head compression

36
Q

Acceleration=

A

Okay!

37
Q

Late deceleration=

A

Placental insufficiency

OB/PEDS: Midterm (21 decks)

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