Ch. 15 Fetal assessment during labor Flashcards

1
Q

Define hypoxemia

A

Deficiency of oxygen in arterial blood

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2
Q

Define hypoxia

A

Inadequate supply of oxygen at cellular level that can cause metabolic acidosis

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3
Q

Define Asphyxia

A

When fetal hypoxic results in metabolic acidosis

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4
Q

What is intermittent Auscultation

A

Listening to fetal heart sounds at periodic intervals to assess FHR

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5
Q

What is contraction duration

A

Measured in sec from beginning to end of contraction

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6
Q

How is the frequency of the contraction measured

A

In minutes, beginning of one contraction to beginning of next

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7
Q

What does each small square on the monitor paper represent

A

10 seconds

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8
Q

What does each large square on the monitor paper represent

A

1min

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9
Q

Define baseline FHR

A

Average rate during a 10min period

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10
Q

Define variability

A

FHR described as irregular waves or fluctuations in the baseline FHR of two cycles per minute or greater

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11
Q

What are the four categories of variabiity

A

Absent, minimal, moderate, marked

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12
Q

Which variability is considered normal

A

Moderate; highly predictive of normal fetal-acid balance

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13
Q

When is a sinusoidal pattern usually present

A

During severe anemia

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14
Q

Define absent variability

A

Amplitude range undetectable

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15
Q

Define minimal variability

A

Range detectable less than 5bpm

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16
Q

Define moderate variability

A

6-25bpm

17
Q

Define marked variability

A

Greater than 25bpm

18
Q

Tachycardia FHR

A

Baseline greater than 160bpm less than 10min, sing of early hypoxemia

19
Q

What are some common causes of FHR tachycardia

A

Infection, prolonged PROM, fetal anemia, drugs (atropine, cocaine)

20
Q

Bradycardia FHR

A

Baseline less than 110bpm for less than 10min

21
Q

What are some common causes of FHR bradycardia

A

Fetal cardiac problem, structural defect, viral infection, CMV, hypoglycemia, hypothermia

22
Q

Define acceleration

A

Abrupt (onset to peak less than 30 sec) increase in FHR above baseline
15bpm, last 15sec, and return to base

23
Q

Are accelerations normal

A

They indicate fetal well being, normal acid-base balance

24
Q

What are early deceleration

A

Onset to lowest greater than 30sec decrease, return to baseline

25
Q

What causes early decelerations

A

Fetal head compression, benign, no intervention

26
Q

What are late decelerations

A

Onset-lowest greater than 30sec, late onset, late recovery; begin after contraction started

27
Q

What traditionally attributes to late decelerations

A

uteroplacental insufficiency

28
Q

What interventions are necessary when late decelerations are present

A

Lateral position, elevate legs, increase IV, discontinue pit, admin oxygen 8-10l, call dr

29
Q

What are variable decelerations

A

Onset to lowest less than 30sec, at least 15bpom decrease in baseline last 15sec and returns to base in less than 2min

30
Q

What causes variable decelerations

A

Compression of umbilical cord

31
Q

What are prolonged decelerations

A

FHR decreases 15bpm, below base last more than 2min less than 10min

32
Q

When is a deceleration considered a baseline change

A

Last longer than 10min

33
Q

What are the interventions when variable decelerations are present

A

Change position (side to side, knee to chest), discontinue oxy, admin 8-10L mask, call Dr., assess for cord prolapse

34
Q

Which category tracing for FHR is considered noraml

A

Category 1

35
Q

What legal responsibility do nurses have when reading fetal monitors

A

Correctly interpret FHR, documenting, timely notification

36
Q

What are the interventions for maternal hypotension

A

Increase IV, lateral position, ephedrine to increase Bp

37
Q

What are the interventions for uterine tachysystole

A

Decrease or discontinue pit, admin uterine relaxant (tocolytic)

38
Q

Define uterine tachysystole

A

Frequent uterine contractions during pregnancy