Ch 14 Fetal monitoring Flashcards Preview

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Flashcards in Ch 14 Fetal monitoring Deck (31)
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1

what method of EFM:
- high risk
- ptns on oxytocin (induction of labor)
- epidural
- NOT home births, birth centers
- ONLY in patient settings

continuous

2

what method of EFM:
- ptns who are ambulatory, low risk
- Can be done w/ doppler if only - FH is required or EFM short strip is only needed

intermittent

3

how long are fetal monitoring strips kept?

21 years total
18 + 3 years to file suit

4

how do you monitor uterine contractions?

palpate

5

ACOG
Reassuring. No further action needed at this time

Cat 1

6

ACOG
Indeterminate. Warrants further observation. → most strips are likely here

Cat 2

7

ACOG
Abnormal. Immediate and prompt intervention required. → delivery within 30 min or DEATH

Cat 3

8

110-160

normal fetal hr

9

Baseline

Must be able to observe a portion of tracing without ___________________ or without variations of ## bpm

Must be able to observe a portion of tracing without periodic/episodic changes or without variations of >25 bpm

10

Fluctuations or ‘waviness’ of the baseline FHR

Variability

11

amplitude peak to trough UNDETECTABLE

like asystole

absent variability

12

due to meds, fetal sleep cycle, anesthesia

amplitude >undetectable but <5

minimal variability

13

normal variability

amplitude >6 and <25

moderate

14

may be related to hypoxia or fetal seizure activity

amplitude >25

marked

15

what is the predictor of oxygenation and acidosis level of the fetus?

variability

16

Smooth, undulating wave form

Can be indicative of severe fetal anemia or of use of certain types of medications (Stadol) (especially if it goes away in a short pd of time)

sinusoidal

17

Transient or sustained fetal heart rate under 110 bpm

Must determine which it is because interventions different

if true - may be cardiac defect
if transient, may be r/t hypoxic event

bradycardia

18

Baseline of over 160 bpm for more than 10 minutes

Prolonged accelerations can be confusing-can be caused by fetal movement

True __________ can be caused by maternal and/or fetal infection, maternal meds, illicit drugs

tachy

19

most common causes of fetal tachy

infection
dehydration
drug abuse

20

what stops uterine contractions, esp b/c they are close together due to oxytocin?

terbutaline

21

fetal heart rate changes that occur WITH contractions

periodic

22

fetal heart rate changes not associated w/ contractions

episodic

23

15 x 15 rule

32 weeks, 15 beats above baseline for at least 15 seconds

24

10 x 10 rule

<32 weeks criteria for accelration becomes 10 x 10

25

normal, or sign of head compression (cephalopelvic disproportion)

early decel

26

occur after contraction

usually b/c of uteroplacental insufficiency

bad sign - no oxygen / cut off oxygen - fetal acidosis / hypoxemia. requires immediate intervention

interventions: position, give mom o2, IVF, stop pitocin, c-section

late decel

27

can be with or without contraction; usually transient; don’t let it linger down below

generally V in shape

cause: cord compression

intervention: positioning; amnioinfusion may be indicated if recurrent to provide cushion to prevent cord compression

variable decelerations

28

Lasts between 2-10 minutes.

Many causes of disruption to fetal oxygen supply.

Cord compression, pushing, hypotension after epidural, prolonged uteroplacental insufficiency (abruption, tachysystole)

prolonged deceleration

29

Predictive of normal acid/base balance

Baseline FHR 110-160 bpm

Baseline variability moderate

Present or absent accelerations

Present or absent early decelerations

No late or variable decelerations

cat 1

30

Not predictive of abnormal fetal acid/base status
Fetal tachycardia present
Bradycardia not accompanied by absent baseline variability
Absent baseline variability not accompanied by recurrent decelerations
Minimal or marked variability
Recurrent late decelerations with moderate baseline variability
Recurrent variable decelerations accompanied by minimal or moderate baseline variability. Overshoots or ‘shoulders’
Prolonged decelerations >2 min. but

Cat 2