Ch. 15 Fetal assessment during labor

Question 1

Define hypoxemia

Answer 1

Deficiency of oxygen in arterial blood

Question 2

Define hypoxia

Answer 2

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

Question 3

Define Asphyxia

Answer 3

When fetal hypoxic results in metabolic acidosis

Question 4

What is intermittent Auscultation

Answer 4

Listening to fetal heart sounds at periodic intervals to assess FHR

Question 5

What is contraction duration

Answer 5

Measured in sec from beginning to end of contraction

Question 6

How is the frequency of the contraction measured

Answer 6

In minutes, beginning of one contraction to beginning of next

Question 7

What does each small square on the monitor paper represent

Answer 7

10 seconds

Question 8

What does each large square on the monitor paper represent

Answer 8

1min

Question 9

Define baseline FHR

Answer 9

Average rate during a 10min period

Question 10

Define variability

Answer 10

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

Question 11

What are the four categories of variabiity

Answer 11

Absent, minimal, moderate, marked

Question 12

Which variability is considered normal

Answer 12

Moderate; highly predictive of normal fetal-acid balance

Question 13

When is a sinusoidal pattern usually present

Answer 13

During severe anemia

Question 14

Define absent variability

Answer 14

Amplitude range undetectable

Question 15

Define minimal variability

Answer 15

Range detectable less than 5bpm

Question 16

Define moderate variability

Answer 16

6-25bpm

Question 17

Define marked variability

Answer 17

Greater than 25bpm

Question 18

Tachycardia FHR

Answer 18

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

Question 19

What are some common causes of FHR tachycardia

Answer 19

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

Question 20

Bradycardia FHR

Answer 20

Baseline less than 110bpm for less than 10min

Question 21

What are some common causes of FHR bradycardia

Answer 21

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

Question 22

Define acceleration

Answer 22

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

Question 23

Are accelerations normal

Answer 23

They indicate fetal well being, normal acid-base balance

Question 24

What are early deceleration

Answer 24

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

Question 25

What causes early decelerations

Answer 25

Fetal head compression, benign, no intervention

Question 26

What are late decelerations

Answer 26

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

Question 27

What traditionally attributes to late decelerations

Answer 27

uteroplacental insufficiency

Question 28

What interventions are necessary when late decelerations are present

Answer 28

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

Question 29

What are variable decelerations

Answer 29

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

Question 30

What causes variable decelerations

Answer 30

Compression of umbilical cord

Question 31

What are prolonged decelerations

Answer 31

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

Question 32

When is a deceleration considered a baseline change

Answer 32

Last longer than 10min

Question 33

What are the interventions when variable decelerations are present

Answer 33

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

Question 34

Which category tracing for FHR is considered noraml

Answer 34

Category 1

Question 35

What legal responsibility do nurses have when reading fetal monitors

Answer 35

Correctly interpret FHR, documenting, timely notification

Question 36

What are the interventions for maternal hypotension

Answer 36

Increase IV, lateral position, ephedrine to increase Bp

Question 37

What are the interventions for uterine tachysystole

Answer 37

Decrease or discontinue pit, admin uterine relaxant (tocolytic)

Question 38

Define uterine tachysystole

Answer 38

Frequent uterine contractions during pregnancy