Chapter 18 Flashcards Preview

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Flashcards in Chapter 18 Deck (35):
1

Fetal Oxygenation requires (5 factors)

Normal maternal blood flow & volume to the placenta.
Normal oxygen saturation in maternal blood
Adequate exchange of O2 and CO2 in the placenta
Open circulatory path between placenta and umbilical cord
Normal fetal circulation and O2 carrying functions.

2

so if mom isn't pumping enough blood to placenta than

mom hemorrhaging, so hypotensive (vasodilation of vessel and decrease volume)

3

sedation is

vasodilating

4

if mom is severely dehydrated, severely anemic, or hypoxic then

can't give oxygen to fetus

5

pathologic influences on fetal oxygenation

Maternal cardiopulmonary alterations (bleeding,hypertension)
Uterine activity (tetonic contractions >90)
Placental disruptions
Interruptions in umbilical blood flow
Fetal alterations

6

two ways to evaluate fetal well being

Low Tech: Auscultation of FHR, Palpation of uterine contractions
Electric Fetal Monitoring: For fetal heart rate and contraction patterns, Internal and External

7

abruptio placentae

premature separation

8

infarcts

blood does't flow through placenta and placenta starts to die, happens over 42 weeks, would make baby stressed, baby gets smaller in the true post dates

9

fetal alterations

low fetal blood volume, fetal hypotension; baby can become anemic = Rh

10

most common monitor

doppler

11

doppler

mother can move around, more natural, can have continuous monitoring - (debate over)

12

abruptio placentae

premature separation

13

infarcts

blood does't flow through placenta and placenta starts to die, happens over 42 weeks, would make baby stressed, baby gets smaller in the true post dates

14

fetal alterations

low fetal blood volume, fetal hypotension; baby can become anemic = Rh

15

most common monitor

doppler

16

doppler

mother can move around, more natural, can have continuous monitoring - (debate over)

17

electronic fetal monitoring advantages -

more data about fetus before, after, and during contractions; it is a permanent record

18

electronic fetal monitoring disadvantages -

reduced mobilities, have to adjust the equipment (esp. as baby progresses), more technical feeling (some mothers want to feel homey/natural)

19

fetal monitors up and down

10 minutes

20

fetal monitors side to side

10 seconds

21

fetal monitors red line

1 minute

22

fetal monitoring contractions and fetal heart rate

30-248 bpm

23

fetal monitoring intensity of contractions

0-100

24

fetal monitoring of intensity

only measure with interior pressure catheter, cannot measure with external monitor

25

documenting with fetal monitors

Name/Hospital number Date/Time of admission
nurse has to document fetal monitor strip every 15 minutes
have to document when do a procedure

26

documenting during labor

ROM -color, amount, internal vs. external monitoring, vital signs, position changes, vaginal exams, maternal N&V, Medications, interventions for nonreassuring patterns, Pitocin drip management, readjustment of monitor, fetal movement

27

monitoring can provide data on

-FHR : Variability,Baseline,Periodic Changes (accelerations/decelerations)
-Contractions: duration, frequency, resting tone
-Intensity of contractions (internal only)
-Relationship between contractions and fetal heart rate

28

external monitoring

-Placed with elastic straps (blue/pink belts) in different spots
-Doesn’t require ROM or dilation
- Somewhat less accurate than internal monitoring
- TOCOTRANSDUCER
- ULTRASOUND TRANSDUCER

29

ultrasound transducer

(relatively rapid galloping click)
FHR assessment, sonar type device, use ultrasonic jelly, loose pick up at times with fetal or maternal movement

30

tocotransducer

uterine activity assessment, placed on uterine fundus, not reliable for intensity

31

internal monitoring

-Accuracy is the main advantage
-Requires ROM and at least 2cms dilated (bc have to have ruptured membranes)
-Invasive and increases potential for infection
-can tell intensity
-have to be positive about baby's position

32

scalp electrode -

“spiral electrode” picks up electrical signs from the fetal heart (EKG), movement doesn’t interfere with pick up
- should only go on baby's head or butt; attaches to baby and potential for more problems

33

types of internal monitoring

scalp electrode, intrauterine pressure catheter, aminoinfusion

34

interuterine pressure catheter -

measures uterine activity, either solid or fluid filled catheter, accurately measures contraction intensity and resting tone during intervals

35

aminoinfusion

LR or NS infused through catheter to
1) decrease cord compression
2) dilute meconium