Electro Fetal Monitoring

Question 1

Internal fetal monitoring:

Answer 1

Fetal scalp electrodes FSE)
Only put in if membranes ruptures and dialated 2-3 cm
Goes into pocket if water and measures exactly how strong moms contractions are

Question 2

What is the acme of the contraction

Answer 2

The peak

Question 3

Palpate

Answer 3

During peak acme of contraction to determine intensity

Question 4

Milked or 1+ palpate

Answer 4

Easily indented
Nose

Question 5

Moderate 2 +

Answer 5

Can slightly indent
(Chin)

Question 6

Strong or 3+

Answer 6

Cannot indent uterus
Forehead

Question 7

IUPC ( inter uterine pressure catheter )

Answer 7

Contraction strength measured in mmhg after membrane reupture

Question 8

Mild contraction IUPC

Answer 8

30 mmhg

Question 9

Strong contraction IUPC

Answer 9

70 mmhg

Question 10

Labor average IUPC

Answer 10

50-75 mmhg up to 110 mmhg with pushing

Question 11

Tachysystole

Answer 11

Greater than 5 contractions in 10 min averaged over 30 minutes

Question 12

Hypertonic uterine activity

Answer 12

Resting tone greater than 20 - 25 mmhg

Question 13

Abnormal uterine activity

Answer 13

Spontaneous or stimulated labor

Question 14

Easy does hypertonic uterine activity lead to

Answer 14

Decrease uteri placental blood flow
Hypoxemia
Hypoxia metabolic acidosis
Metabolic academia

Question 15

Normal base line for FHR

Answer 15

110 -160 bpm

Question 16

Non stress test

Answer 16

Baby FHR related to movement
Reactive good
Non reactive bad

Question 17

Term increase FHR of in the baseline

Answer 17

15 bpm above the baseline lasting 15 seconds

Question 18

Preterm <32 weeks

Answer 18

10 bpm above baseline for 10 seconds

Question 19

What causes fetal response for FHR to have accelerations

Answer 19

Fetal movement , contractions, vag exams, breech presentations

Question 20

Accelerations

Answer 20

Reassuring sign - indicative of a reactive , heathy fetus

Question 21

Early decals

Answer 21

No intervention required but consider doing vag exam
Can indicate head compression
Baby telling us he is on da way

Question 22

Nadir

Answer 22

Lowest point of contraction

Question 23

Baseline variability

Answer 23

Variation in the base line
Is reflective of neuro maturity

Question 24

Absent base line

Answer 24

0-1 bpm
Not good

Question 25

Minimal baseline

Answer 25

< or equal to 5 bpm Biggest indicator that baby is asleep

Question 26

Moderate baseline

Answer 26

6-25 bpm Normal for term baby

Question 27

marked baseline

Answer 27

Normal for preterm Indicated neuro immaturity Abnormal for term baby Over 25 bpm

Question 28

Drugs that could contribute to Tachy cardia

Answer 28

atropine *and terbutaline *( used a lot for suppression of labor ) And drugs illicit such as cocaine and meth

Question 29

Three responses of fetal that is related to o2 pathway

Answer 29

FHR accelerations Variable decel Late decel

Question 30

Variables decel

Answer 30

Abrupt decrease or abrupt return of FHR U or v shape May r may not occur in labor

Question 31

What is considered a severe variable decel

Answer 31

FHR below 70 bpm lasting 30-60 seconds Slow return to base line Decrease in or absent variability Intrauterine resuscitation nursing intervention is required

Question 32

Causes of variable decel

Answer 32

Umbilical cord compression Prolapse cord Nuchal cord Short cord Sudden rapid descent of the fetus

Question 33

Late decel

Answer 33

Ominous ad potentially disastrous non reassuring sign Associated with decreased or absent variability Uterine rescuitation is required This is a positive that babe is in trouble in a CST .. are we creating late decals when contracting?

Question 34

Late decel

Question 35

Positive CST

Answer 35

Late de cells are present w/ a minimum of 50 % contractions occur in 10 min (We monitor for 20 min so it needs to occur in 10 min)

Question 36

Negative CST

Answer 36

No late de cels This is a good thing

Question 37

#1 cause of de cel

Answer 37

Some kind of placental insufficiency Post dates, preeclampsia, diabetes, cardiac disease, placental abruption