Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

OB/Community Health > Fetal Monitoring > Flashcards

Fetal Monitoring Flashcards

1
Q

Why do we use fetal monitoring ?

A

primary mode of intrapartum fetal assessment in the U.S
- useful took for assessing fetal response to labor and uterine activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the goals of intrapartum fetal monitoring ?

A
  • support maternal coping and labor progress
  • maximize uterine blood flow
  • maximize umbilical circulation
  • maximize oxygenation
  • maintain appropriate uterine activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 reasons why fetal oxygen supply can decrease ?

A
  • reduction to blood flow
  • reduction of oxygen content
  • alterations in fetal circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the reasons of reduction of blood flow to fetus ?

A
  • poor maternal circulation
  • poor placental perfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the reasons for reduction of oxygen content to fetus ?

A
  • maternal hemorrhage
  • severe anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the reasons for alterations in fetal circulation in fetus ?

A
  • cord compression
  • head compression
  • placental abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the different types of monitoring techniques ?

A
  • intermittent auscultation
  • electronic external and internal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is intermittent auscultation ?

A

every 30 mins going to listen with the doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is electronic monitoring ?

A
  • External: intermittent and continuous with the Toco which is placed on the fundus because that is where all the pressure is
  • Internal: invasive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the Toco work ?

A

as the mom contract it presses on the button which produces a wave that can be seen on the computer or paper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where do you place an external fetal monitor ?

A

you palpate the mom’s abdomen to feel where the baby’s position is with Leopold’ Maneuver
- US transducer should be placed on fetal back and the Toco near the fundus (top) of uterus
- smooth side is baby’s back and pointy parts are arms/legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is the fetal heart rate best heard ?

A

along the fetal back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 2 internal electronic fetal monitoring devices ?

A
  • fetal scalp electrode (FSE)
  • intrauterine pressure catheter (IUPC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the fetal scalp electrode (FSE) ?

A

direct ECG monitoring of fetal heart where a thin wire is placed under the skin of the fetal head
- mom has to be dilated and water has to be broken
- Contraindications: infection (HIV, Hep B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an intrauterine pressure catheter (IUPC) ?

A

direct measurement of uterine pressure where a catheter is placed between fetal body and uterus
- in mmHg
- membranes must be ruptured (ROM) & cervix must be dilated
- goal is to be on the side of the fundus
- can poke hole in placenta (if have abnormal placenta placement then not done)
- in IN RN’s can’t do this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the fetal heart rate baseline tell you ?

A

reflects the intrinsic rhythm of fetal heart and central nervous system functioning
- assess q30 min
- if pt is on Pitocin then q15min
- ignore any big peaks or downward beaks when counting the average

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the normal fetal heart rate baseline ?

A

110-160 bpm
- baseline rate is the average during a 10 min segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is bradycardia in FHR ?

A

baseline <110 bpm for duration of 10 minutes or longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is tachycardia in FHR ?

A

baseline >160 bpm for duration of 10 mins or longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some causes of bradycardia in FHR ?

A
  • interrupted O2 supply to fetus (occluded umbilical cord, maternal hypotension, hemorrhage)
  • medications (Nubain) (any med given to mom affects the baby through placenta)
  • post maturity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some causes of tachycardia in FHR ?

A
  • maternal fever
  • prematurity
  • medications (terbutaline)
  • abnormal fetal cardiac rhythm
22
Q

What is FHR variability ?

A

indirect measurement of fetal oxygenation & CNS functioning
- sympathetic increases the wave and parasympathetic decreases it

23
Q

What is absent variability ?

A

undetectable/0 and looks like a straight line
- ominious
- represent fetal hypoxia or metabolic acidosis, and CNS dysfunction

24
Q

What is minimal variability ?

A

1-5
- sleep cycle, sedation, sick
- represents hypoxemia, and congenital abnormality

25
What is moderate variability ?
6-25 - normal - represents intact CNS and good fetal oxygenation
26
What is marked variability ?
>25 and if not corrected it can start to look absent - unclear significance
27
What is acceleration ?
increase in FHR of at least 15 bpm above baseline, lasting about 15 secs or more (15x15)
28
What was acceleration represent ?
reassuring sign of fetal well-being - oxygenated and intact CNS - see this when baby is moving around (kicking)
29
What is early deceleration ?
- benign - response to fetal head compression - gradual deceleration that mirrors the contraction - greater then 30 secs
30
What causes early deceleration ?
as baby enters the pelvis there is more pressure put on the head - decrease cerebral circulation/head compression
31
What is late deceleration ?
response to uteroplacental insufficiency - gradual deceleration: starts after the contraction begins - represents not enough bloodflow or O2 to fetus - takes >30 secs from baseline to acceleration
32
What is variable deceleration ?
response to cord compression - abrupt deceleration and return to baseline - can be with or without contractions - when increase pressure on cord then the HR drops - artery constricts so the vein does as well
33
What is prolonged deceleration ?
response to interrupted oxygen supply - when is lasts >2 mins but <10 mins - associated with hypotension or interrupted of the 02 supply
34
What is VEAL CHOP ?
- Variable -----------> cord compression - Early --------------> head compression - Acceleration ---------> Okay ! - Late ----------------> placental insufficiency
35
What is required for normal tracings ?
- moderate variability - baseline rate 110-160 - no late or variable decels - early decels present or absent - accels: present or absent
36
What is required for indeterminate tracings ?
FHR tracings that do not meet the criteria for normal or abnormal
37
What is required for abnormal tracings ?
absent baseline variability and any of the following: - recurrent late decels - recurrent variable decels - bradycardia or sinusoidal pattern
38
What is a category 1 tracing ?
strongly associated with normal acid base status
39
What is a category 2 tracing ?
not predictive of abnormal fetal acid base status but inadequate evidence to classify as normal or abnormal
40
What is a category 3 tracing ?
predicting of abnormal fetal acid base status
41
What does frequency mean ?
measure shortest and longest interval between contractions (minutes) - how often the contractions are coming
42
What does duration mean ?
measure shortest and longest contraction (seconds) - how long contractions are lasting
43
What is intensity ?
measure of strength of contraction - palpation: mild, moderate, strong (palpate on fundus and press and feel for compression) - IUPC: mmHg & MVUs
44
What is resting tone ?
the "tone" of uterus between contractions - during contractions the uterus becomes taut which means it has increased tone - palpation: soft or rigid - IUPC: mmHg
45
What is tachysystole ?
>5 contractions in 10 mins - caused by spontaneous or stimulated contractions - intervention is necessary to reduce contractions and increase resting tone (can lead to fetal compromise if not corrected)
46
What does oxytocin do ?
stimulates contractions
47
What is intrauterine resuscitation ?
interventions used to maximize blood flow and oxygenation in utero when fetus is stressed - interventions often done simultanously - intervention is critical to maintain fetal capacity to tolerate labor
48
What are the goals of intrauterine resuscitation ?
- support maternal coping and labor progress - maximize uteroplacental blood flow - maximize oxygenation - maximize umbilical blood flow - maximize normal uterine activity
49
What are the 4 interventions used for intrauterine resuscitation ?
- increase fluid volume (bolus of lactated ringers (LR)) - increase uterine/umbilical perfusion (reposition to L or R side) - increase oxygenation ( 8-10L O2 with non-rebreather face mask because during labor mouth breathing is common) - increase uterine resting tone (discontinue oxytocin and admin Terbutaline 0.25 mg SQ)
50
What is amnioinfusion ?
used to increase "cushion" of fluid volume around umbilical cord in utero - put IV fluids back into the uterus - infusion of fluid thought IUPC (LR or NS) - check pad for fluid return (if not risk of rupturing uterus) - avoid overdistension of uterus
51
What is amnioinfusion used for ?
intervention used for recurrent variable decelerations - decreased amniotic fluid volume after ROM - umbilical cord compression

OB/Community Health (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions