Fetal Monitoring

Question 1

purpose of fetal monitoring

Answer 1

assess fetal response to stress of labor

Question 2

monitoring techniques

Answer 2

intermittent auscultation

electronic

Question 3

intermittent auscultation advantage/disadvantages

Answer 3

freedom of movement, inexpensive

cant assess FHR variability (no perm. record), not recommended for high risk

Question 4

types of intermittent auscultation

Answer 4

hand held Doppler

fetoscope

Question 5

electronic monitoring types

Answer 5

toco transducer
ultrasound transducer
iupc(intrauterine pressure cath)
fse(fetal scalp electrode)

Question 6

advantage/disadvantage of electronic monitoring

Answer 6

monitor FHR(perm. record)
increased risk of operative interventions, internal monitoring can cause rupture, restricts movement

Question 7

intermittent auscultation guidelines

Answer 7

q30-60 - first stage
q15-30 - second stage
monitor during/after (30 sec) contraction

Question 8

electronic monitoring guidelines

Answer 8

preg w/o comp. q30/q15 (first/second stage)
preg w/comp. q15/5
use of oxytocin q15/q5

Question 9

baseline fetal HR characteristics

Answer 9

baseline fetal hr
baseline variability
accelerations
decelerations
changes over time
contraction pattern

Question 10

baseline fetal HR

Answer 10

110-160 (norm)

avg rate during 10min segment (excluding changes) rate is rounded to 5bpm

Question 11

baseline variability

Answer 11

irregular fluctuations in baseline FHR assessed over 10min

each 10 sec fetal heart beats 18-26 times

Question 12

baseline variability classifications

Answer 12

absent - undetectable

minimal - >undectable25 bpm

Question 13

sinusoidal patterns

Answer 13

assoc w/severe fetal anemia

Question 14

pseudo-sinusoidal

Answer 14

assoc w/maternal narcotics

Question 15

fxr affecting fhr variability

Answer 15

sleep, congenital heart conditions, diabetes, hyper/hypo tension

Question 16

fetal tachycardia

Answer 16

HR above 160bpm for >10min

early sign of fetal hypoxemia

Question 17

nursing interventions for fetal tachy

Answer 17

o2 - 8-10L

reduce fever

Question 18

fetal bradycardia

Answer 18

HR below 110bpm for >10min

late sign of fetal hypoxemia

Question 19

nursing interventions for fetal brady

Answer 19

O2
IV hydration
position change

Question 20

periodic changes occur

Answer 20

in response to uterine contractions

Question 21

episodic changes occur

Answer 21

intermittently, isolated events, not in the presence of uterine activity

Question 22

types of changes

Answer 22

accelerations

decelerations

Question 23

accelerations are

Answer 23

abrupt increase in fhr above baseline >=15bpm lasting >=15sec

Question 24

decelerations are

Answer 24

decelerations in fhr by dominance of parasympathetic response
benign or non-reassuring

Question 25

3 types of decelerations

Answer 25

early late variable

Question 26

early decelerations are

Answer 26

gradual decrease in fhr starting w/contraction ending with return to baseline

Question 27

cause of early decelerations

Answer 27

fetal head compression (vagal response) | no intervention needed

Question 28

late decelerations are

Answer 28

gradual decrease in fhr beginning after contraction ends after contaction

Question 29

late decelerations are caused by

Answer 29

placental insufficiency | ominous when repeated or not resolved w/interventions

Question 30

nursing interventions for late decelerations

Answer 30

position change 02-10L increase IV fluids stop Pitocin

Question 31

variable decelerations are

Answer 31

abrupt decrease in fhr | vary in shape, depth, timing

Question 32

cause of variable decelerations

Answer 32

cord compression

Question 33

nursing interventions for variable decelerations

Answer 33

position change 02 -8-10L discontinue pitocin

Question 34

veal chop acronym

Answer 34

variable - cord early - head acceleration - OK late - placenta

Question 35

cat 1 fhr tracing

Answer 35

normal - fetal well being

Question 36

cat 2 fhr tracing

Answer 36

indeterminant - not predicitive of abnormality

Question 37

cat 3 fhr tracing

Answer 37

abnormal - require prompt intervention

Question 38

cat 3 characteristics

Answer 38

absent variability AND late/variable decelerations brady or sinusoidal pattern

Question 39

uterine activity assessed and monitored for

Answer 39

frequency - start of one to the next contraction | duration - start to the end of a contraction

Question 40

intensity is documented as

Answer 40

external - mild, moderate, strong (+1.2.3) | internal - mmHg via IUPC (intrauterine pressure cath)

Question 41

EFM is not useful in reducing what

Answer 41

cerebral palsy

Question 42

abnormal uterine activity

Answer 42

contractions occuring 90sec. (tetanic contractions) | unusually high resting tone (hypertonus)

Question 43

norm uterine activity

Answer 43

contractions q2-5 min lasting =30sec 5 or less contractions in a 10min period, over 30min