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I & M II > OB and Fetal Monitoring > Flashcards

OB and Fetal Monitoring Flashcards

1
Q

What’s this?

A

Three Stages of Woman

by Gustav Klimt

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2
Q

At what gestational age does CO reach its peak?

When does it normalize?

A

30 weeks

~44 weeks

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3
Q

When does MAP peak in the pregnant pt?

A

about 40 weeks

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4
Q

When does total peripheral resistance reach its nadir in the OB patient?

A

around 20 continuing to 35 weeks

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5
Q

What happens to SVR and PVR in a pregnant woman?

A

both decrease

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6
Q

What are the changes in % to:

platelets
erythrocytes
blood volume
plasma

A

0 %
20
35
45

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7
Q

What occurs to Hct and plasma volume in the pregnant pt?

A

Hct decreases and plasma volume increases

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8
Q

What occurs to MV, alveolar ventilation, TV, RR in the OB pt?

A

all increase

Alveolar (70%)
MV (50%)
TV
RR

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9
Q

What remains unchanged in the OB pt? (4)

A

pH
Vital capacity
Inspiratory lung capacity
Total lung capacity

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10
Q

What decreases in the OB pt?

A

FRC
Expiratory reserve volume
Residual volume

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11
Q

To prevent supine hypotensive syndrome, what do you do?

A

Right uterine displacement

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12
Q

What is normal FHR?

A

120 - 160

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13
Q

What defines fetal stress?

A

Decreased perfusion→hypoxia→low pH⇒low FHR

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14
Q

What is NST?

A

Nonstress Test

uses vibroacoustic stimulation
want to see variability and accelerations = (-) NST

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15
Q

What is a test that measures FHR over 10 minutes with 3 contractions?

A

Contraction Stress Test

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16
Q

What does the biophysical profile (BPP) measure?

A

Fetal breathing
Body movements
Tone
Amniotic fluid
HR
Reactivity

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17
Q

How common is fetal blood sampling?

A

Now uncommon

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18
Q

How is O2 sat measured on the fetus?

A

Fetal Oxygen Saturation (FSpO2) is measured on the scalp of the fetus.

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19
Q

What SaO2 is a concern for the well being of the fetus?

20
Q

What is a normal pH for a fetus?

A

7.25 - 7.35

pH of umbilical = 7.26

21
Q

What is the blood gas SO2 for the fetus?

22
Q

What is the normal PO2 and PCO2 for the fetus?

A

PO2 = 18 - 22 mmHg

PCO2 = 40 - 50 mmHg

23
Q

How can scalp pH be related to APGAR scores?

A

The higher the pH, the higher the Apgar score.

64.4% probability or correlation

24
Q

Label:

25
What does increased SpO2 tell us?
increased pH, healthier baby
26
What occurs during birth?
SpO2 decreases from stress, thus pH decreases.
27
Which ECG electrode is the reference electrode? Where is it placed? What is the name of this electrode?
black one on left uterine wall Hon scalp ECG electrode
28
Label
Top: fetal ECG Bottom: ultrasound
29
What is an external fetal monitoring system called?
Tocogram
30
What are the classes of FHR variability? (4)
None Reduced variability (0 - \< 5 beats/min) Normal variability (5 - 10 beats/min) Increased variability (\> 15 beats/min)
31
What is this graph called? What is enclosed in the red box?
Tocograph Normal FHR pattern
32
What are patterns of FHR changes? (4)
Accelerations (normal) Early decelerations Late decelerations Variable decelerations
33
Which FHR pattern is coincident with contraction?
Early decelerations possibly from compression of the head
34
What FHR patterns will result in decreased uterine blood flow beyond the capacity of the fetus to extract sufficient oxygen?
Late decelerations
35
What will occur to FHR with vagal firing in response to cord compression or sustained head compression?
Variable decelerations
36
What's depicted?
Normal fetal oxygenation Accelerations with contractions
37
What's depicted?
Early deceleration, head compression
38
What's depicted?
Late deceleration, Uteroplacental insufficiency
39
What's depicted?
Variable deceleration, umbilical cord compression
40
What's depicted?
Early deceleration, head compression
41
What's depicted?
Late deceleration, hypoxia
42
What is depicted?
Variable decelerations and absence of HR variability
43
What does the lack of HR variability indicate?
decreased cerebral oxygenation
44
What does APGAR represent? What is it? What is a good score?
Activity Pulse Grimace Appearance of skin color Respiration Backronym named after Dr. Apgar. 10
45
What emergency equipment is needed in the delivery room? (5)
Radiant warmer Suction Suction catheters Infant aw materials including ambu Meds: 1:10,000 **epi, narcan, sodium bicarb, volume expanders**

I & M II (21 decks)

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