Assessment of fetus Flashcards
Which ultrasound needs an empty bladder?
Which needs a full bladder?
Empty bladder - Transvaginal
Full bladder - Transabdominal
What does a nucchal test do?
When does it need to be done?
Screens for chromosome abnormalities
First trimester , 10-14 weeks
What does doppler flow studies do?
When does it begin?
Ratio?
What is a bad test?
Tests for fetal adaptation and reserve to estimate blood flow
First or second trimesters 6-18 weeks
A S/D ration is done w complications. Systolic/diastolic
If increased = trouble
What is PUBS?
What for?
Complication?
Putting a needle into umbilical cord to sample blood and transfusion
- guided by ultrasound
- anemia, infection, thrombocytopenia are all possibilities
cord bleeding complication
What is Chorionic Villus Sampling
If an Rh- mom gets this, what should you give after
Removal of sample from fetal placenta side to look for fetal defects or genetic abnormalities
Give her RhD immunglobulin
Maternal Serum screening is what?
What might be done after?
Screening for down syndrome and anencephaly
Sonogram if results are high to check for leakage
What is a Non Stress test?
Reactive Results vs Nonreactive
What can you do if there’s no fetal movement?
Just when mom monitors fetal movement and the FHR and status is monitored too
Reactive is a normal result w accels
Nonreactive is when there’s no movement or change in FHR - so re-evaluate it too.
- could just be from fetus sleeping tho.
Use a Vibroacoustic stimulation test to wake baby up.
Contraction Stress Test and Breast self stimuli test
Criteria?
Negative strip?
Positive strip?
Another way to evaluate FHR.
Use breast stimulation or oxytocin to cause contractions and to see how baby does under circumstances and looks for decels (bc if there’s nothing that means baby is demised)
You want 3 or more contractions within 10 minutes
Negative strip is actually good bc that means there’s no late or variable decels going on.
Positive strip is when there’s lots of lates or variable decels going on.
- usually lates tho
Fetal Fibronectin is a ______
What is a normal finding? And what does it mean?
What happens if you get a positive test?
Glycoprotein produced by fetal tissues
Normal is a negative test between 20-34 weeks
Strong predictor of no preterm risks
If positive: do sonogram, monitor contractions, check out-coming vaginal contents during contractions
What is an amniocentesis
What should nurse do before amniocentesis?
It obtains amniotic fluid with cells in it.
Needle gets inserted into the uterus and is withdrawn but is guided with sonogram.
Signed consent
Put mom in correct positioning
Empty bladder before procedure
What should the nurse do after amniocentesis?
After amniocentesis, assess for
bleeding infection improper healing VS fetal movement
Amniocentesis sample can be used to determine lung maturity.
What components of the sample are found?
L/S ratio - 2:1 by 35 weeks
PG levels: present beyond 35 weeks. if absent, means lungs aren’t mature
Lamellar body counts - + 50k by 35 weeks.
- can be high w diabetic patients
What is the Biophysical profile?
Measures a combination of things like:
Non-stress test- reactive or nonreactive
Fetal breathing movement - at least one episode of FBM of 30 sec over 30 min
Gross body movements - want 3 body movements within 30 minutes or less
AFI or amniotic fluid volume
Fetal tone or extension of extremities and then a return to normal
How is the Biophysical profile scored?
the combination test
0-2 strong suspect
4-6 low risk – below 6 is bad
8 - normal GOOD
10 - normal, low risk of chronic asphyxia
So if your score is below 6 - that puts you at greater risk for early rupture???
Daily Maternal Assessment of Fetal activity
What if kick count is low?
How to stimulate movement on your own?
Mom paying attention to how many times baby kicks
- do in 3rd trimester
If kick count is low could be from lots of reasons.
- sleeping, antidepressants, drinking, smoking, or oxygenation issues
incase baby is sleeping - try to move positions, drink juice, re-establish o2 really
