Ch. 15 Flashcards
Fetal assessment
Fetal bradycardia is most common during
Prolonged umbilical cord compression
While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurses first priority is to
Change the womans position
The nurse caring for the laboring woman should understand that early decelerations are caused by
Altered fetal cerebral blood flow
The nurse providing care for the laboring woman comprehends that accelerations with fetal movement
Are reassuring
The nurse providing care for the laboring woman realizes that variable fetal heart rate (FHR) decelerations are caused by
Umbilical cord compression
The nurse providing care for the laboring woman should understand that late fetal heart rate (FHR) decelerations are the result of
Uteroplacental insufficiency
The nurse providing care for the laboring woman should understand that amnioinfusion is used to treat
Variable decelerations
The nurse caring for the woman in labor should understand that maternal hypotension can result in
Uteroplacental insufficiency
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by
Change in position
While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate (FHR) begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends. The nurse should
Document the finding in the clients record
Which fetal heart rate (FHR) finding would concern the nurse during labor
Late decelerations
The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is
Fetal sleep cycles
The baseline fetal heart rate (FHR) is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is evaluating the patients most recent 10-minute segment on the monitor strip and notes a late deceleration. This is likely to be caused by which physiologic alteration
Placental abruption
Maternal supine hypotension
A tiered system of categorizing FHR has been recommended by regulatory agencies. Nurses, midwives, and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and understand the significance of each category. These categories include
Category I
Category II
Category III
Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by
Expanding maternal blood volume
Why is continuous electronic fetal monitoring usually used when oxytocin is administered?
Uteroplacental exchange may be compromised
The nurse knows that proper placement of the tocotransducer for electronic fetal monitoring is located
Over the uterine fundus
Which maternal condition is considered a contraindication for the application of internal monitoring devices
Unruptured membranes
The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The nurse notes that the intrauterine pressure at the peak of the contraction ranges from 65 to 70 mm Hg and the resting tone range is 6 to 10 mm Hg. The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. On the basis of this information, the nurse should
Document the findings because they reflect the expected contraction pattern for the active phase of labor
In assisting with the two factors that have an effect on fetal status (i.e., pushing and positioning), nurses should
Encourage the womans cooperation in avoiding the supine position
A nurse may be called on to stimulate the fetal scalp
To elicit an acceleration in the fetal heart rate (FHR)
The nurse caring for a woman in labor understands that prolonged decelerations
Usually are isolated events that end spontaneously
What correctly matches the type of deceleration with its likely cause
Late decelerationuteroplacental inefficiency
Which deceleration of the fetal heart rate would not require the nurse to change the maternal position
Early decelerations
Fetal well-being during labor is assessed by
The response of the fetal heart rate (FHR) to uterine contractions (UCs)
You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase intravenous (IV) fluid, and perform a vaginal examination. The cervix has not changed. Five minutes have passed, and the fetal heart rate remains in the 80s. What additional nursing measures should you take?
Notify the care provider immediately
What three measures should the nurse implement to provide intrauterine resuscitation? Select the response that best indicates the priority of actions that should be taken
Reposition the mother, increase intravenous (IV) fluid, and provide oxygen via face mask
Perinatal nurses are legally responsible for
Correctly interpreting fetal heart rate (FHR) patterns, initiating appropriate nursing interventions, and documenting the outcomes
As a perinatal nurse you realize that a fetal heart rate that is tachycardic, is bradycardic, or has late decelerations or loss of variability is nonreassuring and is associated with
Hypoxemia
A new client and her partner arrive on the labor, delivery, recovery, and postpartum unit for the birth of their first child. You apply the electronic fetal monitor (EFM) to the woman. Her partner asks you to explain what is printing on the graph, referring to the EFM strip. He wants to know what the babys heart rate should be. Your best response is
The top line graphs the babys heart rate. Generally the heart rate is between 110 and 160. The heart rate will fluctuate in response to what is happening during labor.
According to standard professional thinking, nurses should auscultate the fetal heart rate (FHR)
Before and after ambulation and rupture of membranes
When using intermittent auscultation (IA) for fetal heart rate, nurses should be aware that
Ultrasound can be used to find the fetal heartbeat and reassure the mother if initial difficulty was a factor
When using intermittent auscultation (IA) to assess uterine activity, the nurse should be cognizant that
The examiners hand should be placed over the fundus before, during, and after contractions
What is an advantage of external electronic fetal monitoring
The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor
When assessing the relative advantages and disadvantages of internal and external electronic fetal monitoring, nurses comprehend that both
Can be used during the antepartum and intrapartum periods
During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have
A normal baseline heart rate
The nurse caring for the woman in labor should understand that increased variability of the fetal heart rate may be caused by
Methamphetamines
Commonly 45 seconds or more in the second stage of labor
Relaxation time
Generally ranging from two to five contractions per 10 minutes of labor
Frequency
Average of 10 mm Hg
Resting tone
Peaking at 40 to 70 mm Hg in the first stage of labor
Strength
Remaining fairly stable throughout the first and second stages
Duration
