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RNSG 1251 UNIT 1 > ch. 18: fetal assessment during labor > Flashcards

ch. 18: fetal assessment during labor Flashcards

1
Q

What is an intrauterine pressure catheter (IUP)?

A

-catheter is introduced into uterine cavity
-can monitor FREQUENCY, DURATION, INTENSITY of ctx
-only way to measure INTENSITY
-membrane HAS TO BE RUPTURED

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2
Q

What are the 5 essential components of FHR tracing?

A

1) baseline rate
2) baseline variability
3) accelerations
4) decelerations
5) changes or trends over time

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3
Q

What is the normal range for FHR?

A

110-160

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4
Q

What is considered FHR tachycardia?

A

> 160 bpm

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5
Q

What is considered FHR bradycardia?

A

<110 BPM

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6
Q

What are PERIODIC changes?

A

Occurring w/ UTERINE CTXs

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7
Q

What are EPISODIC (nonperiodic) changes?

A

NOT associated w/ uterine ctxs

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8
Q

What is FHR VARIABILITY?

A

-beat to beat variation in FHR
-from the interaction of SNS & PNS
-occurs due to intact neuro pathway and an indicator of the health of the CNS
-has 4 categories: absent, minimal, moderate, marked

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9
Q

What is ABSENT variability?

A

amplitude range undetectable

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10
Q

What is MINIMAL variability?

A

amplitude range < 5 bpm

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11
Q

What is MODERATE variability?

A

amplitude range of 6-25 bpm
-considered NORMAL

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12
Q

What is MARKED variability?

A

amplitude range > 25 bpm
-sig unclear and may represent normal variation

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13
Q

What are FHR ACCELERATIONS?

A

visually apparent increase on FHR above the baseline rate at least 15 bpm x 15 sec w/ return to baseline less than 2 min from beginning of acceleration

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14
Q

What is the clinical significance of FHR ACCELERATIONS?

A

-normal pattern that represents alertness or fetal well being
-NO INTERVENTIONS ARE REQUIRED

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15
Q

What is sinusoidal FHR pattern?

A

-undulating wavelike pattern
-associated w/: fetal anemia, chorioamimotitis, fetal sepsis, opioid admin

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16
Q

What is VARIABLE DECELERATION?

A

visually abrupt and apparent W, V, or U shaped decrease in FHR below the baseline at least 15 bpm x 15 sec during or w/o ctx

17
Q

What is the cause of VARIABLE DECELERATION?

A

umbilical cord compression

18
Q

What is the clinical significance of VARIABLE DECELERATIONS?

A

usually transient and correctable

19
Q

What interventions can be done to correct VARIABLE DECELERATIONS?

A

-change maternal position: put pt in left lateral
-admin O2 at 10 L/min
-discontinue Pitocin

20
Q

What is EARLY DECELERATION?

A

apparent, gradual decrease in & return to baseline FHR associated w/ contraction pr vaginal examination

21
Q

What is the cause of EARLY DECELERATIONS?

A

fetal head compression

22
Q

What is the clinical significance of EARLY DECELERATIONS?

A

benign pattern

23
Q

What interventions should be done for EARLY DECELERATIONS?

A

-NONE
-check for labor progress

24
Q

What is LATE DECELERATION?

A

-apparent decrease and return to baseline FHR associated w/ contractions
-usually occurs at PEAK of the ctx and returns to baseline after ctx is over

25
What is the clinical significance of LATE DECELERATIONS?
-non reassuring sign that indicates UTEROPLACENTAL INSUFFICIENCY -NEEDS IMMEDIATE INTERVENTION
26
What interventions should be done to correct LATE DECELERATIONS?
S top Pitocin L eft lateral position O xygen at 10L/min B olus
27
What is PROLONGED DECELERATION?
apparent decrease in FHR of at least 15 bpm below the baseline lasting > 2min but < 10 min
28
How do you measure CTX FREQUENCY?
in minutes from the beginning of one ctx to the beginning of the next
29
How do you measure CTX DURATION?
in seconds from the beginning to the end of a ctx
30
What is considered UTERINE HYPERSTIMULATION?
when there are more than 5 ctx in 10 min period
31
What do MILD CTXs feel like?
can easily be indented like the tip of the nose
32
What do MODERATE CTXs feel like?
can be slightly indented like the chin
33
What do STRONG CTXs feel like?
CANNOT be indented like the forehead
34
What does CATEGORY I of FHR pattern classification mean?
-normal
35
What are examples or CATEGORY I?
-FHR 110 to 160 -baseline variability MODERATE -NO late or variable decelerations -early decelerations present or absent -accelerations present or absent
36
What does CATEGORY II of FHR pattern classification mean?
-Indeterminate -not good or bad but requires continued observation and evaluation
37
What does CATEGORY III of FHR pattern classification mean?
-ABNORMAL - IMMEDIATE evaluation and intervention is needed
38
What are examples of CATEGORY III?
-absent variability and any of the following: 1) recurrent LATE DECELERTIONS 2) recurrent VARIABLE DECELERATIONS 3) BRADYCARDIA -sinusoidal pattern

RNSG 1251 UNIT 1 (8 decks)

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