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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
Q

What is the clinical significance of LATE DECELERATIONS?

A

-non reassuring sign that indicates UTEROPLACENTAL INSUFFICIENCY
-NEEDS IMMEDIATE INTERVENTION

26
Q

What interventions should be done to correct LATE DECELERATIONS?

A

S top Pitocin
L eft lateral position
O xygen at 10L/min
B olus

27
Q

What is PROLONGED DECELERATION?

A

apparent decrease in FHR of at least 15 bpm below the baseline lasting > 2min but < 10 min

28
Q

How do you measure CTX FREQUENCY?

A

in minutes from the beginning of one ctx to the beginning of the next

29
Q

How do you measure CTX DURATION?

A

in seconds from the beginning to the end of a ctx

30
Q

What is considered UTERINE HYPERSTIMULATION?

A

when there are more than 5 ctx in 10 min period

31
Q

What do MILD CTXs feel like?

A

can easily be indented like the tip of the nose

32
Q

What do MODERATE CTXs feel like?

A

can be slightly indented like the chin

33
Q

What do STRONG CTXs feel like?

A

CANNOT be indented like the forehead

34
Q

What does CATEGORY I of FHR pattern classification mean?

A

-normal

35
Q

What are examples or CATEGORY I?

A

-FHR 110 to 160
-baseline variability MODERATE
-NO late or variable decelerations
-early decelerations present or absent
-accelerations present or absent

36
Q

What does CATEGORY II of FHR pattern classification mean?

A

-Indeterminate
-not good or bad but requires continued observation and evaluation

37
Q

What does CATEGORY III of FHR pattern classification mean?

A

-ABNORMAL
- IMMEDIATE evaluation and intervention is needed

38
Q

What are examples of CATEGORY III?

A

-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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