Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ATI Maternal Newborn > Ch. 6: Assessment of Fetal Well-Being > Flashcards

Ch. 6: Assessment of Fetal Well-Being Flashcards

1
Q

What are the 3 types of ultrasounds?

A

External abdominal ultrasound
Internal transvaginal ultrasound
Doppler ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What ultrasound is invasive?

A

Internal transvaginal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an advantage of the internal transvaginal ultrasound?

A

Does not require a full bladder; especially useful in clients who are obese and those in the first trimester to detect an ectopic preg, identify abnormalities, and establish gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who is the Doppler ultrasound useful in?

A

IUGR and poor placental perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prep for the ultrasound (with exception of transvaginal), we need to advise the client to drink _______ prior to the ultrasound to fill the bladder, life and stabilize the uterus, displace the bowel, and act as an echo lucent to better reflect sound waves to obtain a better image of the fetus

A

1-2 quarts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What position is client in for ultrasound?

A

Supine position with wedge under right hip to displace the uterus and prevent supine hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What position is the client in for the transvaginal ultrasound?

A

Lithotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Uses a real time ultrasound to visualize physical and physiological characteristics of the fetus and obsess for fetal biophysical responses to stimuli

A

Biophysical profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 5 variables measured in the BPP?

A 
Reactive FHR
Fetal breathing movements
Gross body movements
Fetal tone
Qualitative amniotic fluid volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What BPP scores indicate normal?

A

8-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most widely used technique for antepartum evaluation of fetal well being performed during the THIRD trimester

A

Nonstress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the nonstress test?

A

Noninvasive procedure that monitors response of the FHR to fetal movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is the NST done?

A

Doppler transducer: monitor FHR
Tocotransducer: monitor uterine contractions

Those are attached to clients abdomen; client pushes a button attached to the monitor whenever she feels a fetal movement, and it is now on the tracing

This allows nurse to assess FHR in relationship to fetal movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the indications for NST during pregnancy?

A
  1. Assess intact CNS during THIRD trimester

2. Rulling out risk for fetal death in clients who have diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is considered a reactive NST?

A
  • FHR is normal baseline with moderate variability

- Accelerates to 15 bp for at least 15 seconds and occurs two or more times during 20 min period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is considered nonreactive NST?

A
  • FHR does not accelerate with fetal movement

- Does not meet criteria for reactive NST after 40 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If the NST comes out to be nonreactive, what is indicated?

A

CST or BPP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What position is client in for NST?

A

Reclining chair
Semi Fowler or
Left lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does nipple stimulated contraction stress test (CST) consist of?

A

Woman lightly brushing her palm across her nipple for 2 min…pituitary gland releases endogenous oxytocin…Then stop the nipple stimulation when contraction begins…same process repeated after 5 min rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CST: Analysis of the FHR response to contractions (which decrease placental blood flow) determines how the fetus will _________.

A

Tolerate stress of labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CST: How much data need to be obtained to use?

A

A pattern of a least 3 contractions w/in 10 min time period with duration of 40-60 seconds each

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CST: If nipple stimulation fails, what can we give to do this test?

A

Oxytocin

*but contractions started with oxytocin may be difficult to stop and can lead to preterm labor!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications for CST?

A
  • High risk pregnancies (diabetes, post term)

- NST

24
Q

Negative CST

  • Normal or abnormal?
  • How is this indicated?
A

Negative is normal

Indicated w/in 10 min period, with 3 uterine contractions and there are NO late decelerations of FHR

25
Q

Positive CST

  • Normal or abnormal?
  • How is this indicated?
A
  • Positive is abnormal
  • Indicated with persistent and consistent late decelerations on more than 1/2 of the contractions (suggesting uteroplacental insufficiency)

Variable decelerations may indicate cord compression

Early decelerations may indicate fetal head compression

26
Q

The aspiration of amniotic fluid by insertion of a needle transabdominally into a client’s uterus and amniotic sac under direct ultrasound guidance locating the placenta and determining the position of the fetus

A

Amniocentesis

27
Q

When can amniocentesis be performed?

A

After 14 weeks gestation

28
Q

When can AFP be measured from the amniotic fluid of amniocentesis and what is this used to assess?

A

16-18 weeks; NTD or chromosomal disorders

29
Q

Why would we test fetal lung maturity from the fluid from an amniocentesis?

A

If gestation is less than 37 weeks and there was ROM, preterm labor, or a complication indicating a C section

30
Q

What should the fetal lung tests show that indicate fetal lung maturity?

A
  • L/S ration 2:1

- Presence of phosphatidylglycerol (absence of PG is associated with resp distress)

31
Q

Amniocentesis: Should clients bladder be empty or full for this procedure?

A

Empty–to reduce risk of inadvertent puncture

32
Q

If client is Rh-, what needs to be administered after the amniocentesis?

A

Rhogam to protect against isoummunization

33
Q

After amniocentesis, what should we tell the client to report to her provider if she experiences them?

A
  • Fever, chills
  • Leakage of fluid/bleeding from insertion site
  • Decreased fetal movement
  • Vaginal bleeding
  • Uterine contractions
34
Q

After amniocentesis, we should encourage what to the client?

A

Drink plenty of liquids and rest for the 24 hours post procedure

35
Q

The most common method used for fetal blood sampling and transfusion. This procedure obtains blood from the umbilical cord by passing a fine-gauge, fiber-optic scope (fetoscope) into the amniotic sac using the amniocentesis technique. The needle is advanced into the umbilical cord under ultrasound guidance, and blood is aspirated from the umbilical VEIN

A

Percutaneous umbilical blood sampling (PUBS)

36
Q

Why would we do a PUBS procedure (4)?

A
  • Fetal blood type, RBC, chromosomal disorders
  • Karyotyping of malformed fetuses
  • Fetal infection
  • Alteread acid-base balance of fetuses with IUGR
37
Q

Assessment of a portion of the developing placenta (chorionic villi), which is aspirated through a thin sterile catheter or syringe inserted through the abdominal wall or intravaginally through the cervix under ultrasound guidance and analyzed

A

CVS

38
Q

CVS is a first trimester alternative to amniocentesis with one of its advantages being an early diagnosis of any abnormalities. When can CVS be performed?

A

10-12 weeks gestation

Remember, amniocentesis can be performed after 14 weeks gestation!

39
Q

CVS indications?

A

Women at risk giving birth to baby with genetic chromosomal abnormality

*this cannot determine spina bifida or anencephaly (the amniocentesis can determine this with the AFP which can be done at 16-18 weeks gestation)

40
Q

CVS: bladder full or empty?

A

Full

41
Q

What has a higher risk for spontaneous abortion: CVS or amniocentesis?

A

CVS

42
Q

A blood test that ascertains information about the likelihood of fetal birth defects; does not diagnose the actual effect; may be performed instead of MSAFP because it has more reliable results

A

Quad marker screening

43
Q

What all does quad marker screening test for?

A
  • hCG (hormone produced by placenta)
  • AFP (hormone produced by fetus)
  • Estriol (hormone produced by placenta and fetus)
  • Inhibin A (hormone produced by ovaries and placenta)
44
Q

When can quad marker screening be done?

A

16-18 weeks gestation

45
Q

Quad marker: What may low AFP indicate?

A

DS

46
Q

Quad marker: What may high AFP indicate?

A

Risk for NTD

47
Q

Quad marker: Higher levels than the expected range of hCG and Inhibin-A indicates a risk for ___

A

DS

48
Q

Quad marker: Lower levels than the expected reference range for estriol may indicate a risk for ____

A

DS

49
Q

A screening tool used to detect NTD; clients who have abnormal findings should be referred for quad marker screening, genetic counseling, ultrasound, and an amniocentesis

A

MSAFP

50
Q

When can MSAFP be done?

A

16-18 weeks gestation

51
Q

What does high levels of MSAFP indicate?

A

May indicate NTD or open abdominal defect

52
Q

What do low levels of MSAFP indicate?

A

May indicate DS

53
Q

A nurse is caring for a client and reviewing the findings of the clients BPP. Which of the following are variables included in the test? (SATA)

A. Fetal weight
B. Fetal breathing movement
C. Fetal tone
D. Reactive FHR
E. Amniotic fluid volume
A

B, C, D, E

54
Q

A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis to assess fetal lung maturity. Which of the following is a test for fetal lung maturity?

A. AFP
B. L/S ration
C. Kleihauer-Betke test
D. Indirect Coomb’s test

A

B

55
Q

A nurse is caring for a client who is pregnant and undergoing a NST. The client asks why the nurse is using an acoustic vibration device. Which of the following is an appropriate response by the nurse?

A. It is used to stimulate uterine contractions
B. It will decrease the incidence of uterine contractions
C. It lulls the fetus to sleep
D. It awakens a sleeping fetus

A

D

56
Q

A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements by the client requires clarification?

A. I will report cramping or signs of infection to the physician
B. I should drink lots of fluids during the 24 hours following the procedure
C. I need to have a full bladder at the time of the procedure
D. The test is done to detect genetic abnormalities

A

C

57
Q

A nurse is caring for a client who is pregnant and to undergo CST. Which of the following findings are indications for this procedure? (SATA)

A. Decreased fetal movement
B. IUGR
C. Postmaturity
D. Advanced maternal age
E. Amniotic fluid emoboli
A

A, B, C, D

ATI Maternal Newborn (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions