chapter 14- Fetal assessment during labor

Question 1

how often do you listen to fetal heart rate when in labor

Answer 1

Intermittent auscultation every 30 minutes during active labor for low-risk women and every 15 minutes for high-risk women
During second stage of labor intermittent auscultation every 15 minutes for low-risk women and every 5 minutes for high-risk women

Question 2

what does an external tocodynameter do

Answer 2

Sensing the increased tone of the uterus during a contraction.
Times the frequency & duration of the contraction.
Palpation is needed to assess the contraction strength
Strong (forehead)
Moderate (chin)
Mild (nose)

Question 3

what are the criteria for using continuous internal monitoring

Answer 3

ruptured membranes
cervical dilation of at least 2 cm
present fetal part low enough to allow placement of the scalp electrode
Skilled practitioner available to insert spiral electrode

Question 4

what is normal fetal heart rate

Answer 4

110-160

Question 5

what is the baseline fetal heart rate

Answer 5

average rate during a 10 minute segment that excludes periodic or episodic changes and segments of the baseline that differ by more than 25 beats/min

Question 6

what are the 4 categories of baseline variability

Answer 6

Absent: fluctuation range undetectable
Minimal: fluctuation range observed at <5 beats per minute
Moderate: (normal) fluctuation range from 6 to 25 beats per minute
Marked: fluctuation range >25 beats per minute

Question 7

what do you do for absent variability

Answer 7

C section stat

Question 8

what can cause minimal variability

Answer 8

narcotics, magnesium (give calcium gluconate), sleep, position

Question 9

what does marked variability look like

Answer 9

a jackolantern

Question 10

to be deemed tacky or bradycardia the heart rate has to be consistent for how long

Answer 10

10 minutes or more

Question 11

what causes early, late, variable, and prolonged decelerations?

Answer 11

1. response to head compression
2. due to uteroplacental insufficiency
3. due to umbilical cord compression

Question 12

what do early decelerations look like

Answer 12

the nadir is in sync with the contractions

Question 13

what do late decelerations look like

Answer 13

they come right after the contraction

Question 14

what do variable decelerations look like

Answer 14

they are a sharp drop and are variable