Chapter 18

Question 1

what can cause decreased oxygen supply

Answer 1

Reduction of blood flow through maternal vessels
Reduction in oxygen content in maternal blood
Alterations in fetal circulation
Reduction in blood flow to intervillous space in placenta

Question 2

what is intermittent auscultation

Answer 2

Listening to fetal heart sounds at periodic intervals to assess FHR
Easy to use, inexpensive, less invasive than EFM
Difficult to perform on women who are obese
Does not provide a permanent record

Question 3

what is the point of maximum impulse

Answer 3

chest or back

Question 4

what is the spiral electrode used for

Answer 4

internal monitor for fetal HR

Question 5

How are spiral electrodes placed

Answer 5

placed in bony part of fetal head , not placed on fontanels, harder to place and stay in place with lots of hair

Question 6

when are spiral electrodes indicated

Answer 6

If your having trouble pickup baby up or. Heavier mother and not picking baby up, if decels or nonreassuring fetal patterns, internal monitoring is used

Question 7

what is a intrauterine pressure catheter (IUPC)

Answer 7

Only way to measure intensity of contraction
inserted vaginally , goes up into uterus and picks up pressure that uterus is applying to it,

Question 8

what is the definition of baseline fetal HR

Answer 8

average rate for 10 min without periodic or episodic changes, periods of marked variability, or segments that vary by more than 25 bpm

must have at least 2 min period to get baseline

Question 9

what is variability

Answer 9

Described as irregular waves or fluctuations in the baseline FHR of two cycles per minute or greater

Question 10

what are the types of variability

Answer 10

Absence
Minimal
Moderate
Marked

Question 11

what is absent variability

Answer 11

No variation in beat to beat changes
Severe anemia
Severe neuro dysfunction
Will deliver baby if not fixed
Something wrong with baby

Question 12

what is minimal variability

Answer 12

< 5 bpm variation around baseline
Tiny fluctuations in beat to beat changes
Can be okay
baby have sleep cycles up to 90 min
Can occur if opioid medication was given
Wouldn’t be rushing to deliver baby right away

Question 13

what is moderate variability

Answer 13

6-25 bpm variation around baseline hr
ideal, what we want
normal , reassuring

Question 14

what is marked variability

Answer 14

> 25 bpm variation
not good
can indicate same type of abnormalities
blood loss, neuro dysfunction , oxygen deprivation

Question 15

what is a sinusoidal fetal HR pattern

Answer 15

Don’t have any variability
Constant wavelike pattern
Bad, wont see pattern long term and not deliver baby
Common with opioid, but it will be brief and will correct itself
Have to do interventions to see if it fixes

Question 16

what is fetal tachycardia

Answer 16

HR greater than 160 beats/min for 10 min or more

Question 17

what is fetal bradycardia

Answer 17

HR less than 110 beats/min for 10 min or more

Question 18

What are changes in FHR

Answer 18

periodic changes occurring with UCs
Episodic (nonperiodic changes) not associated with UCs
Accelerations - indicate fetal well being

Question 19

what is normal fetal HR

Answer 19

110-160

Question 20

what are early decelerations

Answer 20

response to fetal head compression
mirror contractions
Periodic cuz associated with contractions
Peak of contraction mirrors Lowes point of deceleration

Question 21

what are late decelerations

Answer 21

caused by uteroplacental insufficiency
deceleration begins after peak of contraction not good but if 1 or 2 occur and they correct with intervention then its okay
not corrected = deliver baby

Question 22

what are variable decelerations

Answer 22

caused by umbilical cord compression
Looks like V, U, W
more abrupt in decline
greater than 30 to the lowest point from baseline
can be hard to tell difference from late decel
think like kinking waterhose

Question 23

what are prolonged decelerations

Answer 23

these are bad , decrease in HR longer than 2 min , will need to do interventions

Question 24

What is category 1 EFM

Answer 24

this is normal
Baseline FHR
moderate variability
no late or variable decals
may or may not have early decals
may or may not have accelerations

Question 25

category 2 indeterminate FHR pattern

Answer 25

Bradycardia w/o absence of variability
Tachycardia
Minimal or absence of baseline variability not accompanied by recurrent decelerations
Marked baseline variability
No accelerations in response to fetal stimulation
Periodic or episodic decelerations

Question 26

category 3 nonerassuring fetal HR pattern

Answer 26

associated with fetal hypoxemia
Recurrent or late decelerations
Bradycardia
Sinusoidal pattern
need to deliver baby

Question 27

what are some interventions for abnormal patterns

Answer 27

changing positions
oxygen use
increasing fluids, fluid bolus