Chapter 18

Question 1

FHR monitoring is done to assess….

Answer 1

Fetal oxygenation

Question 2

Abnormal FHR patterns are associated with _______ (deficit of oxygen in fetal arterial blood) which can lead to severe fetal ______ and can cause ____________ which is known as ______.

Answer 2

Hypoxemia, hypoxia, metabolic acidosis, asphyxia.

Question 3

Five essential components of FHR tracings:

Answer 3

baseline rate, baseline variability, accelerations, decelerations, and changes over time

Question 4

In order the use internal monitoring what must have happened?

Answer 4

ROM and dilation of 2-3cm.

Question 5

Minimal varibality is amplitude change of _____bpm, moderate is ___________bpm, and marked is _______bpm.

Answer 5

25

Question 6

Causes of absent or minimal variability:

Answer 6

Congenital abnormalities, neurologic injury, CNS depressant medications (demerol), anesthesia, tachycardia, prematurity, or SLEEP.

Question 7

Causes of fetal tachycardia:

Answer 7

Hypoxemia (early), cardiac arrythmias, maternal fever, infection, drugs, hyperthyroidism, fetal anemia, and caffeine/stimulants

Question 8

Interventions for fetal tachycardia

Answer 8

-Reduce fever, oxygen (10L/min nonrebreather)

Question 9

Causes of fetal bradycardia

Answer 9

Heart block, structural defects, viral infection, medications, heart failure, maternal hypoglycemia or hypothermia

Question 10

Interventions for fetal bradycardia

Answer 10

Dependent on cause

Question 11

_____ changes are those that occur with UCs and _____ changes are those not associated with UCs

Answer 11

Periodic, episodic

Question 12

Causes of accelerations

Answer 12

fetal movement, vaginal exam, electrode application, fetal scalp stimuation, fetal reaction, breech, occiput posterior, UCs, fundal pressure, adbominal palpation

Question 13

Cause of early declerations

Answer 13

Head compression (from UCs, vag exam, fundal pressure, or placement of internal monitoring).

Question 14

Causes of late declerations

Answer 14

Disruption of oxygen to fetus: uterine tachysystole, maternal supine HYPOTENTION, epidural/anesthesia, placenta previa, placental abruption, hypertensive disorders…. etc.

Question 15

Interventions for late decelerations:

Answer 15

Change position, correct hypotention (elevate legs), increase IV solution rate, palpate to assess for tachysystole, discontinue oxytocin, administer oxygen, notify physician, consider internal monitoring, assist with birth.

Question 16

Interventions for prolonged decelerations

Answer 16

Notify provider immediately and begin late decleration interventions

Question 17

Cause for variable declerations

Answer 17

cord compression

Question 18

Interventions for Variable decelerations

Answer 18

change position, discontinue oxytocin, administer oxygen, notify provider, assist with vaginal examination (cord prolapse), assist with amnioinfusion, assist with birth

Question 19

The _______ FHR pattern looks like waves and indicates….

Answer 19

sinosoidal. Fetal anemia, fetal acidosis, placental previa

Question 20

Category 1 of FHR patterns is _______. Category 2 can be….. while category 3 is…

Answer 20

normal, bradycardia and other abnormalities not accompanied by absence of baseline variability. Nonreassuring patterns indicative of hypoxemia

Question 21

Corrective measures taken to change abnormal FHR patterns are called

Answer 21

Intrauterine resusitation

Question 22

In order to start an amnioinfusion, a ____ must be present

Answer 22

IUPC

Question 23

________ inhibits UCs and is given when UCs are causing abnormal FHR patterns. The most common drug is _______.

Answer 23

Tocolysis, terbutaline/brethine

*Given for tachysystole contractions