Class 4 - fetal heart rate

Question 1

maternal conditions associated with adverse fetal outcomes in antenatal/antepartum (6)

Answer 1

Hypertensive disorders of pregnancy
Diabetes
Antepartum hemorrhage
Maternal medical conditions
Maternal MVA / Trauma
Birther perception of decreased or absent fetal movement

Question 2

fetal conditions associated with fetal adverse outcomes in antenatal./antepartum

Answer 2

IUGR
Prematurity
Oligohydramnios
Polyhydramnios
Abnormal umbilical artery doppler, BPP or NST
Single umbilical artery
Isoimmunization
Multiple pregnancy
Velamentous cord insertion
Significant fetal abnormality (compatible with life)

Question 3

intrapartum maternal reasons for continuous monitoring (10 total)

Answer 3

-Vaginal bleeding in labour
-Intrauterine infection/chorioamnionitis
-Previous cesarean birth
-Prolonged membrane rupture at term (>24 hrs at term)
-Combined spinal – epidural analgesia
-Oxytocin Induced or augmented labour
-Post-term pregnancy (>42 weeks gestation)
-Tachysytole
Labour Dystocia
-Difficulty reliably determining uterine activity and/or fetal heart rate with IA

Question 4

fetal reasons for continuous monitoring (intrapartum)

Answer 4

-Prematurity
-Meconium-stained amniotic fluid
-Abnormal fetal heart rate on intermittent auscultation
-Breech presentation
-FHR arrhythmia

Question 5

how often do we listen to FHR during latent phase? (IA)

Answer 5

Q1hr

Question 6

how often to listen to FHR in first/active phase?

Answer 6

Q15-30

Question 7

describe Nursing care with both IA and EFM

Answer 7

-One-to-one nursing care
-Leopolds Manoeuvre – see class 2 and pre class prep
-Assess uterine activity and fetal heart rate characteristics
-Interpretation /
— Classification of fetal heart rate pattern
-Interventions as needed (Intrauterine resuscitation and other interventions)
-Communication and documentation
-Continued Supportive Care

Question 8

what is the difference between periodic and episodic changes in FHR?

Answer 8

periodic- with contractions
episodic: not associated with cntraxns

Question 9

what are three intrauterine resuscitation actions i can take immediately when atypical or abnormal HR noted?

Answer 9

-stop or decrease oxytocin
-change maternal position
- check birther’s VS

Question 10

what fetal pH from a scalp sample would warrent immediate birth?

Answer 10

less than or equal to 7.20