Conference Two - Module 5 (Exam 2) 1

Question 1

Maternal Cardiopulmonary Deficits During Labor

Answer 1

1. Hypovolemia
2. Supine hypotension

Question 2

Compromised Uterine Activity During Labor

Answer 2

1. Dystonic Contraction Pattern
2. Decreased Resting Tone

Question 3

Placental Disruptions During Labor

Answer 3

1. Poorly functioning placental tissue
2. Hemorrhagic disorders

Question 4

Umbilical Cord Issues during Labor

Answer 4

1. Cord Compression
   
   1. Nuchal Cord
      
      1. Cord around neck
   2. Knot in Cord
2. Inadequate Amniotic Fluid

Question 5

Fetal Compromise during Labor

Answer 5

1. Severe/persistent bradycardia or tachycardia
2. CNS or cardiac abnormalities

Question 6

Auscultation

Answer 6

Doppler or fetoscope

Question 7

Palpation

Answer 7

Palpates contractions and resting tone

Question 8

Advantages of Auscultation and Palpation

Answer 8

1. Maternal mobility/comfort
2. Fewer interventions
3. Less costly

Question 9

Limitations of auscultation and palpation

Answer 9

1. FHR monitoring is intermittent
   
   1. Difficulty in recognizing changes early
2. Interruptions may be distracting for mom while in labor

Question 10

Advatanges of Electronic Fetal Monitoring

Answer 10

1. Increased data volume
2. Continual FHR response is documented
3. Partner/Coach involvement
4. Excellent staff teaching modality/opportunity

Question 11

Limitations of Electronic Fetal Monitoring

Answer 11

1. Reduced maternal mobility
2. Frequent adjustments are required
3. Decreased “natural” environment
4. Tempation to “nurse the monitor”

Question 12

Maternal Elements of EFM

Answer 12

1. Contraction Frequency
2. Contraction Duration
3. Contraction Intensity
4. Uterine Resting Tone

Question 13

Frequency

Answer 13

The period of time from the beginning of one contraction to the beginning of the next. Contains 1 contraction and 1 resting tone.

Question 14

Duration

Answer 14

The period of time from the beginning of one contraction to the end of the same contraction.

Question 15

Intensity

Answer 15

The strength of the uterine contraction

Question 16

Resting Tone

Answer 16

The degree to which the uterus returns to a non-contracted state between contractions

Question 17

External Contraction Monitoring

Answer 17

1. TOCO
2. Graphically measures only frequency and duration
3. Intensity and Resting tone must be assessed manually via palpation

Question 18

How to palpate intensity

Answer 18

1. Mild = nose
2. Moderate = chin
3. Strong = forehead

Question 19

Internal Contraction Monitoring

Answer 19

1. Intrauterine Pressure Catheter
2. Graphically measures frequency, duration, intensity, and resting tone
3. Used for higher risk

Question 20

FHR Monitoring

Answer 20

Purpose: Sureillance of fetal oxygenation

All significant decelerations reflect interruption in oxygen transfer to the fetus and sustained or recurrent interruption can lead to fetal injury

A normal FHR tracing reliably precludes fetal hypoxic injury at the time the tracing was done

Question 21

Fetal Hypoxia

Answer 21

Acidosis

umbilical artery pH <7.0