DIAGNOSTICS (3)

Question 1

transcervical or transabdominal insertion of a needle into the fetal portion of the placenta.

Answer 1

chorionic villi sampling

Question 2

cvs is performed at what weeks gestation?

Answer 2

8-12wks

Question 3

what are examined to detect chromosome abnormalities and genetic disorders such as?

Answer 3

• chorionic villi cells
• down syndrome
• cystic fibrosis

Question 4

this is done at 8-10 wks of pregnancy wherein chorionic cells are located by ultrasound

Answer 4

biopsy & analysis of chorionic villi for chromosomal analysis

Question 5

what is the other term for chorionic villi sampling?

Answer 5

biopsy of placenta

Question 6

as a nurse on duty, what should you instruct your client after the chorionic villi sampling procedure?

Answer 6

to report bleeding, infection, or leakage of fluid after procedure

Question 7

(CVS)
as a nurse on duty, you should be aware of the reportable s/sx the patient should look out for. what are these?

Answer 7

• chills or fever (infection)
• uterine contraction / vaginal bleeding (threatened miscarriage)

Question 8

what test involves measurement of AFP, estriol, and hCG in maternal serum?

Answer 8

AFP/Triple Screen

Question 9

at what week of gestation is AFP/Triple Screen is being tested? and what is its purpose?

Answer 9

• 15-20wks
• screen for fetal structural & chromosomal abnormalities

Question 10

what is alpha-feto protein?

Answer 10

substance produced by the liver that is present in the amniotic fluid and maternal serum

Question 11

if this is detected as abnormal, the woman is next referred for ultrasound to confirm gestational age and to evaluate neural tube defects & other structural abnormalities.

Answer 11

estriol

Question 12

what is often associated with Trisomy 21 (down syndrome) ?

Answer 12

low estriol, elevated hCG, low AFP

Question 13

what is associated if the fetus has an open spinal or abdominal defect?

Answer 13

high in maternal serum (MSAFP)

Question 14

this test assess fetal well-being that analyses the response of the fetal heart to fetal movement.

Answer 14

non-stress test (NST)

Question 15

what does accelerations of FHR with fetal movement indicates?

Answer 15

the fetus has adequate oxygenation and intact CNS

Question 16

how can you tell that the fetus has a reactive NST? is this a good sign?

Answer 16

baby’s heart rate should accelerate by 15 beats for at least 15 seconds, twice in a 20min period. this is a sign that the baby is healthy

Question 17

what does reactive NST indicates?

Answer 17

intrauterine survival for one week.

Question 18

as the nurse on duty, what preparation should you do for the mother before the NST?

Answer 18

feed with food or fluids before the test to stimulate fetal movements

Question 19

this assesses the ability of the fetus to withstand the stress of uterine contraction done during labor

Answer 19

contraction stress test (CST)

Question 20

CST is a means of evaluating the?

Answer 20

respiratory function of the placenta

Question 21

induced or spontaneous contraction results in?

Answer 21

decrease transport of O2 to the fetus.

Question 22

if placental reserve is insufficient, what can occur?

Answer 22

fetal hypoxia and decrease in FHR

Question 23

when is contraction stress test initiated?

Answer 23

3 contractions in every 10 minutes.

Question 24

what is accelerations?

Answer 24

temporary normal increases in FHR caused by fetal movement / compression of umbilical vein during contraction

Question 25

this is the periodic decreases in FHR resulting from pressure of the fetal head during contractions. - begins when contraction starts, ends when contraction ends

Answer 25

Early Decelerations

Question 26

what are late decelerations?

Answer 26

delayed decelerations until 30-40 seconds after onset of a contraction and continue beyond the end of contraction.

Question 27

what do you call the lowest point of deceleration that occurs near the end of the contraction instead of at its peak?

Answer 27

Nadir

Question 28

what sign shows uteroplacental insufficiency ?

Answer 28

ominous pattern in labor

Question 29

what is uteroplacental insufficiency?

Answer 29

decreased blood flow through the intervillous spaces of the uterus during contractions.

Question 30

late decelerations occur with what? or with abnormal uterine tone caused by administration of what?

Answer 30

- hypertonia - oxytocin

Question 31

as the nurse on duty, you saw that your patient is having late decelerations. what nursing intervention would you do?

Answer 31

- stop or slow administration of oxcytocin - change position to lateral (left) to relieve pressure from vena cava - administer IVF or O2 as prescribed.

Question 32

if late decelerations persist, what should you prepare for? why do you need to do it?

Answer 32

- deliver the infant - may lead to fetal death

Question 33

what are variable decelerations?

Answer 33

decelerations that occur at unpredictable times in relations to contractions

Question 34

what may cause variable decelerations?

Answer 34

- compression of cord ( cord prolapse ) - fetus is lying on the cord - oligohydramnios

Question 35

as the nurse on duty, you saw that your patient is having variable decelerations. what nursing intervention should you do ?

Answer 35

- change into T-position - administer fluids and O2 as prescribed - if not relieved, amnioinfusion may be prescribed

Question 36

if the interpretation result of CST shows that there is persistent late decelerations with more than half the contractions, what does this indicate?

Answer 36

a positive result. fetus is no longer receiving adequate oxygen. needs to be delivered

Question 37

how can you say that the interpretation result of CST is negative?

Answer 37

- no late decelerations in 10 min period - it is safe for the fetus to remain in utero for the next 7 days