Electronic Fetal Monitoring Flashcards

1
Q

5 essential components of electronic fetal monitoring

A

Baseline fetal heart rate, variability, accelerations, decelerations, and changes in fetal heart rate over time

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2
Q

Main goal of fetal monitoring

A

Maximize oxygenation

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3
Q

What does a continuous electronic fetal monitor measure?

A

Uterine contraction and fetal heart rate,intermittent or continuous monitoring, and can be used to monitor the fetal heart rate internally

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4
Q

Noninvasive tool used to monitor the fetus externally

A

Tocotransducer for uterine contractions (is used transabdominally)

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5
Q

how is an internal fetal monitor placed?

A

Membranes must be ruptured, cervix needs to be wide enough and presenting part of fetus must be low

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6
Q

What are the two types of internal fetal monitors?

A

Spinal electrode for fetal heart rate,internal uterine pressure catheter for uterine contractions

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7
Q

How can contractions be assessed?

A

Palpation

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8
Q

How would you assess it a contraction is mild, moderate, or strong?

A

Mild: uterus is easily dented with palpation 1+
Moderate: uterus is slightly dented with palpation 2+
Strong: uterus cannot be dented with palpation 3+

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9
Q

What is the downside of using a doppler/fetoscope?

A

Variability

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10
Q

Can you tell contraction strength from the monitor strip?

A

No. an interuterine pressure catheter would have to be present

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11
Q

What may be seen on a woman that receives an epidural? Why?

A

Pulse ox, because epidurals may cause respiratory depression

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12
Q

When is the fetal heart rate considered variable?

A

When there are irregular fluctuations in the fetal heart rate of 2 cycles per minute or greater

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13
Q

What can cause fetal tachycardia?

A

Maternal fever/dehydration, fetal hypoxia, certain drugs, , fetal anemia, fetal/maternal infection, maternal hyperthyroidism, fetal heart failure or dysrhythmia

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14
Q

When is tachycardia non-reassuring?

A

When associated with late decelerations, severe variable decelerations or absence of variability

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15
Q

When is bradycardia non-reassuring?

A

When associated with loss of variability or late decelerations

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16
Q

What can cause fetal bradycardia?

A

Fetal hypoxia late sign), maternal supine position or hypotension, prolonged umbilical cord compression or cord prolapse

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17
Q

Can variability predict the presence of hypoxemia or metabolic activity?

18
Q

What is moderate variability associated with?

A

Adequate cerebral oxygenation

19
Q

What is the variability in heart rate for fetuses with absent, minimal, average/ moderate or marked variability?

A

Absent: undetectable
Minimal: detectable, but ≤ 5bpm
Average/moderate: 6-25bpm
Marked: > 25bpm

20
Q

Is absent variability assuring or non-reassuring?

A

Nonreassuring

21
Q

If minimal variability is seen in a fetal monitor, what are the things that should be considered?

A

“Three ss”: sleep? sedation? sick?

22
Q

Is minimal variability reassuring or nonreassuring?

A

Non reassuring

23
Q

Is a sinusoidal pattern considered assuring or non reassuring?

A

Non reassuring

24
Q

Changes in the fetal heart rate associated with uterine contractions are classified into which categories?

A

Accelerations or decelerations

25
What are early decelerations caused by?
Head compression resulting in vagal reflex
26
What do early decelerations look like?
Uniform in shape, onset, and recovery Inversely mirror contraction in the beginning, end, and nadir/peak
27
What causes late decelerations?
Uteroplacental insufficiency
28
What do late decelerations look like?
Fetal heart rate returns to baseline after contraction ends. Will have a uniform shape, gradual onset and recovery
29
When are late decelerations considered non-reassuring?
Always!
30
What does a nurse do when late decelerations begin?
Reposition, hydrate, give oxygen, discontinue oxytocin, notify provider
31
What causes variable decelerations?
Umbilical cord compression
32
Shape of variable decelerations
"V" or "u"
33
When are variable decelerations non-reassuring?
If they are repetitive, prolonged, severe, or slow return to baseline
34
What should a nurse do to counteract variable decelerations?
Reposition, hydrate, give oxygen, notify provider, do an amnioinfusion
35
What is usually the cause of prolonged deceleration?
Prolonged cord compression
36
When is prolonged deceleration considered non-reassuring?
Always!
37
What does a prolonged deceleration look like?
Abrupt decrease in fetal heartrate of at least 15bpm below baseline, lasting 2-10 minutes
38
What is uterine tachysystole?
More than 5 contractions in 10 minutes
39
What is intrauterine resuscitation?
Interventions for none assuring FHR patterns
40
What kind of drug is oxytocin?
Uterotonic
41
When should pitocin be discontinued?
When there is uterine tachysystole