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IM 6 Test 1 > Electronic Fetal Monitoring > Flashcards

Electronic Fetal Monitoring Flashcards

1
Q

What some nursing interventions for EFHM? (4)

A

Have pt empty bladder
Palpate the fundus- put toco on fundus
Preform Leopolds- place ultrasound on PMI
Monitor VS

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2
Q

What are the two parts of IFM

A

Fetal scalp electrodes (FSE)- Cervical dilation needs to be 2-3
Intrauterine pressure catheter (IUPC)

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3
Q

Where do you palpate to determine intensity of Contractions

A

The fundus

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4
Q

When do you palpate during the contraction to determine intensity

A

During the peak (ACME)

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5
Q

How would you document these finding of intensity’s of contractions
Cannot indent uterus
Can slight indent
Easily indent

A

3+ (Forehead)
2+ (Chin)
1+ (Nose)

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6
Q

What is the normal contraction ratio

A

5 or less contractions in 10 mintues

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7
Q

What is normal resting tone ?

A

10 mm of Hg

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8
Q

What is a normal FHR?

A

110-160 bpm

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9
Q

How long do you need to wait to find a baseline?

A

2 minutes

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10
Q

What are some periodic FHR patterns

A

FHR changes in relations to a uterine contraction

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11
Q

What are some episodic FHR Patterns

A

FHR Changes unrelated to contractions

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12
Q

FHR Accelerations :
Term
Preterm
What does it mean
What nursing intervention is required

A

15x15
10x10
A reactive, healthy fetus
No intervention is required

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13
Q

Early Decelerations
Define:
What is happening
Nursing intervention?

A

FHR slowly decelerates as the ctx begins and returns to baseline as Ctx ends
Response to fetal head compression
No interventions needed

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14
Q

What are the four types of baseline variability

A

Absent- 0-1 changes in bpm
Minimal- 1-5 changes in bpm
Moderate- 6-25 changes in bpm
Marked- >25 changes in bpm

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15
Q

What three things needs to be considered when looking at baseline

A

Gestational age
Fetal sleep cycles
Changes from last baseline

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16
Q

What are some causes for decreases in variabilty

A

Medication- narcotics, CNS depressant, mag sulfate, anesthesia
Hypoxiap- (Turn patient)

17
Q

Variable decelerations
Define:
Causes
Nursing intervention

A

A decrease in FHR that is varied in shape, size, and timing
Slow return to baseline
Issue with the o2 pathway, cord compression
Intrauterine resuscitation nursing interventions

18
Q

Late Decelerations
Define
Causes
Nursing Interventions

A

Gradual decrease in FHR that begins after the ctx and returns after the ctx is over
Uteroplacental insufficiency- preeclampsia, post dates, diabetes, placenta abruption
Intrauterine resuscitation is needed

19
Q

Prolonged decelerations
Define
Cause
Nursing Intervention

A

Decrease in FHR lasting 2 or more minutes
Interruption of uteroplacental perfusion, umbilical blood flow
Intrauterine resuscitation is needed

20
Q

What is the 5 steps for Intrauterine Resuscitation (IUR)

A

Turn Patient - left lateral
Turn oxytocin off
Turn up IV fluids- IV bolus
Turn 02 up-10L w/ NR mask
Notify physician

21
Q

What is VEAL CHOP

A

FHR. Cause. Intervention
Variable Cord Compression. Move pt
Early Head Compression. Not needed
Acceleration. OK. Nothing
Late. Placenta Insufficiency Emergency

22
Q

What is category I for FHR
Variability
Baseline FHR
Accelerations:
Decelerations:
Nursing Intervention

A

Moderate variability
110-160
Accelerations: present or absent
Decelerations: NO late or variable
No action is needed

23
Q

Category III FHR
Requirements
Nursing interventions

A

Absent variability and any of the following
Recurrent late or variable deceleration
Bradycardia
Sinusoidal pattern
IUR

24
Q

What are some nursing interventions for abnormal FHR patterns

A

Assess VS
Assess hydrations
Assess UA
Assess maternal pain and anxiety
Perform vaginal exam to R/O prolapsed cord
IUR

25
Q

What are the ABCD for management FHR issues

A

Assess the o2 pathway
Begin corrective measures
Clear obstacle to rapid delivery
Delivery plan

IM 6 Test 1 (4 decks)

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