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Maternity > Exam 2: Fetal Assessment During Labor > Flashcards

Exam 2: Fetal Assessment During Labor Flashcards

1
Q

Cloudy or smelly amniotic fluid =

A

infection

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2
Q

green amniotic fluid =

A

meconium

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3
Q

pH of amniotic fluid

A

alkaline (turn blue)

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4
Q

Leopold’s maneuver will answer what 4 questions

A

fetal presentation

fetal position

confirm presentation

altitude

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5
Q

FHR: cephalic presentation best heard

A

in lower quadrants

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6
Q

FHR: breech presentation best heard

A

on or above umbilicus

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7
Q

External monitoring: FHR and UC

A

FHR: ultrasound transducer

UC: tocotransducer

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8
Q

Guidelines for assessing FHR: initial

A

10 to 20 minute continuous FHR assessment on entry into labor/birth area

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9
Q

Guidelines for assessing FHR: intermittent auscultation

A

every 30 minutes during active labor for low risk women

every 15 minutes for high risk women

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10
Q

Guidelines for assessing FHR: during the second stage of labor

A

intermittent auscultation every 15 minutes for low risk

every 5 minutes for high risk

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11
Q

4 specific criteria must be met for continuous interval monitoring of FHR

A

ruptured membranes

cervical dilation of at least 2 cm

presenting fetal part low enough to allow placement of the scale electrode

skilled practitioner available to insert spinal electrode

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12
Q

Baseline FHR

A

average during 10 minutes

normal = 110-160 BPM

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13
Q

Causes of bradycardia

A

congenital heart block
maternal hypotension
severe hypoxia
prolonged hypoglycemia
second stage of labor
anesthetics
maternal hypothermia

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14
Q

causes of tachycardia

A

premature
maternal fever
chorioamnionitis
fetal anemia
cardiac arrhythmias
maternal hyperthyroidism
fetal hypoxia
drugs

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15
Q

Irregularities in FHR

A

absent: fluctuation undetectable

minimal: fluctuation range observed less than 5 bpm

moderate (normal) fluctuation range between 6-25 bpm

marked: fluctuation rate over 25 bpm

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16
Q

Why are variability important

A

reflects intact neurological system

optimal fetal oxygenation

measure of fetal oxygenation reserve

single MOST important characteristics of FHR

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17
Q

Nadir

A

FHR lowest point

18
Q

Guidelines for assessing FHR –> accelerations increased baseline

A

more than 15 bpm above baseline

over 15 seconds but less than 2 minutes

19
Q

Guidelines for assessing FHR –> accelerations are signs fo fetal well being

A

movement

contractions

vaginal exam

20
Q

Do we treat early decelerations

A

no

21
Q

Late decelerations begin

A

after the peak of the contraction and return to baseline FHR after the end of the contraction

22
Q

Late decelerations require

A

immediate intervention –> wrong with the placenta

23
Q

Late decelerations management

A

notify HCP

decrease or discontinue pitocin

repoisiton

provide O2 (8 to 10 L/min)

IV fluid bolum

Vaginal exam

24
Q

Variable decelerations are from

A

umbilical cord compression

25
Q

Variable decelerations: shaped

A

U, V, W

26
Q

Variable decelerations treatment

A

reposition

increase IV fluids

provide O2

vaginal exam

27
Q

Three tier FHR interpretation system

A

cat 1: normal tracing

cat 2: indeterminate tracing –> further investigation

cat 3: an abnormal tracing –> need interventions

28
Q

What are the 5 essential components of FHR tracings

A

baseline rate

baseline variability

accelerations

deceleration’s

change or trends over time

29
Q

Most concerning FHR patterns (3)

A

bradycardia

minimal/absent variability

late decelerations

30
Q

T/F can a doppler flow study detect fetal compromise

A

yes it can

31
Q

Nuchal translucency screening

A

11-14 weeks

subcutaneous accumulation of fluid behind the fetal neck, using ultrasound

32
Q

Alpha fetoprotein analysis

A

elevation: neural tube defects, turners syndrome, hydrocephaly

low: down syndrome (trisomy 21)

Done between 15-20 weeks maternal blood sample

33
Q

Triple marker screening test

A

AFP, hCG, unconjugated estriol

34
Q

Quadruple screen test

A

AFP, hCG, unconjugated estriol, hormone, inhibin A

35
Q

Do screen test diagnose

A

no they don’t diagnose a problem they only signal that further testing should be done

36
Q

What are we looking for to test fetal lung maturity

A

L/S

lecithin, sphinogomyelin

2 or higher = lung maturity
1.5 or lower = RDS

37
Q

chorionic villus sampling

A

diagnostic test for chromosome abnormalities and other inherited disorders

38
Q

Harmony test

A

early as 10 weeks

analyze free DNA in blood –> trisomy’s

39
Q

NST

A

non invasive test that doesn’t require contractions

40
Q

How often are NST recommended?

A

twice weekly after 28 weeks for clients with diabetes and other high risk conditions

41
Q

Reactive vs non reactive NST result

A

reactive: 2 FHR accelerations from baseline of at least 15 bpm for at least 15 seconds (within 20 min recording period)

42
Q

5 parameters of a biophysical profile

A

body movement
fetal tone
fetal breathing
amniotic fluid volume
non stress test

Maternity (9 decks)

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