fetal assessment during labor

Question 1

Leopold’s Maneuvers to diagnose

Answer 1

Fetal position & presentation
Number of fetuses
Degree of presenting part’s descent/engagement into the maternal pelvis
Expected location of best spot (PMI) to hear the FHR

Question 2

Leopold’s Maneuvers nursing considerations

Answer 2

• Make sure mother is not flat on her back
• Have mother void before procedure
• Assess for contractions & if contracting wait until contraction is over

Question 3

one strip is how many min

Answer 3

8 min

Question 4

1 collum =

Answer 4

1 min

Question 5

1 box

Answer 5

10 beats/10 seconds

Question 6

normal range of heart rate

Answer 6

110-160

Question 7

baseline

Answer 7

wear heart rate settles for least 2 min

Question 8

acceleration

Answer 8

at least 12 beats above baseline last least 15 seconds

- at least 10 beats above baseline at last 10 seconds for a 32 weeker

Question 9

VEAL

Answer 9

variable decelerations
early decelerations
accelerations
late decelerations

Question 10

CHOP

Answer 10

cord compression
head compression
okay
placental insufficiency

Question 11

variable decelerations

Answer 11

cord compression

Question 12

early decelerations

Answer 12

head compression

- prepare for labor

Question 13

accelerations

Answer 13

okay

Question 14

late decelerations

Answer 14

placental insufficiency

cause: utero-placental insufficiency

clinical significant: Abnormal pattern; associated w/ fetal hypoxemia, low APGAR scores, fetal academia, an ominous sign esp. if associated w/ fetal tachycardia & loss of variability

Question 15

prolonged decelerations

Answer 15

decrease in FHR at least 15 beats below baseline lasting at least 2 minutes but not longer than 10 minutes

Question 16

interventions for declerations

Answer 16

LION

• Turn patient to left or right lateral position
• If pt on labor inducing medication (cervical ripening agent or oxytocin IV); remove it
• Administer a bolus of current IV fluids of 500-1000ml
• Administer O2 100% via non-rebreather (until fetus recovers)
• Notify provider [anticipate orders for internal monitors, tocolytic medications, or possible amnioinfusion (for deep recurrent variable decels)
• Perform sterile vaginal exam
• If No improvement, prepare for c-section

Question 17

category 1

Answer 17

• Baseline 110-160 bpm
• Moderate baseline FHR variability
• Late or variable decelerations are absent
• Early decelerations and accelerations may be present or absent
• NORMAL – followed in routine manner, no specific action required

Question 18

category 2

Answer 18

• Include ALL FHR tracings not categorized as I or III
• Bradycardia/Tachycardia
• Minimal or marked variability
• Are indeterminate – require evaluation and continued surveillance and reevaluation

Question 19

category 3

Answer 19

• Absent variability AND any of the following:
• Recurrent late decelerations, recurrent variables, bradycardia
• Sinusoidal pattern
• ABNORMAL – require PROMPT evaluation/delivery