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ENRP 1 > Fetal Heartrate Monitoring (Moulton) > Flashcards

Fetal Heartrate Monitoring (Moulton) Flashcards

1
Q

Between external and internal monitoring, which will provide the most accurate tracings?

A

Internal

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2
Q

What are the two types of external electronic fetal monitoring?

What are the two types of Internal electronic fetal monitoring?

A

1) Doppler ultrasound transducer
2) Pressure sensitive Tocodynanometer transducer

3) Fetal Scalp Electrode
4) Intrauterine Pressure Catheter

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3
Q

With external electronic fetal monitoring,
What is placed on maternal abdomen overlying the fetal heart and records reflected sound waves from the fetal heart back to the transducer.

A

Doppler ultrasound transducer

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4
Q

1) With external electronic fetal monitoring, a pressure sensitive tocodynamometer transducer detects and records what?
2) What does it NOT measure

A

1) Frequency of Contractions

2) Strength of contraction

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5
Q

1) Rate is computed from the R wave peaks of the fetal echocardiogram with what internal electronic fetal monitoring device?
2) Who should it be avoided in?

A

1) Fetal scalp electrode

2) HIV patients

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6
Q

What internal electronic fetal monitoring device gives precise measurement of the intensity of the uterine contractions in millimeters of mercury?

A

Intrauterine pressure catheter

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7
Q

1) Fetal Heart rate is determined by the?

2) Modulation of the rate occurs physiologically through innervation of the heart by the which nerves?

A

1) Atrial pacemaker

2) Vagus and Sympathetic

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8
Q

1) A fetus with low oxygen cannot handle the stress of what?

2) What will happens as a result?

A

1) Contractions

2) Fetus will become Hypoxic

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9
Q

1) Hypoxia, when severe, will result in anaerobic metabolism, resulting in the accumulation of pyruvic and lactic acid resulting in fetal __1__.
2) What is the pH of fetal scalp blood normally between?
3) pH less than what is considered abnormal.

A

1) Acidosis
2) 7.25-7.30
3) 7.20 (fetal acidosis)

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10
Q

With each contraction, blood flow from the mother to the baby initially ceases as what is compressed?

A

Uterine myometrial vessels (arteries and veins)

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11
Q

With a fetal monitoring strip, the upper tracing monitors?

The lower tracing measures?

Each small box equals how many seconds?

Dark line to dark line equals?

A

1) FHR (Fetal Heart Rate)
2) Uterine contractions
3) 10 seconds
4) 1 minute

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12
Q

1) How many contractions (or less) in how long in a 30 minute period for NORMAL UTERINE ACTIVITY?
2) What is it called if there are more contractions in the same time?

A

1) 5 Contractions in 10 minutes

2) Tachysystole (more than 5 contractions in 10 minutes)

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13
Q

With a fetal monitoring strip contractions can be measured from?

A

Peak to peak

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14
Q

What are Montevideo units?

What should they be at for a 2 hour period?

A

1) Sum of the contractions in a 10 minute period

2) Greater than 200

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15
Q

__1__ are calculated from readings of intrauterine pressure catheter by subtracting baseline from peak contraction for each contraction during a 10-minute window and adding the pressures.

The uterine contraction pattern should exceed __2__ units for at least 2 hours.

A

1) Montevideo units

2) 200 Montevideo

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16
Q

What is the range for a normal FHR?

Tachycardia is defined as?

Bradycardia is defined as?

A

1) 110-160 bpm
2) > 160 bpm
3) < 110 bpm

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17
Q

What is a late sign of hypoxia?

What is an early sign of hypoxia?

A

1) Bradycardia

2) Tachycardia

18
Q

Maternal hypotension will result in?

Maternal fever will result in?

A

1) Bradycardia

2) Tachycardia

19
Q

What is the most common cause of fetal tachycardia?

A

Chorioamnionitis

20
Q

__1__ produce tachycardia in response to hypoxia.

__2__ influence FHR via the vagus n. in response to changes in fetal blood pressure.

A

1) Chemoreceptors

2) Baroreceptors

21
Q

Baseline variability is due to fluctuations in the baseline FHR that are irregular in amplitude and frequency.

Variability is visually quantified as the amplitude of __1__ in bpm of change in baseline rate.

Absent variability is when the amplitude range is __2__.

Minimal variability is when the amplitude range is __3__.

Moderate (normal) variability is when the amplitude range is __4__.

• Marked variability is when the amplitude range is __5__.

A

1) Peak-to-trough
2) Undetected
3) <5 bpm
4) 6-25 bpm
5) > 25 bpm

22
Q

1) What is decreased variability is an indicator of?

It is associated with __2__ and __3__.

A

1) Possible fetal stress

2) Hypoxia and acidemia

23
Q

What can caused decreased baseline variability?

A

Prematurity
Fever (maternal)

Tachycardia (fetal)
Substance abuse
Hyperthyroidism

PF TSH

24
Q

FHR may vary with uterine contractions by slowing or

accelerating. These responses are categorized as?

A

No change, acceleration, and deceleration

25
Q

1) What type of FHR change is characterized by the FHR maintains the same characteristics as in the preceding baseline FHR?
2) What FHR change is an abrupt increase in FHR and is normal response?

A

1) No change

2) Acceleration

26
Q

Acceleration at 32 weeks or greater
is defined as heart rate of greater than or equal to __1__ bpm above baseline for __1__ sec or more (but less than 2 minutes).

Acceleration at less than 32 weeks
is defined as heart rate of greater than or equal to __1__ bpm above baseline for __1__ sec or more (but less than 2 minutes).

A

1) 15 bpm
2) 15 seconds
3) 10 bpm
4) 10 seconds

27
Q

Prolonged acceleration of FHR is defined by these changes lasting greater than?

There is a change in baseline if the acceleration lasts how many minutes or more?

A

1) 2 minutes

2) 10 minutes

28
Q

Spontaneous fetal movement
Scalp stimulation
Vibroacoustic stimulation
Vaginal examination

are all causes of?

A

Acceleration

29
Q

What type of FHR change is characterized by the FHR decreasing in response to uterine contractions?

These changes may be subclassified as?

A

1) Decelerations

2) Early, variable, late

30
Q

What are Early decelerations are secondary to?

What does this cause?

Which then leads to what?

This causes the activation of what?

This activation produces a decrease in

Recovery occurs as __6__ is relieved.

A

1) Head compression
2) Increased intracranial pressure
3) Decreased Cerebral blood flow
4) Vagus nerve
5) Heart rate
6) Pressure is relieved

31
Q

The __1__ of the deceleration occurs at the same time as the __2__ of the contraction and thus is a “mirror image” in which deceleration?

A

1) Lowest point
2) Peak
3) Early deceleration

32
Q

1) What can cause Variable decelerations?
2) What can help alleviate this?
3) There will be an abrupt decrease in FHR can before, during, or after what starts?

A

1) Umbilical cord compressions
2) Amnioinfusion
3) Contraction

33
Q

Variable decelerations is characterized by a decrease in FHR of

1) How much
2) Lasting for how long
3) For what duration?

A

1) >15 bpm
2) >15 seconds
3) <2 minutes

34
Q

Variable Decelerations

If the umbilical cord is only slightly compressed, this will obstruct the __1__ which returns re-oxygenated blood to the fetal heart.

The initial normal fetal response to this is a slight __2__ in fetal heart rate to compensate for the lack of blood return and the slowly diminishing oxygen supplies.

If this slight __2__ in FHR is followed by a major drop in FHR, this phenomenon is called a “__3__.”

A

1) Umbilical vein (low pressure system)
2) Increase
3) Shoulder

35
Q

Which deceleration is the most ominous deceleration?

A

Late decelerations

36
Q

Late decelerations are caused by?

A

Uterine placental insufficiency

37
Q

1) What do repetitive late decelerations indicate?

2) The low point of the deceleration occurs __2__ the peak of the contraction.

A

1) Metabolic acidosis and low arterial pH

2) After

38
Q

Prolonged decelerations is defined as a decrease in FHR from baseline that is

1) How much
2) For how long?

3) Prolonged decelerations are commonly seen during what?

A

1) 15 bpm
2) 2-10 minutes
3) Maternal Pushing

39
Q

1) Smooth, sine wave-like undulating pattern in FHR baseline is characteristic of?
2) What is the cycle frequency?
3) It is seen with what?

A

1) Sinusoidal pattern
2) Cycle frequency of 3-5 per minute
2) Fetal anemia

40
Q

Amnioinfusion is the process of instillation of normal saline to alleviate what?

This can eliminate what problem?

A

1) Cord compression

2) Variable decelerations

41
Q

1) When the scalp is stimulated, if an acceleration of 15 bpm lasting 15 seconds occurs the fetal pH value almost always is?

This is especially useful to differentiate fetal sleep from __2__, when the fetal tracing shows reduced variability but no decelerations.

A

1) 7.22 or greater

2) Acidosis

42
Q

1) How long from decision‐to‐incision for emergency caesarean delivery?
2) Electronic Fetal monitoring does NOT result in reduction of?

A

1) 30 minutes

2) Cerebral palsy

ENRP 1 (23 decks)

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