fetal monitoring

Question 1

Fetal compromise

Answer 1

Fetal bradycardia occurs when the fetal heart rate falls below 110 beats/minute during a 10-minute period of continuous monitoring. When fetal bradycardia is accompanied by decreased variability, it is considered ominous and could be a sign of fetal compromise. (Olds’).
Persistent contraction durations longer than 90 seconds or contraction intervals less than 60 seconds may reduce fetal oxygen supply (Leifer 61 q. 3)
Green-stained amniotic fluid means that the fetus passed the first stool before birth, and it is an indicator of fetal compromise.(Leifer 62 p. 5)
Intervention: Oxytocin is discontinued if signs of fetal compromise or excessive uterine contractions occur. (Leifer 87 p.2)

Question 2

Fetal factors that indicate electronic fetal monitoring

Answer 2

Meconium passage: Internal fetal monitoring with the internal fetal scalp electrode is often utilized when meconium-stained amniotic fluid is present.

Multiple gestation
Decreased fetal movement (Olds’)

Question 3

Maternal factors that indicate electronic fetal monitoring

Answer 3

Preeclampsia

Grand multiparity’

Question 4

When assessing pregnant clients, when should the nurse know are accurate? Select all that apply.

Answer 4

A variable deceleration could be caused by cord compression.
A fetal heart rate of 165 bpm is considered fetal tachycardia.
Accelerations in the fetal heart rate are considered a sign of fetal well-being.

Question 5

The nurse-midwife is concerned that a woman’s uterine activity is too intense and the obesity prevents an accurate movement of it. Based on this information, the nurse should anticipate the order for what?

Answer 5

An intrauterine pressure catheter