fetal monitoring

Question 1

• fetal well-being
• signs of compromise
• response of FHR & uterine contractions (UC)

Answer 1

electronic fetal monitoring

Question 2

intermittent monitoring examples

Answer 2

fetoscope, doppler, ultrasound transducer

Question 3

• only low-risk omen on no pitocin/epidural
• NST completed beforehand
• intermittent auscultation every 15-30min during active labor, every 5-15min while pushing

Answer 3

guidelines for intermittent fetal monitoring

Question 4

what measures uterine contractions/activity?

Answer 4

TOCO, palpation

Question 5

machine to produce continuous tracing FHR, most common practice

Answer 5

continuous EFM

Question 6

external measuring of FHR

Answer 6

ultrasound transducer

Question 7

external measuring FHR

Answer 7

fetal scalp electrode (FSE)

Question 8

external monitoring uterine activity

Answer 8

TOCO

Question 9

internal monitoring uterine activity

Answer 9

intrauterine pressure catheter (IUPC)

Question 10

• if receiving pitocin/epidural
• review q30min during 1st stage
• q15min while pushing

Answer 10

continuous EFM guidelines

Question 11

measured from time start to time end of contraction

Answer 11

duration

Question 12

beginning of one contraction to beginning of another contraction

Answer 12

frequency

Question 13

how much FHR changes from second to second

Answer 13

variability

Question 14

flatline

Answer 14

absent variability

Question 15

0-5 beats change

Answer 15

minimal variability

Question 16

6-25 beats change

Answer 16

moderate variability

Question 17

> 25 beats change

Answer 17

marked variability

Question 18

15beats above baseline lasting for at least 15sec

Answer 18

acceleration

Question 19

these signify cord compression

Answer 19

variable decelerations

Question 20

these signify head compression

Answer 20

early decelerations

Question 21

these signify uteroplacental insufficiency

Answer 21

late decelerations

Question 22

interventions for late decelerations

Answer 22

• IV bolus
• discontinue oxytocin
• change maternal position
• notify MD after interventions
• prepare for c-section

Question 23

only occur with contractions

Answer 23

periodic changes

Question 24

not always associated with contractions, but sometimes do

Answer 24

episodic changes

Question 25

• external, 20min of monitoring
• watching for at least 2 acels

Answer 25

nonstress test (NST)

Question 26

what is a reactive NST?

Answer 26

at least 2 acels observed in 20min window

Question 27

• when contraction occurs, watch FHR
• watching for late decls

Answer 27

contraction stress test

Question 28

what is a negative CST?

Answer 28

no late decels observed

Question 29

transducer ultrasound

Answer 29

all patients start with it, measured externally uterine

Question 30

TOCO measures

Answer 30

uterine contraction frequency & duration

Question 31

fetal scalp electrode guidelines for placement:

Answer 31

• skilled practitioner insertion
• HIV neg, Hep B neg
• presenting fetal part low enough to allow placement
• cervical dilation at least 2cm

Question 32

• while on pitocin
• goes inside uterus, measures pressure around it
• accurate measure contraction frequency, intensity, uterine resting tone
• MVUs

Answer 32

IUPC, internal monitor

Question 33

over ____ MVUs are needed for dilation/progression, and no more than _____ MVUs

Answer 33

200, 300