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Mgmt Test 1 - OB > Fetal Monitoring > Flashcards

Fetal Monitoring Flashcards

1
Q

purpose of fetal monitoring

A

assess fetal response to stress of labor

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2
Q

monitoring techniques

A

intermittent auscultation

electronic

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3
Q

intermittent auscultation advantage/disadvantages

A

freedom of movement, inexpensive

cant assess FHR variability (no perm. record), not recommended for high risk

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4
Q

types of intermittent auscultation

A

hand held Doppler

fetoscope

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5
Q

electronic monitoring types

A

toco transducer
ultrasound transducer
iupc(intrauterine pressure cath)
fse(fetal scalp electrode)

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6
Q

advantage/disadvantage of electronic monitoring

A 
monitor FHR(perm. record)
increased risk of operative interventions, internal monitoring can cause rupture, restricts movement
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7
Q

intermittent auscultation guidelines

A

q30-60 - first stage
q15-30 - second stage
monitor during/after (30 sec) contraction

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8
Q

electronic monitoring guidelines

A

preg w/o comp. q30/q15 (first/second stage)
preg w/comp. q15/5
use of oxytocin q15/q5

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9
Q

baseline fetal HR characteristics

A 
baseline fetal hr
baseline variability
accelerations
decelerations
changes over time
contraction pattern
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10
Q

baseline fetal HR

A

110-160 (norm)

avg rate during 10min segment (excluding changes) rate is rounded to 5bpm

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11
Q

baseline variability

A

irregular fluctuations in baseline FHR assessed over 10min

each 10 sec fetal heart beats 18-26 times

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12
Q

baseline variability classifications

A

absent - undetectable

minimal - >undectable25 bpm

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13
Q

sinusoidal patterns

A

assoc w/severe fetal anemia

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14
Q

pseudo-sinusoidal

A

assoc w/maternal narcotics

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15
Q

fxr affecting fhr variability

A

sleep, congenital heart conditions, diabetes, hyper/hypo tension

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16
Q

fetal tachycardia

A

HR above 160bpm for >10min

early sign of fetal hypoxemia

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17
Q

nursing interventions for fetal tachy

A

o2 - 8-10L

reduce fever

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18
Q

fetal bradycardia

A

HR below 110bpm for >10min

late sign of fetal hypoxemia

19
Q

nursing interventions for fetal brady

A

O2
IV hydration
position change

20
Q

periodic changes occur

A

in response to uterine contractions

21
Q

episodic changes occur

A

intermittently, isolated events, not in the presence of uterine activity

22
Q

types of changes

A

accelerations

decelerations

23
Q

accelerations are

A

abrupt increase in fhr above baseline >=15bpm lasting >=15sec

24
Q

decelerations are

A

decelerations in fhr by dominance of parasympathetic response
benign or non-reassuring

25
Q

3 types of decelerations

A

early
late
variable

26
Q

early decelerations are

A

gradual decrease in fhr starting w/contraction ending with return to baseline

27
Q

cause of early decelerations

A

fetal head compression (vagal response)

no intervention needed

28
Q

late decelerations are

A

gradual decrease in fhr beginning after contraction ends after contaction

29
Q

late decelerations are caused by

A

placental insufficiency

ominous when repeated or not resolved w/interventions

30
Q

nursing interventions for late decelerations

A

position change
02-10L
increase IV fluids
stop Pitocin

31
Q

variable decelerations are

A

abrupt decrease in fhr

vary in shape, depth, timing

32
Q

cause of variable decelerations

A

cord compression

33
Q

nursing interventions for variable decelerations

A

position change
02 -8-10L
discontinue pitocin

34
Q

veal chop acronym

A

variable - cord
early - head
acceleration - OK
late - placenta

35
Q

cat 1 fhr tracing

A

normal - fetal well being

36
Q

cat 2 fhr tracing

A

indeterminant - not predicitive of abnormality

37
Q

cat 3 fhr tracing

A

abnormal - require prompt intervention

38
Q

cat 3 characteristics

A

absent variability AND
late/variable decelerations
brady or sinusoidal pattern

39
Q

uterine activity assessed and monitored for

A

frequency - start of one to the next contraction

duration - start to the end of a contraction

40
Q

intensity is documented as

A

external - mild, moderate, strong (+1.2.3)

internal - mmHg via IUPC (intrauterine pressure cath)

41
Q

EFM is not useful in reducing what

A

cerebral palsy

42
Q

abnormal uterine activity

A

contractions occuring 90sec. (tetanic contractions)

unusually high resting tone (hypertonus)

43
Q

norm uterine activity

A

contractions q2-5 min
lasting =30sec
5 or less contractions in a 10min period, over 30min

Mgmt Test 1 - OB (11 decks)

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