Fetal Monitoring

Question 1

What do you hear with intermittent auscultation?

Answer 1

Actual heart sounds

Question 2

What has EFM been shown to help reduce?

Answer 2

Neonatal seizures

Question 3

What does the ultrasound transducer detect?

Answer 3

Mechanical activity

Question 4

What does an fse measure?

Answer 4

R-r interval

Question 5

When should you avoid placing a fse?

Answer 5

If mom is positive with HIV, herpes, hep b, hep c, or guillain barre syndrome

Question 6

What happens with respiratory acidemia?

Answer 6

CO2 not effectively removed, builds up
Converts to hydrogen and bicarbonate
Hydrogen ions cause decrease in pH

Question 7

What happens in metabolic acidemia?

Answer 7

Peripheral tissues switch to anaerobic metabolism
Lactic acid builds up as by product
Ph buffers released 
Ph buffers get used up
Vital organs become damaged

Question 8

How long must a sinusoidal pattern persist?

Answer 8

20 minutes

Question 9

When can a fetus have a 10x10 accel?

Answer 9

Before 32 weeks

Question 10

What constitutes a category 1 fhr tracing?

Answer 10

Baseline 110-160
Moderate variability
No late/variable decels

Question 11

What constitutes a category 3 fhr tracing?

Answer 11

Sinusoidal 
Absent variability WITH:
     Bradycardia
     Recurrent lates 
     Recurrent variables

Question 12

What is hypertonus?

Answer 12

High resting tone (above 30)

Question 13

What is uterine tetany?

Answer 13

Contraction strong to palpation or >90 with IUPC that lasts >90 seconds

Question 14

How do you determine dysrhythmias from artifact?

Answer 14

Dysrhythmias look more organized, artifact more chaotic

Question 15

What is the fhr in SVT?/what can happen?

Answer 15

Usually 180-210, can be higher

Can develop hydrops in as little as 12 hrs

Question 16

What’s the main difference between intermittent auscultation and electronic fetal monitoring?

Answer 16

Auditory vs visual assessment