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Term 5: OB > Fetal Monitoring > Flashcards

Fetal Monitoring Flashcards

1
Q

What is the purpose of monitoring?

A
  • To detect and treat hypoxia asap to prevent acidosis

- See how fetus handles stress

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2
Q

What can decreases O2 to fetus be caused by?

A
  • Contractions
  • HTN
  • Hypotension
  • Hypovolemia
  • Anemia
  • Alteration in fetal circulation (pinched cord)
  • Head compression of fetus
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3
Q

Auscultation

A
  • Done with fetoscope/doppler
    • immediately p ROM
    • listen during and beyond contraction
  • Increase/decrease of 30 bpm indicate distress
  • Delay in return to baseline is sign of distress
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4
Q

What are some modes of monitoring?

A
  • External (indirect)
  • Internal (direct)
  • Intrauterine Pressure Catheter (IUPC)
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5
Q

FM paper

A

-Each square=10 sec

  • Paper speed set at 3 cm/min
    • can be set lower for certain circumstances
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6
Q

Parts of EFM

A

Fetal-Ultrasound

 - detects movement of heart not sound 
 - use gel on transducer 
 - Apply to baby’s back

Uterine-Tocotransducer (Toco)

 - monitors via pressure button
 - no gel 
 - apply to fundus (top) of uterus
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7
Q

Benefits of EFM

A
  • continuous and complete
  • noninvasive
  • can show contraction before pt feels it
  • shows fetal movement
  • records FHR in relation to contraction
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8
Q

Limits of EFM

A
  • slippage
  • keeps pt in bed
  • limited (maternal size, position, movement)
  • may half or double heart tone
  • artifact may show as variability
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9
Q

Types of IFM?

A

Fetal - spiral electrode

Uterine -IUPC

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10
Q

Spiral Electrode Benefits

A
  • continuous recorded FHR in any position
  • accurate STV
  • 0 artifact
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11
Q

Spiral Electrode Limits

A

Can cause infection
-keep clean, s/s: baby tachy

Cord prolapse

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12
Q

IUPC Benefits

A

Accurate freq, duration, and intensity

Resting tone of uterus

Port for fluid withdrawal or infusion

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13
Q

TOLAC

A

Trial of labor after c section

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14
Q

VBAC

A

Vaginal birth after c section

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15
Q

IUPC Limits

A

invasive

Can cause infection

Catheter obstruction

Placental injury

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16
Q

Frequency

A

Beginning of contraction to beginning

17
Q

Duration

A

Beginning of contraction to end

18
Q

Hyperstimulation

A

Interval <60 sec

19
Q

Peak intrauterine pressure

A

Peak of contraction

20
Q

Intensity

A

Difference between peak and resting tone

21
Q

Strength

A

Measure by touching

Mild, medium, or strong

22
Q

Hypertonus

A

Resting tone >25 (can rupture uterus if too high)

23
Q

Interval

A

End to beginning of contraction (60 sec)

24
Q

Monte vedeo units (MVU)

A

Add up intensity of contractions within 10 min period

Tells you if its adequate labor (150-300)

> 300 too strong; potential to rupture

25
Q

Dystocia

A

Difficult labor (slow, not doing anything)

26
Q

NADIR

A

Peak of depression of FHR

27
Q

Irritability

A

squiggly line

d/t dehydration, infection

28
Q

*Variability

A

Are short term and long term

Can only be seen on monitor (Cant listen)

Indicates well-being

29
Q

Long term variability

A 
Absent: 1-3 bmp
Minimal: 3-5 bmp
Average:6-10 bpm
Moderate: 11-25 bpm
Marked: >25

Now called - decreased, average, increased

30
Q

Absent or exaggerated variability

A

Find out why: acidosis, CNS depression (fentanyl given?), trauma, meds, infection?

If on EFM switch to IFM

d/c pitocin (don’t just turn down), bolus of fluids (makes contraction slower)

31
Q

What are drugs that can slow contractions?

A

Terbutaline

Mag, sulfate

32
Q

What can a early deceleration be due to?

A

Fetal head compression

33
Q

What can a late deceleration be due to?

A

uteroplacental insufficiency

34
Q

What can a variable deceleration be due to?

A

Cord compression

35
Q

Decelerations

A

At least 15 bpm decrease from baseline lasting 15 sec

36
Q

Late decelerations

A

Interventions: lay pt on L side, fluid bolus, O2 by mask (8-10 1/min), check BP, call provider

Risk factors: diabetes, vasoconstriction (ciggs)

Always document decels, interventions, and who you called and what they said

Orders: ephedrine 5-10 mg SLOW for bp; terbutaline 0.25 mg SLOW to slow contractions (can make pt nervous, have beta blocked handy in case of chest pain)

Term 5: OB (6 decks)

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