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Women's Health > Fetal Monitoring > Flashcards

Fetal Monitoring Flashcards

1
Q

three principles of fetal heart tracings

A

1) heart tones (top of strip)
2) uterine contractions (bottom of strip)
3) fetal heart tones in relationship to uterine contractions

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2
Q

normal heart tones of fetus

A

110-160 bpm lasting >10 min

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3
Q

what is bradycardia defined as in fetus

A

<110 bpm

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4
Q

causes of bradycardia

A

anything that decreases pressure to placenta (decrease O2 to fetus)
hypoxia, maternal hypotension, r/t epideral

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5
Q

what do you give if fetus is bradycardic

A

give mom oxygen (10 L of O2 on nonbreather mask)
give mom bolus of fluid (500 cc saline to increase BP)
change mother position, TURN PT (fetus cord may be compressed)

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6
Q

what is tachycardia defined as in fetus

A

> 160 bpm

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7
Q

cause of tachycardia in fetus

A

maternal/fetal INFECTION, fetal hypoxia, street drugs (meth, cocaine)

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8
Q

what is chorioamnionitis

A

infection of chorion and amnion of placenta
fetus and mom are infected- need to give them antibiotics
causes increase in HR and fever

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9
Q

measure of changes in fetal heart rate/ waviness

controlled by fetal brain (sympathetic and parasympathetic system)

A

variability

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10
Q

NO changes in fetal heart rate

ie/ consistently 140 bpm

A

Undetected

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11
Q

what does undetected variability mean

A

SEVERE brain damage

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12
Q

undetected or less than or equal to 5 bpm
little bit wavy, some activity
okay for 20 min/ hr

A

minimal variability

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13
Q

what is usually the cause of minimal variability and intervention

A 
sleeping fetus (if > 20 min be concerned)
intervention: give mother caffeine and sugar to wake baby up
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14
Q

what is moderate variability indicative of

A

Good parasympathetic and sympathetic nervous system

heart and brain are reacting together

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15
Q

describe what moderate variability looks like

A

squiggly line

6-25 bpm

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16
Q

describe marked variability

A

OMINOUS
early hypoxia or fetal seizures
>25 bpm
thick, wavy lines

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17
Q

form of long term variability
6-25 beats above baseline
periodic “hills” in EKG

A

accelerations

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18
Q

describe what type of accelerations you want

A

2 accelerations every 10 min
GOOD
up 15 beats, lasts 15 sec

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19
Q

why are accelerations good

A

indicates that baby gets enough Oz to supply muscles/body to move

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20
Q

what do no accelerations indicate

A

damage to cord

fetus not getting enough O2

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21
Q

during uterine contractions…

A

blood flow is REDUCED to placenta

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22
Q

what is the normal cycle of uterine contractions

A

normal flow, reduced flow, no blood flow, reduced flow, normal flow

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23
Q

contractions that last 5 min…

A

hypoxic baby

24
Q

contractions=______

A

stress

25
Q

done on high risk pts who may not supply fetus with enough Oz

A

non stress test

26
Q

2 or more accelerations in 10-20 min

A

reactive NST

27
Q

fetus did not meet acceleration requirement

A

nonreactive NST

28
Q

causes of nonreactive NST

A

sleep: monitor for 2 hrs and give glucose
hypoxia: further testing necessary with stress test or biophysical profile

29
Q

ideally, what contraction frequency do we want

A

contracts every 3-5 min lasting 45-90 seconds

30
Q

each box is how many seconds

A

10

31
Q

need relaxation period for what

A

normal arterial transfusion to gap

O2 pushed to gap

32
Q

contractions…

A

pushes baby out and dilates cervix

33
Q

resting…

A

gives baby O2

34
Q

from the beginning of one contraction to the beginning of the next contraction

A

frequency

35
Q

what frequency do you want

A

every 3-5 min

36
Q

delivered to help women go into labor

starts to increase the amount of uterine contractions

A

Pitocin

37
Q

how is Pitocin given

A

IV if contractions are <3 min

nurse triates med to optimal dose

38
Q

if contractions are closer than 3-5 min apart lasting 45-90 sec this occurs

A

hyperstimulation

39
Q

as resting period is decreased…

A

O2 to fetus is decreased

causes prolonged constriction of endometrial arteries

40
Q

interventions for hyperstimulation

A

1) turn down or off the Pitocin

2) give a tocolytic to relax uterus

41
Q

do not want contractions ______ if giving pitocin

A

> 3 minutes apart

42
Q

types of tocolytic

A

brethine

terbutaline

43
Q

decelerations have _______ to contractions

A

NO relationship

44
Q

these are variable decreases in beats lasting 15 sec

A

decelerations

45
Q

what do decelerations look like

A

all look different

U, V, or W shaped

46
Q

what are decelerations caused by

A

manual cord compression

47
Q

interventions for decelerations

A

change position to remove force on cord

O2 per 10 L non rebreather

48
Q

if severe decelerations then do this

A

amniofusion- float away from force

discontinue Pitocin to allow fetus to rest

49
Q

this is a good sign, fetal head compression

moving down for delivery

A

early decelerations

50
Q

starts before the peak of the contractions
smooth, not shaped
no nursing interventions

A

early decelerations

51
Q

OMNIOUS

occurs after the peak of the contraction

A

late decelerations

52
Q

what do late decelerations indicate

A

uteroplacental insufficiency

presence of fetal hypoxia from the inability of the placenta to perfuse to the fetus

53
Q

intervention for late decelerations

A 
change maternal position
turn of Pitocin (stop closing arterioles)
O2 per 10L non rebreather
LR bolus to increase pressure
notify physician
54
Q

pneumonic to remember for fetal monitoring

A

VEAL CHOP

55
Q

what does the fetal monitor pneumonic stand for

A 
Variables Cord compression(change position)
Early decelerations Head compressions (no intervention)
Accelerations Okay (placenta is good shape/able to give O2 to aby and take CO2 from gap)
Late decelerations P-uteroplacental insufficiency (fetus is hypoxic, change position, shut off Pitocin, give O2, fluid bolus, and call provider)

Women's Health (31 decks)

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