Fetal monitoring and pain management Lecture 9

Question 1

FHR baseline is?

Answer 1

110 to 160 bpm

Question 2

What are the parameters for absent baseline variability?

Answer 2

Flat line

Question 3

What are the parameters for minimal baseline variability?

Answer 3

0 to 5 bpm

Question 4

What are the parameters for moderate baseline variability?

Answer 4

6 to 25 bpm

Question 5

What are the parameters for marked baseline variability?

Answer 5

Greater than 25 bpm

Question 6

What are the parameters for fetal bradycardia?

Answer 6

Less than 110 bpm, times 10 minutes

Question 7

What are the parameters for fetal tachycardia?

Answer 7

Greater then 160 bpm, times 10 minutes

Question 8

Maternal/fetal assessment requires a monitoring strip for how many minutes to acquire a baseline?

Answer 8

20 minutes

Question 9

What types of external monitoring is used to monitor the FHR?

Answer 9

Intermittent:

Auscultation (IA) and Ultrasound (U/S)

Question 10

What type of internal monitoring is used to monitor the FHR?

Answer 10

Fetal Scalp Electrode (FSE)

Question 11

What types of external monitoring is used to monitor the uterine contractions?

Answer 11

Palpation and Tocodynamometer (Tocos)

Question 12

What type of internal monitoring is used to monitor the uterine contractions?

Answer 12

Intrauterine Pressure Catheter (IUPC)

Question 13

What are the causes of periodic changes in accelerations?

Answer 13

Fetal movement

Fetal stimulation

Question 14

What are the parameters i.e. bpm and seconds for an acceleration?

Answer 14

Greater than 37 weeks; 15 bpm for 15 seconds

Less than 37 weeks; 10 bpm for 10 seconds

Question 15

Since drugs can make the baby sleepy, when is the best time to give IV medications to the laboring woman?

Answer 15

At the height of the contraction.

Question 16

What are the characteristics of an early deceleration? What does it look like on the strip?

Answer 16

Consistent/uniform appearance, mirror the UC, and the nadir usually remains above 100

Question 17

What is an early deceleration caused by?

Answer 17

Fetal head compression during on the cervix during contraction.

Question 18

What are the interventions for an early deceleration?

Answer 18

No intervention needed.

Question 19

What are the characteristics of an late deceleration? What does it look like on the strip?

Answer 19

Consistent/uniform appearance, similar to an early deceleration, but shifted slightly to the right of the uterine contraction - begin after the contraction and return to baseline after the contraction is over.

Question 20

What is the cause of a late deceleration?

Answer 20

uteroplacental insufficiency

Question 21

Why is a late deceleration an unreassuring sign?

Answer 21

The fetus is deprived of oxygen and waste removal is compromised leading to fetal acidosis.

Question 22

Uteroplacental insufficiency is caused by?

Answer 22

Hypotenstion or excessive contractions

Question 23

What are the interventions for a late deceleration?

Answer 23

• Discontinue Pitocin prn
• Turn woman on side
• Increase IV rate
• Provide O2 (8 to 10L)
• Possible tocolysis
• Possible c/s

Question 24

What are the characteristics of a variable deceleration? What does it look like on the strip?

Answer 24

Shape, duration and nadir are variable as in relation to contractions, ma be U,V, or W shaped.

Question 25

What is a variable deceleration caused by?

Answer 25

Umbilical cord compression

Question 26

What are the causes of a variable deceleration?

Answer 26

Nuchal cord, oligo, prolapse

Question 27

What are the interventions for a variable deceleration?

Answer 27

• Position change
• Aminoinfusion
• Vacuum delivery
• c/s

Question 28

What are the four components to uterine activity?

Answer 28

• Frequency - at least one minute uterine rest between contractions; Q2-3min is usual
• Duration - usual is 60 60 90 seconds
• Intensity - adequate is 50 to 75 mmHg (IUPC)
• Resting tone - less than 20 mmHg (IUPC)