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OB211_01_Unit II > Intrapartum Fetal Monitoring: FHR Tracing > Flashcards

Intrapartum Fetal Monitoring: FHR Tracing Flashcards

To practice reading tracings go to: https://ncc-efm.org/game/efmgame.cfm

1
Q

On a FHR strip, each box indicates…

A

10sec of time

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2
Q

Each section between bold vertical lines indicates…

A

1min of time

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3
Q

What do the upper and lower sections of the strip represent?

A

Upper = FHR

Lower = Contractions/uterine activity

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4
Q

Define the baseline FHR on the strip

A

FHR average over 10mins

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5
Q

What do accelerations indicate and is it bad?

A
  • Normal HR increases with fetal movement.
  • This is a reassuring pattern
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6
Q

What are decelerations?

A

Drops in fetal heart rate

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7
Q

What are the three types of decelerations?

A
  • Early
  • Late
  • Variable
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8
Q

What are the nursing interventions for late decels?

A

Reposition mother, monitor and document

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9
Q

What are the nursing interventions for variable decels?

A

Reposition, O2 administration @ 8-10L/min w/ non-rebreather mask

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10
Q

A FHR reading is either _____ or _____.

A

Reassuring or non-reassuring

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11
Q

During the second stage of labor, fetal heart tones are documented…

A

every 5 to 15 minutes.

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12
Q

During the early phase of labor, fetal heart tones only need to be documented every

A

30 minutes

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13
Q

During the latent phase of labor, fetal heart tones only need to be documented every

A

30 minutes

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14
Q

Regarding Cesareans, The guidelines for decision to incision are

A

30 minutes.

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15
Q

What causes early decelerations?

A

Head compressions caused by uterine contractions.

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16
Q

What are the characteristics of early decelerations on a FHR tracing?

A
  • Mirror contraction
    • The FHR dips when the contraction peaks
    • The peaks align
  • Consistent in appearance
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17
Q

What interventions are needed for early decels?

A

They require no intervention

18
Q

What causes late decelerations and what do they indicate?

A
  • They are caused by uteroplacental insufficency
  • It indicates lack of O2 reserve and may be acute or chronic
19
Q

What are the characteristics of late decelerations on a FHR tracing?

A
  • FHR may remain in normal range
  • Deceleration shifts to the right in relation to the peak of the contraction
  • NOTE A LATE RETURN TO BASELINE HEART RATE
20
Q

What interventions are needed for late decels?

A
  • Reposition mother,
  • Monitor and document
    • NOTE A LATE RETURN TO BASELINE HEART RATE
21
Q

What causes variable decelerations?

A
  • Caused by umbilical cord compression
  • May be unrelated to contraction
22
Q

What are the characteristics of variable decelerations on a FHR tracing?

A
  • No uniformity
  • Shape and duration may vary
23
Q

What interventions are needed for early decels?

A
  • Reposition mother
  • O2 administration @ 8-10L/min w/ non-rebreather mask
  • Monitor and document
24
Q

What are the 3 categories of FHR patterns?

A
  1. Reassuring
  2. Indeterminate
  3. Non-reassuring
25
Q

Reassuring or Non-reassuring?

Early Decelerations

A
  • Reassuring
  • These are expected, but do need to be monitored for any shifts or changes
26
Q

Reassuring or Non-reassuring?

Late Decelerations

A
  • non-reassuring
  • An intervention is necessary
27
Q

Reassuring or Non-reassuring?

Variable Decelerations

A
  • Non-reassuring
  • An intervention is necessary
28
Q

What is a deceleration called that occurs over a period of several contractions?

A

Prolonged deceleration

29
Q

What is the formula for interventions of Category III patterns?

A
  • Clarification of data
  • Identify cause
  • Improve oxygenation
  • increase maternal blood oxygen saturation
30
Q

What do Category I patterns indicate re: acid base status?

A

They are strongly associated with a normal acid base status

31
Q

What do Category II patterns indicate re: acid base status?

A

Not predictive of abnormal fetal acid base status but inadequate evidence to classify as normal or abnormal

32
Q

What do Category III patterns indicate re: acid base status?

A

Predictive of abnormal fetal acid base status

33
Q

What are the five essential components of the FHR tracing that must be evaluated regularly?

A
  • Baseline rate
  • Baseline variability
  • Accelerations
  • Decelerations
  • Changes or trends over time
34
Q

If any of the essential components of FHR tracing are abnormal what corrective actions must be taken?

A
  • Immediately improve fetal oxygenation
    • (aka intrauterine resuscitation)
    • Reposition can improve on its own
    • Provide O2 if reposition not enough
35
Q

If not receiving accurate data via external FHR monitoring, what action may be indicated?

A

The need for internal monitoring via IUPC and spiral electrode

36
Q

Define FHR variability

A

The variation of FHR tracing line from baseline

37
Q

Is low FHR reassuring or non-reasurring?

What is it indicative of?

A
  • non-reassuring
  • lack of activity or response to labor
  • indicative of CNS issue
  • emergent and doc needs to be notified
38
Q

FHR >160 indicate

A

Tachycardia

39
Q

FHR <110 indicates

A

Bradycardia

40
Q

To practice reading FHR tracings, go to:

https://ncc-efm.org/game/efmgame.cfm

Unit II exam may include FHR equipment used.

To review that, visit the Intrapartum Fetal Monitoring deck in Unit I

A

To practice reading FHR tracings, go to:

https://ncc-efm.org/game/efmgame.cfm

Unit II exam may include FHR equipment used.

To review that, visit the Intrapartum Fetal Monitoring deck in Unit I

OB211_01_Unit II (2 decks)

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