Intrauterine Resuscitation

Question 1

When do we monitor FHR?

Answer 1

During contraction and for at least one minute afterwards

Question 2

How frequently do we do FHR assessment during latent phase?

Answer 2

Every 1 hour

Question 3

How frequently do we do FHR assessment during active phase?

Answer 3

Every 30 minutes

Question 4

How frequently do we do FHR assessment during second stage?

Answer 4

Every 15 minutes (low risk)

Question 5

We should assess FHR following:

Answer 5

• AROM or SROM
• Vag exam
• Fetal stimulation
• Recognition of tachysystole
• Admin of meds that can affect fetal status
• Insertion of cervical foley bulb
• Placement of epidural or spinal

Question 6

When do we initiate interventions for intrauterine resuscitation

Answer 6

When nonreassuring FHR pattern is noted

Question 7

What is the goal of intrauterine resuscitation?

Answer 7

To improve uteroplacental perfusion and increase maternal oxygenation and cardiac output

Question 8

What is the first priority of intrauterine resuscitation?

Answer 8

Open maternal and fetal vascular systems

Question 9

Second priority of intrauterine resuscitation?

Answer 9

Increase blood volume

Question 10

Third priority of intrauterine resuscitation?

Answer 10

Optimize oxygenation of circulating blood volume

Question 11

What are the 6 clinical situations in which early decels most frequently occur?

Answer 11

• During sterile vag exam
• During second stage pushing
  3. During application of FSC
  4. With CPD
  5. After ROM
  6. With vertex presentation

Question 12

What are nursing interventions for early decels?

Answer 12

NONE

Question 13

What is the order of nursing interventions for Variable Decels?

Answer 13

1. Reposition patient on L or R side
2. Cut off Pit
3. O2 10 L via facemask
4. IV Bolus 300 ml LR (need an order but there is usually a standing order)
5. Notify provider
   - Another treatment may be amnioinfusion by the provider

Question 14

What is the primary objective of Variable Decel interventions?

Answer 14

Alleviate cord compression

Question 15

What is the primary objective of Late Decel interventions?

Answer 15

Promote fetal oxygenation

Question 16

What is the order of nursing interventions for Late Decels?

Answer 16

1. Reposition patient on L or R side
2. Give IV bolus of 300 ml LR (need order but there is usually standing order)
3. Cut off Pit
4. O2 10 L via facemask
5. Notify provider

Question 17

What are two other FHR conditions that would result in need to notify provider?

Answer 17

1. Tachycardia (FHR over 160 bpm for 10 min or longer)

2. Bradycardia (FHR under 110 bpm for 10 min or longer)

Question 18

What is failure to rescue?

Answer 18

Recognizing that there is a problem and taking action but failing to follow through to ensure that the problem is adequately addressed and responded to