L&D/Maternal-Fetal Monitoring/Quick Notes

Question 1

Baseline FHR

Answer 1

110-160 beats/min

Saunders 348

Question 2

Fetal Bradycardia

Answer 2

FHR less than 110 beats/min for 10 minutes

Question 3

Fetal Tachycardia

Answer 3

FHR greater that 160 beats/min for 10 minutes

Question 4

If fetal brady or tachycardia occur...
Nursing actions (4)

Answer 4

1) Reposition mother
2) Admin oxygen (non rebreather 15 l)
3) Assess mothers VS
4) Notify Provider

Question 5

Variability

Answer 5

Fluctuations in baseline FHR

Question 6

Reassuring FHR pattern

Answer 6

Reassuring FHR patterns are those that are associated with fetal well-being and lack of acute distress. Reassuring FHR readings include periodic accelerations, mild variable decelerations lasting less than 30 seconds, or early decelerations that mirror contractions in duration and timing

Question 7

Nonassuring FHR pattern

Answer 7

Nonreassuring FHR patterns are those that suggest fetal compromise or a declining ability to cope with the stress of labor.
Nonreassuring patterns include a significant decrease in baseline variability or baseline heart rate, progressive fetal tachycardia or bradycardia, persistent late decelerations, or recurrent late return to baseline after decelerations.

Question 8

Accelerations

Answer 8

Brief FHR increase 15 beats/min for 15 secs

Question 9

Brief FHR increase 15 beats/min for 15 secs

Assuring or nonassuring?

Answer 9

Assuring

Reactive test if at least 2 in 20 minutes

Question 10

Non reactive result

Answer 10

Acceleration not present or does not meet Assuring criteria

indicates fetus at risk or asleep

Question 11

Late decelerations are (2) caused by

Answer 11

1) impaired placental exchange

2) Uteroplacental insufficiency

Question 12

Nonreassuring Fetal Heart Rate Patterns (8)

Saunders 350

Answer 12

1) Brady
2) Tachy
3) Late decele
4) Prolonged decel
5) Hypertonic uterine activity
6) Decrease or Absent variability
7) Variable decelerations falling less than 70 beats/min for longer than 60 minutes
8) Undetected variability

Question 13

Nonreassuring Fetal Heart Rate Patterns
Priority Nursing Actions

(Saunders 350)

Answer 13

1) Identify cause
2) dc oxytocin (pitocin) infusion
3) Change mother’s position
4) Oxygen 8-10 l non rebreather
5) Infuse IV fluids
6) FHR assess, continue monitoring
7) C-section in needed
8) Document: Event, actions taken, mother’s response
9) Notify provider

Question 14

Nonreassuring Fetal Heart Rate Patterns
Priority Nursing Actions
Identify cause

Answer 14

1) Prolapsed cord
2) Hypo or hypertension
3) Fever
4) Oxytocin stop infustion, tocolytic may be prescribed

Question 15

Variable decelerations indicate

Variable decelerations falling less than 70 beats/min for longer than 60 minutes before returning to baseline

Answer 15

restricted flow to umbilical cord

Question 16

Variable decelerations

Priority Nursing Action

Answer 16

Change position
Adm oxygen
dc Pitocin
VS
Notify provider
prepare for amniofusion if prescribed

Question 17

Fetal Reactivity via NST

Answer 17

Two accelerations of 15 beats per min lasting 15 seconds

Question 18

An increasing baseline FHR indicates?

An above average baseline FHR us acceptable up to 160

Answer 18

Maternal Infection

Question 19

NST are contractions expected ?

Answer 19

NO

Question 20

What types of heart rates (decelerations) are associated with contractions? (3)

Answer 20

Early
Late
Variable

Question 21

FHR repeatedly drops abruptly to 90 beats per minute unrelated to contractions …indicates?

Answer 21

Umbilical cord compression

Waveform V or U