maternal and newborn

Question 1

minimal or absent variability

Answer 1

To determine if minimal or absent variability is caused by a deep fetal sleep state, use a vibroacoustic
stimulator to “wake” the fetus. Minimal or absent variability accompanied by FHR <110 indicates fetal hypoxia.

Question 2

Baseline FHR: Average over 10 min

Answer 2

Tachycardia: Baseline FHR >160 bpm
Potential causes: Anything that can cause
maternal tachycardia (fever, dehydration)
Interventions: Treat the cause (antipyretics
for fever).

Question 3

Bradycardia: Baseline FHR <110 bpm

Answer 3

Potential causes: Maternal hypoglycemia
Interventions: Treat the cause (correct
hypoglycemia).

Question 4

External fetal monitoring

Answer 4

Standard during normal labor
FHR is measured using an ultrasound
transducer positioned over the fetal back (point
of maximal impulse).
Frequency and duration of contractions are
measured using a tocodynamometer placed
over the fundus.

Question 5

Internal fetal monitoring

Answer 5

Used when external monitoring is inaccurate
(in obesity or frequent movement) but is invasive
andrisk for infection
Can only be performed after membranes have
ruptured and cervical dilation is ≥2 cm
FHR is measured using a fetal scalp electrode
(FSE) attached to the fetal scalp.
Frequency, duration, and intensity of
contractions are measured using an intrauterine
pressure catheter (IUPC).

Question 6

Variable decelerations

Answer 6

occur independent of
contractions and indicate cord compression.
The nurse should assess for umbilical cord
prolapse and initiate intrauterine resuscitation.

Question 7

Late decelerations

Answer 7

start after the contraction
and indicate placental insufficiency. The
nurse should immediately initiate intrauterine
resuscitation.

Question 8

Tocolytics

Answer 8

terbutaline
Can cause maternal
headache, flushing,
dyspnea, and maternal or fetal
tachycardia
magnesium sulfate
Depresses CNS and
respirations: Discontinue
for signs of toxicity (RR <12,
absent DTRs, oliguria).
nifedipine
Can cause transient
hypotension and tachycardia
indomethacin
Contraindicated >32 weeks
due to risk for premature PDA
closure

Question 9

Intrauterine resuscitation i

Answer 9

improves placental perfusion and fetal hypoxia (STOP-IN: Stop oxytocin, Tocolytic,
Oxygen, Position, Increase IV fluids, Notify HCP).