NUR 102 Exam 1 Fetal Monitoring Flashcards

1
Q

When do you perform Fetal monitoring?

A

During Pregnancy

During Labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fetal monitoring during pregnancy involves what three things?

A
  • Non-stress test
  • Stress test
  • BPP (Biophysical profile) (non stress test and ultrasound study)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Biophysical profile (non stress test and ultrasound study for) what 4 things?

A
  • Fetal breathing
  • Fetal movement
  • Fetal tone
  • Amniotic fluid volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In BPP..if the scoring drops what does this mean?

A

The baby is headed for trouble!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

To determine the well being of the fetus what do we do?

The decisions for care is based on what?

A

Fetal monitoring

Fetal heart tracing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 fetal heart tracings?

A
  • Reassuring- (this is good..we are happy with this)
  • Non-reassuring (we watch this closely)
  • Omnious (DELIVER THE BABY ASAP!!!)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

As a nursing student..can I touch the strip?

A

NOOOO!!!!!!!!!! DON’T EVER TOUCH THE STRIP!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If pt has an “internal fetal monitoring” is a transducer helpful also?

A

NO, you DON’T NEED a TRansducer if you have an internal fetal monitoring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is on the top and bottom of the Fetal Heart Monitor Tracing?

A

On the top - Fetal heart tracing

On the bottom- Uterine Contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If we need to monitor with out a baseline can we?

A

NO… WE ALWAYS NEED A BASELINE 1ST!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If the fetal heart line is going straight..is that okay?

A

No..not mostly..although it may be the baby is sleeping..but if the beats are absent..give the mom’s belly a little nudge or (even some juice if not contraindicated..per my sister) to wake the baby up!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

On fetal heart monitor tracing…each dark line is what?

A

A minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

On the fetal heart monitoring tracing The unbolded lines are what?

A

10 beats a minute!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What device is used to rupture the membranes ( break the bag of waters)?

A

Amnihook

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is a contraction timed?

A

From the beginning of 1 contraction to the beginning of the next contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Does timing the contraction include the mountain and the rest period?

A

YES IT DOES! Count each dark line, the lump of contraction (mountain) and the rest period is your frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When we are assessing the baseline of FHR, do we ignore the episodic changes?

A

YES! The baseline..is the mean FHR over a 10 minute segment EXCLUDING the episodic(significant changes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The beat to beat changes in the baseline FHR are called what?

A

Variability

It is irregular in amplitude and frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most important predictor of adequate fetal oxygenation during labor?

A

Baseline VARIABILITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 4 characteristics of Variabilty?

A

Absent- undetectable -Omnious
Minimal -5 beats per min of fewer
Moderate (normal) 6-25 beats per min
Marked -More than 25 beats per min

21
Q

What is the average FHR for early gestation?

A

140-160

22
Q

What is the average for baby’s FHR once born?

A

120-160

23
Q

Does FHR Increase or decrease with age?

A

The older it is..the FHR decreases!!

The older we get the lower our HR gets..that’s why an adults range is 60-100 bpm!

24
Q

Minimal variability is what?

A

5 beats per min or fewer

25
Q

Moderate variability is what?

A

6-25 beats per min?

This is normal..WE like moderate!!

26
Q

Marked variability is what?

A

More than 25 beats per min

27
Q

If the FHR of newborn is 110..what does this mean?

A

He’s probably sleeping

28
Q

NOTE!! You can eyeball to see the trend on the FHR Monitor

A

NOTE!!

29
Q

A visually apparent, abrupt increase in fetal heart rate of 15 or more beats per min above baseline is what?

A

Accelerations

30
Q

Are accelerations good or bad?

A

Accelerations are a good thing, the baby is responding to whatever the baby is doing..NOT what the mom is doing!!!
But if it goes up too high, i.e 220 something is wrong, i’e if baby or mom is septic it may stay high & it won’t be alot of variability.

31
Q

Are there accelerations due to what the mom is doing?

A

No..Accelerations are only to what the baby is doing!

32
Q

Decrease in FHR is called a what?

A

Decelerations

33
Q

What is the lowest FHR in a deceleration called?

A

NADIR

34
Q

What 3 ways are FHR decelerations classified?

A

Early
Late
Variable

35
Q

* A Prolonged Deceleration is Omnious*

“We had a de-cel to the 20’s with no recovery”

A

NOTES!!

36
Q

Onset, nadir and recovery coincide with the beginning, peak and ending of the contraction.
It’s caused by head compression is called what?

A

Early decelerations

37
Q

Nadir occurs after the peak of the contraction & the deceleration is caused by uteroplacental insufficiency is called what?

A

Late Decelerations

38
Q

“U” or “W” shaped and vary with successive contractions & caused by umbilical cord compression is called what?

A

Variable Decelerations

39
Q

What are the deceleration Nursing Interventions for Early Decelerations? (head compression)

A

May NOT require intervention

40
Q

What are the Nursing interventions for Late Decelerations? (uteroplacental insufficiency)

A

Turn to LEFT SIDE & Administer oxygen!

Discontinue oxytocin per Chapman

41
Q

What are the Nursing interventions for Variable Decelerations? ( cord compression)

A

Turn patient to lateral position!

Decrease or discontinue oxytocin per Chapman

42
Q

Visually apparent decrease from baseline that is more than 15 bpm, lasting equal or more than 2 min, but less than 10 minutes is what?

A

Prolonged Deceleration

43
Q

What are the nursing interventions for Prolonged Decelerations?

A
  • Assess for prolapsed cord
  • Change maternal position as needed to alleviate decelerations
  • Anticipate immediate intervention for a deceleration lasting more than 3 minutes!
44
Q

What has an absence of variability
Smooth, wave like undulating shape
Caused by severe fetal hypoxia, anemia
Pseudosinusoidal: which is caused by medications i.e demerol?

A

Sinusoidal pattern

45
Q

Greater than 5 contractions per 10 minutes is called what?

A

Uterine Hyperstimulation….

note that hyperstimulation may also produce contractions that are sustained!

46
Q

When timing contractions..The beginning to the end of the same contraction is called the what?

A

Duration

47
Q

When timing contractions….the beginning of one whole contraction to the beginning of the NEXT contraction is called the what?

A

Frequency

48
Q

In order to do Internal Fetal Monitoring..how should the membranes be?

A

The Membranes must be ruptured

49
Q

Spiral electrode into fetal scalp

Uterine Pressure Catheter into amniotic sac to measure intensity of contractions and for amnioinfusions is all for what?

A

Internal Fetal Monitoring

& remember Membranes MUST be RUPTURED!!