OB Test 2 Chapter 18

Question 1

o Electronic fetal monitoring

Answer 1

visualizes fetal heart rate patterns on a monitor or tracing. It is the primary mode of intrapartum fetal assessment in the United States.

Question 2

o During labor, frequent fetal monitoring is part of nursing care. The fetal oxygen supply must be maintained to prevent

Answer 2

fetal compromise and to promote newborn health after birth.

Question 3

o The goal of intrapartum fetal heart rate monitoring is to differentiate normal (or reassuring) patterns from

Answer 3

abnormal (or nonreassuring) patterns, which can indicate fetal compromise.

Question 4

o Fetal well-being during labor is gauged by

Answer 4

the response of the fetal heart rate to uterine contractions. Monitoring of fetal well-being includes assessment of the fetal heart rate, uterine activity, and maternal vital signs.

Question 5

o Intermittent auscultation involves

Answer 5

using a fetoscope or other device to periodically listen to fetal heart sounds and assess the fetal heart rate.

Question 6

o Electronic fetal monitoring may be done in two modes.

Answer 6

 In the external mode, external transducers are placed on the maternal abdomen to assess fetal heart rate and uterine activity.
 In the internal mode, a spiral electrode is applied to the fetal presenting part to assess the fetal heart rate, and an intrauterine pressure catheter is used to assess uterine activity and resting tone.

Question 7

o Standardized definitions of many common fetal heart rate patterns have been endorsed for use in clinical practice by the American College of Nurse-Midwives, the American College of Obstetricians and Gynecologists, and the Association of Women’s Health, Obstetric and Neonatal Nurses.

Answer 7

o	The five essential components of the fetal heart rate tracing are the:
	Baseline fetal heart rate
	Baseline variability
	Accelerations
	Decelerations
	And changes or trends over time.

Question 8

This section presents critical points about nursing care related to electronic fetal monitoring.
o The nurse’s responsibilities include:

Answer 8

Assessing fetal heart rate and uterine activity patterns

Implementing independent nursing interventions

Documenting the outcomes of those interventions

And reporting abnormal patterns to the physician or nurse-midwife.

Question 9

o The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have published recommendations for electronic fetal monitoring.

Answer 9

For low risk women, the fetal heart rate tracing should be evaluated at least every 30 minutes during the first stage of labor and every 15 minutes during the second stage.

For women with risk factors, the fetal heart rate tracing should be evaluated at least every 15 minutes during the first stage of labor and every 5 minutes during the second stage.

Question 10

oIf fetal heart rate patterns are abnormal, take basic corrective measures, such as:

Providing supplemental oxygen
Assisting the woman to change positions
And increasing intravenous fluid administration

Answer 10

oDepending on the cause of the abnormal pattern, use other measures, such as:

Correcting maternal hypotension
Reducing uterine activity
And altering second-stage pushing techniques.

Question 11

oIf indicated, use additional methods to assess fetal status.

Commonly used assessments include fetal scalp or vibroacoustic stimulation, and umbilical cord acid-base determination.

Amnioinfusion and tocolytic therapy may be used to try to improve abnormal fetal heart rate patterns.

Fetal scalp blood sampling and fetal pulse oximetry are rarely performed.

Answer 11

oThe nurse must address the emotional, informational, and comfort needs of the woman and her family when she and her fetus are being monitored.

oThe nurse must initiate and update fetal assessment documentation according to facility protocol.