Test 2

Question 1

Baseline Fetal Heart Rate

Answer 1

110-160 bpm

Question 2

3 types of variability with FHR.

Answer 2

Absent
→ We don’t want this
Minimal
Moderate
→ Predicts a well-oxygenated fetus with normal acid-base balance (at that time)
→ Says there is a good acid-base balance
Marked

Question 3

What is an acceleration predictive of?

What does it reflect an absence of?

Answer 3

Predictive of adequate central fetal oxygenation

Reflects absence of fetal acidemia ( an umbilical arterial pH (UApH) of less than 7.0 and base deficit ≧12 mmol/L)

Question 4

Early decels ________ the mother’s uterine contraction.

Answer 4

Mirrors

Question 5

Early decelerations: Any intervention needed?

Answer 5

Nope!

Question 6

Variable decelerations: Any intervention needed?

Answer 6

Yes, usually due to nuchal cord
ABRUPT drop, not gradual like earlies
Not in a pattern

• Reposition the client (side to side; knee-chest)
• Discontinue oxytocin (makes contractions stronger, maybe slow it down)
• Administer O2 via face mask 8-10 L/min → better perfusion to fetus
• Vaginal exam
• Amnioinfusion (if prescribed → when water has broken, puts fluid back in to give room for cord to stop compression.)

Question 7

Late decelerations: Any intervention needed?

Answer 7

YAS. We don’t want to see this.

Drop of fetal heart rate is after the peak of the contraction; there is a pattern.

• Change maternal position (side-lying) → trying to get better profusion to the placenta. Do this first, it will help the other things work better.
• Discontinue oxytocin. Baby is not tolerating this, don’t want to stress them more.
• IV bolus (LRS 500 ml) to promote fetal oxygenation
• Administer O2 via face mask 8-10 L/min
• Notify provider
• Fetal spiral/scalp electrode for more invasive monitoring
• Plan for delivery and care of the neonate

Question 8

What are VEAL CHOP?

Answer 8

V – Variable Decelerations → C – Cord Compression
E – Early Decelerations → H – Head Compression
A – Accelerations → O – OK
L – Late Decelerations → P – Placental insufficiency

Question 9

How long does a nonstress test take?

Answer 9

20-40 minutes

Question 10

What does a reactive nonstress test look like?

Answer 10

An increase in FHR by at least 15 beats over baby’s baseline for at least 15 seconds at least 2 times in 20 minutes

If under 32 weeks, only expect to see the FHR rise by 10 bpm/10 seconds

Question 11

What does a nonreactive nonstress test look like? And what would the next step be?

Answer 11

• FHR that did not have sufficient accelerations

* Follow up with BPP or US

Question 12

If nonstress test is not reactive, what should we do first?

Answer 12

Give preg person juice; baby might be sleeping

Question 13

What is a nonstress test looking at?

Answer 13

• Looking at fetal movement and FHR accelerations

* This correlates with adequate oxygenation and shows that the ANS is functioning correctly

Question 14

What are some reasons one would get a nonstress test?

Answer 14

High-risk preg, gestational HTN, HTN, diabetes, multiple gestation, trauma, bleeding, feeling of decrease in fetal movements, concern for placental problems.

Question 15

Describe true labor contractions?

Answer 15

• True labor contractions occur at regular intervals and increase in frequency, duration, and intensity
• True labor contractions bring about changes in cervical effacement and dilation

Question 16

Describe false labor contractions?

Answer 16

False labor is characterized by irregular contractions with little or no cervical change