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SUM'20 - Advanced Principles > Week 2 FHR Interpretation (everything)- not presented > Flashcards

Week 2 FHR Interpretation (everything)- not presented Flashcards

1
Q

Fetal HR Monitoring =

A

Fetal brain monitoring

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2
Q

Brain monitors and responds to what :

A
  1. extrinsic Influences
  2. Intrinsic influences
  3. Homeostatic interactions b/w the fetus and the environment
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3
Q

The Goal of FHR Monitoring is to

A

maintain optimal blood flow (oxygenation) of the brain w/o compromising other organs

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4
Q

Strip Review / Essential characteristics for tracing interpretation:

Clinical Setting -

A

provides the background risk

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5
Q

Strip Review / Essential characteristics for tracing interpretation:

Baseline -

A

Important to determine all other freatures

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6
Q

Strip Review / Essential characteristics for tracing interpretation:

Variability-

A

a marker of normal pH

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7
Q

Strip Review / Essential characteristics for tracing interpretation:

Decelerations -

A

A marker of ongoing O2 deprivation

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8
Q

Strip Review / Essential characteristics for tracing interpretation:

Contractions -

A

potential cause of O2 deprivation

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9
Q

Strip Review / Essential characteristics for tracing interpretation:

Accelerations -

A

a marker of normal pH

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10
Q

Strip Review / Essential characteristics for tracing interpretation:

Change over time -

A

evidence of an evolving process and marker of time course

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11
Q

Order of Oxygen transfer from Environment to fetus:

A 
Environment
Lungs
Heart
vasculature
Placenta
Cord
Fetus
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12
Q

The subsequent fetal response if oxygen transfer is disrupted (fetal response); in order:

A 
Hypoxemia
Hypoxia
Metabolic Acidosis
Hypotension
Potential Injury
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13
Q

Types of decelerations

A

Early, Late, Variable (videos)

PPT:
variable
late
prolonged

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14
Q

Significant FHR decelerations (variable, late, prolonged) represent

A

interruptions in fetal oxygen transfer

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15
Q

Interruptions in fetal oxygen transfer are represented by

A

decelerations

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16
Q

Disrupted oxygen transfer does not cause injury unless

A

there is progression to metabolic acidemia

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17
Q

Metabolic acidemia + disrupted oxygen transfer =

A

injury potential

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18
Q

the presence of FHR variability and/or accelerations predict

A

the ABSENCE of metabolic acidosis

* the converse is not always true*

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19
Q

The absence of metabolic acidosis is seen by

A

the presence of FHR variability and/or accelerations

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20
Q

Three Tier System:

Describe Category 1 -

A
  • “Go to” definition of normal.

Baseline: 110-160 bpm
Variability: moderate (6-25 bpm)
Accelerations: present or absent
Decelerations: No late/variable/prolonged

21
Q

Baseline: 110-160 bpm

A

Category 1

22
Q

Variability: moderate (6-25 bpm)

A

Category 1

23
Q

Decelerations: No late/variable/prolonged

A

Category 1

24
Q

Accelerations: present or absent

A

Category 1

25
Q

Three Tier System:

Describe Category 3

A

Absent variability WITH any one of the following:

  • recurrent late decelerations
  • recurrent variable decelerations
  • bradycardia

Sinusoidal Pattern

  • cycle frequency 3-5/min last at least 20”
  • If persists, likely evidence that you are “in deep doo doo”
26
Q

Absent variability WITH any one of the following:
- bradycardia

Category?

A

Category 3

27
Q

Absent variability WITH any one of the following:
- recurrent late decelerations

Category?

A

Category 3

28
Q

Sinusoidal Pattern
-cycle frequency 3-5/min last at least 20”

Category?

A

Category 3

29
Q

Three Tier System:

Describe Category 2

A

Baseline:
-Bradycardia (<110bpm) with preserved variability
-Tachycardia (>160bpm)
Variability
-Minimal (< or = to 5bpm but detectable)
-Absent (undetectable) *But NOT accompanied by recurrent decelerations
-Marked (>25bpm)
Accelerations
-Absence of acceleration with scalp stimulation
Decelerations:
-Late/Variable/recurrent/Prolonged

30
Q

Three Tier System:

Describe Category 2 BASE LINE (brady and tachy)

A
  • Bradycardia (<110bpm) with preserved variability

- Tachycardia (>160bpm)

31
Q

Three Tier System:

Describe Category 2 Variability:

A
  • Minimal (< or = to 5bpm but detectable)
  • Absent (undetectable) *But NOT accompanied by recurrent decelerations
  • Marked (>25bpm)
32
Q

Three Tier System:

Describe Category 2 Accelerations/Decelerations:

A

Accelerations
-Absence of acceleration with scalp stimulation

Decelerations:
-Late/Variable/recurrent/Prolonged

33
Q

Bradycardia <110bpm with preserved variability

Category?

A

Category 2

34
Q

Absence of acceleration with scalp stimulation

Category?

A

Category 2

35
Q

Tachycardia > 160bpm

Category?

A

Category 2

36
Q

Describe Category 1:

A

“Strongly predictive of normal fetal acid-base status”

37
Q

“Strongly predictive of normal fetal acid-base status” Describes what category?

A

Category 1

38
Q

Describe Category 2:

A

“Indeterminate…. [they] require evaluation and continued surveillance and reevaluation, taking into account the entire associated clinical circumstances”

39
Q

“Indeterminate…. [they] require evaluation and continued surveillance and reevaluation, taking into account the entire associated clinical circumstances” describes what category?

A

category 2

40
Q

Describe category 3:

A

“Predictive of abnormal fetal acid-base status”

41
Q

“Predictive of abnormal fetal acid-base status” describes category?

A

Category 3

42
Q

Moderate variability predicts pH

A

> 7.15

-Negative predictive value 98%

43
Q

Minimal/absent variability AND decels are associated with a pH

A

<7.15

- though predictive value still poor (23%)

44
Q

Increases with depth of recurrent decelerations increases the

A

likelihood of acidemia

*especially late and w/minimal or absent variability

45
Q

pH > 7.15

A

moderate variability

46
Q

pH < 7.15

A

absent or minimal variability and decels

47
Q

Name, in order the evolving fetal compromise process:

A
  1. Recurrent variable/late decels
  2. Progressively deeper decelerations
  3. Reflexive fetal tachycardia (+/-)
  4. Progressive reduction in variability moderate to minimal to absent
  5. Terminal Bradycardia
48
Q

Reverse order of fetal compromise process (5 steps):

A
  1. terminal bradycardia
  2. progressive reduction in variability moderate to minimal to absent
  3. reflexive fetal tachycardia (+/-)
  4. Progressively deeper decelerations
  5. Recurrent variable/ late decelerations

SUM'20 - Advanced Principles (16 decks)

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