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1 AWHONN Fetal Heart monitoring basics Test
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1 AWHONN Fetal Heart monitoring basics Test 2023 -2024 a) Frequency b) Duration - ANSWER Which contraction characteristics can be assessed wi th a tocodynamometer? a) Frequency b) Duration c) Intensity Uterus - ANSWER All Fetuses of mothers in labor experience an interru ption of the oxygenation pathway at which point? a) Throughout labor and delivery unless the use of a more accurate method is clearly indicated - ANSWER The FHR can be monitored using doppler ultraso und? a) Throughout labor and delivery unless the use of a more accurate method is clearly indicated b) Internally c) Only early in labor d) The FHR cannot be monitored by doppler ultrasound b) 110-160 bpm - ANSWER What is the normal range for FHR base lin e in a term infant? a) 80-120 bpm b) 110-160 bpm c) 140-180bpm d) it depends on the sex of the fetus Mother's inhalation to lungs to mat. circulatory system to hemoglobi n in RBC's to bloodstream in uterus. Uterus to spiral arteries to placenta to intervill ous space to travel via simple diffusion into the villi. The capillaries to the umb. ve in to the fetus. The umb. artery sends waste (CO2) to the intervillous space to the mothers venous system. - ANSWER Trace the flow of oxygen from mother to fetus and back. 1. Mother (blood plasma, cardiac output, hemoglobin concentration & O 2 saturation) 2. Placenta/intervillous space (uterine contractions & calcification's) 3. Fetus (vagal response aka decel or cord compression) - ANSWER What factor s impact maternal oxygen delivery? 30-50% lateral recumbent or semi-Fowler's - ANSWER By what % does maternal cardiac output increase above the non-pregnant state and what position helps this uter oplacental blood flow? >5 contractions in 10 min (more frequently than Q 2 min) averag ed over 30 min window. Caused by oxytocin, aminoinfusion or in rare cases spontaneously. - ANSWER Define tachysystole contractions and the cause of. Maintaining mat. volume, mat. positioning, intravenous hydration. De creasing mat. pain/anxiety. 1. Reposition pt to side. 2. Admin IV fluid bolus. 3. Admin 0.25mg terbutaline SQ. 4. Admin O2 10L via non rebreather face mask. - ANSWER List interven tions for tachysystole contractions. higher conc. to lower concentration. 1.Oxygen from maternal (higher) to fetal compartment (lower) to fetal hgb the n transported to fetal tissue. 2. CO2 returns to intervillous space by passive diffusion and is removed by the mat. venous system. - ANSWER Describe passive diffusion as related to the mater nal placental fetal system. Place her in lateral position, & increase IV fluids. If no improveme nt may need to give epi to increase vascular tone. - ANSWER Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What nursing interventions could you use to raise the client's blood pressure? Choose all that apply. A) Place the woman in a supine position. B) Place the woman in a lateral position. C) Increase intravenous (IV) fluids. D) Continuous Fetal Monitor E) Administer ephedrine per MD order systolic BP >= 140mm hg, a diastolic BP>= 90 mm hg or MAP of >=105 - ANSWE R Define maternal hypertension (gestational). 17g/dl, fetal hgb has a higher oxygen affinity than an adult to develop in an oxygen poor environment. The fetal circulatory pattern ensures blood with hi gher O2 and nutrition content is delivered to the vital organs (brain and heart) to tolerate the stress of labor. - ANSWER What is the normal expected value for a term fetal HGB? 1 vein, 2 arteries encased in wharton's jelly. O2 (high content) travels via the vein CO2 travels via 2 arteries back to placenta - ANSWER detail the umbilical cord A decrease of blood flow and O2 delivery to fetus & increases CO 2 level in fetus. Transient cord compression can be common in labor. Variable FHR decel's i s frequently associated with cord compression. - ANSWER Define cord compression. May lead to hypoxemia and fetal acidemia. The depth of vari able deceleration's is not enough to determine degree. Evaluate oxygenation through baseline heart rate characteristics through rate, variability and presence or absence of accelerations. - ANSWER Explain persistent or recurrent cord compression concerns and what to look at. A normal part of labor. As contractions build increased uterine pressure prevents blood from entering/leaving the intervillous space. During the peak the fetu s relies completely on its oxygen reserve (an aerobic challenge that is not an issue for a health fetus. - ANSWER Explain transient interruptions in fetal oxygen supple during l abor. Chronic deficiency of placenta function, usually from an interruptio n of oxygenation pathway due to abruption, mat. hypo or hypertension or other issues. I nfant is not tolerant of contractions. Can result in fetal grow restrictions (FGR) - ANSWER De fine Uteroplacental insufficiency (UPI) Assess baseline FHR Determine rhythms (regular vs irregular) ID accelerations and deceleration's but not the type of decelerat ion (early/late/variable) The fetal heartbeat is best heard over the fetal back. - ANSWER A uscultation of Fetal Heart Sounds tell you what information? Where is the best place to listen? Palpation to determine presentation and position of the fetus and aid in location of fetal heart sounds. Head=hard, round, movable object Buttocks=soft and irregular shape Back=smooth, hard surface felt on one side of the abdomen Irregular knobs and lumps on opposite side of abdomen may be ha nds, feet, elbows, and knees - ANSWER Leopold's Maneuvers Uses sonar to track the fetal myocardium & converts movement into sou nd. If placed incorrectly may pick up maternal heart. Perform Leopold's maneuvers to find fetal back, locate heartbeat, count FHR, check mothers pulse and compare. - ANSWER Handheld Fetal Doppler ID risk factors such as HTN (=vasoconstriction), Maternal smoking, abrupti on, post-term pregnancy, maternal diabetes and consider FHR characteristics - ANSWER How can you determine if the placenta is functioning optimally? 500-700ml to the uterus per minute, 80% is directed to the placenta - A NSWER How muchThe benefits of buying summaries with Stuvia:
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