NUR 252 Maternal and Newborn Review Questions and Correct Answers
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Course
NUR 252
Institution
NUR 252
What does fetal monitoring tell us? Fetal oxygenation, acid-base status of the fetus, ability of the CNS to regulate FHR
What is the best predictor of fetal health? Variability
What conditions can affect the fetal oxygen supply? 1. Maternal HTN/Hypotension 2. Hypovolemia 3. Anemia 4. Damaged vasc...
NUR 252 Maternal and Newborn Review
Questions and Correct Answers
What does fetal monitoring tell us? ✅Fetal oxygenation, acid-base status of the fetus,
ability of the CNS to regulate FHR
What is the best predictor of fetal health? ✅Variability
What conditions can affect the fetal oxygen supply? ✅1. Maternal HTN/Hypotension
2. Hypovolemia
3. Anemia
4. Damaged vasculature
**Alterations in fetal circulation - 2 vessel cord or other congenital abnormalities
What are potential consequences of Uterine Hypoxia/asphyxia? ✅Cerebral palsy
Epilepsy
RDS (Resp distress syndrome)
Renal damage
NEC (Necrotizing Enterocolitis)
Chronic brain impairment
What does the TOCO transducer measure and where is it placed? ✅Measure
Contraction or uterine activity. It cannot measure strength of contraction.
Top near the fundus
What does the ultra sound transducer do? ✅It detects the fetal heartrate and is placed
near the pubic bone on the lower portion of the pregnant belly.
*note: it requires ultrasound jelly
What is a IUPC? ✅Intrauterine pressure catheter
This can detect the strength or effectiveness of the contractions
How can a nurse measure the strength of a contraction without the IUPC? ✅palpating
the fundus:
-tip of nose- mild
-chin- moderate
-forehead-strong
,What is intermittent monitoring? ✅A Doppler US used to monitor HR one min before
during and one min after contraction
What are the 3 main important components of the Fetal Heart Monitoring Strip? ✅1.
Baseline Heart Rate
2. Variability
3. Periodic Changes
What are the kinds of variability of a FHR? ✅1. Absent
2. Minimal
3. Moderate
4. Marked
What are the kinds of periodic FHR changes? ✅1. Accelerations
2. Decelerations
-Early Decels (benign)
-Late Decels (Ominous)
-Variable Decels (Ominus)
-Prolonged Decels (Can be Ominous)
What is a normal baseline fetal heart rate range? ✅110-160 bpm (for 10 min)
What are periodic accelerations? ✅Transient increases above the FHR baseline
-Fetal movement
-Contractions
These are positive and reassuring they are increases that are at least 15 beats from
baseline and last for at least 15 seconds
What are periodic early decelerations? ✅-gradual onset before peak of contraction
with a return to baseline before the end of the contraction
-uniform in shape
-Caused by: head compression via contraction
-Not associated with Hypoxia
What do early decelerations look like? ✅
What is a periodic variable decelerations? ✅-shaped U, V, W "varied in shape"
-rapid decrease and increase in rate
-Variable in duration, timing depth not uniform
-Caused by cord compression
What are interventions for variable deceleration? ✅-position change
-vaginal exam (ck for prolapsed cord)
, -stop oxytocin
-anticipate amnioinfusion
-call dr
What is an amnioinfusion? ✅a transvaginal infusion of fluid to compensate for the loss
of amniotic fluid
What are late decelerations? ✅-decline of FHR begins after the contraction and is
delayed onset and delayed return to baseline
-Caused: Utero-placental insufficiency
What are interventions for late decelerations? ✅-lateral positioning
-stop oxytocin
-oxygen
-IV fluid bolus
-notify dr
-anticipate expedient delivery
How does maternal positioning affect fetal perfusion? ✅the baby can compress the
aorta and vena cava when mom is on her back. turning on the side helps to improve
circulation of these main vein/artery
How long does a prolonged deceleration have to go before it is now a "prolonged"?
✅greater than 2 min
What is a category I Fetal Heart Rate pattern? ✅Normal and strongly predictive of a
normal acid base balance status of the fetus
What is a category II FHR pattern? ✅Indeterminate: this is not predictive of abnormal
fetal acid-based status but requires continued surveillance and re-evaluation
There is no proof of good or bad it is unknown without more info.
What is a category III FHR pattern? ✅This is predictive of abnormal fetal-acid base
status at the time of strip.
This is proof of things going wrong and you should prepare to deliver
VEAL CHOP ✅V- Variable Decels - Cord Compression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placental insufficiency
What is gravida and para? ✅Gravida is number of pregnancies
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