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11/8/2024 12:08 PM
NURS352 Exam Study Guide
Antepartum Fetal Surveillance - answer✔fetal movement assessment, nonstress test, contraction stress
test, biophsycial profile, umbilical artery doppler velocimetry, ultrasound, amniocentesis, chorionic villi
sampling
maternal conditions that warrant additional fetal surveillance - answer✔antiphospholipid syndrome,
hyperthyroidism, hemoglobinopahties, cyanotic heart disease, lupus, chronic renal disease, type 1
diabetes, hypertensive disorders,
pregnancy conditions that warrant additional fetal surveillance - answer✔pregnancy induced
hypertension, decreased fetal movement, oligohydramnios, polyhydramnios, intrauterine growth
restriction, postterm pregnancy, isoimmunixation, fetal anomalies, previous fetal demise, multiple
gestation
fetal movement assessment - answer✔kick counts, done after dinner with mother resting on side with
10 movements in 2 hours and no smoking for 2 hours before counting
advatages of fetal movement assessment - answer✔low tech, can be done daily, done on all
pregnancies, reassuring for mother
intrapartum fetal assessment - answer✔electronic fetal monioring- external or internal monitoring,
intrauterine pressure catheter
components of EFM interpretation - answer✔baseline, variability, periodic changes
3 tier fetal heart rate interpreteation - answer✔3 categories
variability in EFM - answer✔variation of FHR around baseline of 5-10 which indivates parasympathetic
system, chemoreceptors, baroreceptors and cardiac responsiveness health
acceleration in EFM - answer✔up 10-25 of baseline which indiates sympathetic system
what decreases variability - answer✔prematurity-specifically before 28 weeks, hypoxia, congenital heart
anomalies, fetal tachycardia, fetal metabolic acidosis, CNS depressants, , fetal sleep
cycles,betamethasone, neurological abnormality
when should variability be present - answer✔after 32 weeks
Absent variability - answer✔amplitude range undetectable
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minimal variability - answer✔<5 bpm
moderate variability - answer✔6-25 bpm
Marked variability - answer✔>25 bpm
most significant sign of fetal compromise - answer✔Variability in FHR that is persistently absent or
minimal
normal range hr fetal - answer✔120-160
fetal bradcardia - answer✔less than 120
causes of bradycardia in fetus - answer✔heart block, occiput posterior, transverse position, serious fetal
compromise
tachycardia in fetus - answer✔over 160
mild tachycardia in fetus - answer✔160-180
severe tachycardia in fetus - answer✔over 180
tachycardia over 200 bpm in fetus - answer✔usually due to congenital anomaies or fetal
tachyarrhythmia
persisent tachycardia w fetal hypoxia, fetal anemia, maternal fever suggests - answer✔chorioamnionitis
category 1 - answer✔Baseline 110-160, variability is moderate, accelerates present or absent, early
decelerations present or absent, and variable or late decelerations absent
what does category 1 mean - answer✔Not a risk to a fetus - normal acid-base status at time, routine
care
category 2 - answer✔tachy or brady cardia w/o absent variability, minimial variability, absent variability
w/o recurrent decelerations, marked variability, absence of accelerations after stim, recurrent variable
decelerations with miniminal or mod varaibility, prolonged decelation from 2-10 min, reccurent late
decelerations w mod variability, variable decelerations w slow return to baseline or overshoot
what does category 2 mean - answer✔indeterminate, not predictive of abnormal fetal acid base status
but requires continued monitoring
category 3 - answer✔sinusoidal pattern or absent variabiilty w recurrent late decelerations, recurrent
variable decelerations, or bradycardia
what does category 3 mean - answer✔abnormal fetal acid base status, efforts to expedite can resolve
underlying cause
deceleration classifications - answer✔early, variable, late, prolonged
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early deceleration - answer✔FHR decrease before contraction, mirror image of contraction and EHR
late deceleration - answer✔The slowing of the fetal heart rate after the onset of a uterine contraction
and persisting after the contraction ends.
VEAL CHOP - answer✔V- Variable C- Cord Comphression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placenta insuff
types of reduced placental exchange - answer✔excessive contractions, hypotension, maternal
hypoxemia, hypertension, diabetes IUGR, abruption
IUGR - answer✔intrauterine growth restriction
late deceleration picture - answer✔
early deceleration picture - answer✔
variable deceleration picture - answer✔
variable deceleration - answer✔Periodic change in fetal heart rate caused by umbilical cord
compression; decelerations vary in onset, occurrence, and waveform. usually V or W shaped
severe variable deceleration with overshoot - answer✔variability preserved and shows good reserve
fetal distress nursing interventions - answer✔reposition patient, turn off pitocin, increase IV rate, admin
O2, assess labor and scalp stimulation, assess for cord prolapse, notify provider, prepare for labor and
resus
non stress test - answer✔electronic monitoring w/o contractions
what happens to heart rate when fetus moves - answer✔accelerates
loss of reactivity w/o contractions indicates - answer✔sleep cycle or CNS depression or fetal acidosis
non stress test results - answer✔reactive or nonreactive
reactive in non stress test - answer✔2 or more accelerations of 15bpm for 15 seconds w/in 20 minutes-
heart is reactive to movement
nonreactive in non stress test - answer✔no FHR accelerations or accelerations less than 15 pbm for 40
min period
contraction stress test - answer✔a stress test used to evaluate the ability of the fetus to tolerate the
stress of labor and delivery, FHR changes in contractinos