Exam 2: NSG222 / NSG 222 (Latest 2024 / 2025 Update) Family Nursing | Review with Questions and Verified Answers | 100% Correct | Grade A - Herzing Q: Performing Leopold Maneuvers Answer: Leopold maneuvers are a method for determining the presentation, position, and lie of the fetus through the use...
NSG 222 - Family Nursing Exam 2 Question: Performing Leopold Maneuvers Answer: Leopold maneuvers are a method for determining the presentation, position, and lie of the fetus through the use of four specific steps. This method involves inspection and palpation of the maternal abdomen as a scr eening assessment for malpresentation. The flat palmar surfaces of the nurse's hands with the fingers together palpate the uterus A longitudinal lie is expected, and the presentation can be cephalic, breech, or shoulder. Each maneuver answers a question: · Maneuver 1: What fetal part (head or buttocks) is located in the fundus (top of the uterus)? · Maneuver 2: On which maternal side is the fetal back located? (Fetal heart tones are best auscultated through the back of the fetus.) · Maneuver 3: What is the presenting part? · Maneuver 4: Is the fetal head flexed and engaged in the pelvis? Question: Fetal Assessment During Labor and Birth Answer: A fetal assessment identifies well -being or signs that indicate compromise. The character of the amniotic fluid is assessed, but the fetal assessment focuses primarily on determining the FHR pattern. Umbilical cord blood analysis and fetal scalp stimulatio n are additional assessments performed as necessary in the case of questionable FHR patterns. Question: Analysis of Amniotic Fluid Answer: Amniotic fluid should be clear when the membranes rupture. Rupturing of membranes is either spontaneous or artifici al by means of an amniotomy, during which a disposable plastic hook (an Amnihook) is used to perforate the amniotic sac. Cloudy or foul -smelling amniotic fluid indicates infection. Green fluid may indicate that the fetus has passed meconium secondary to transient hypoxia, prolonged pregnancy, cord compression, intrauterine growth restriction (IUGR), maternal hypertension, diabetes, or chorioamnionitis; however, it is considered a normal occurrence if the fetus is in a breech presentation. If it is determine d that meconium - stained amniotic fluid is due to fetal hypoxia, the maternity and pediatric teams work together to prevent meconium aspiration syndrome, which can lead to respiratory distress. This would necessitate suctioning after the head is born befor e the infant takes a breath and perhaps direct tracheal suctioning after birth if the Apgar score is low. In some cases, an amnioinfusion (introduction of warmed, sterile normal saline or Ringer's lactate solution into the uterus) is used to dilute moderat e to heavy meconium released in utero to assist in preventing meconium aspiration syndrome. Question: Analysis of Fetal Heart Rate Answer: Monitoring of the FHR throughout labor and birth is essential to assure fetal well-being to optimize neonatal outco mes. Analysis of the FHR is one of the primary evaluation tools used to determine fetal oxygen status indirectly. FHR assessment can be done intermittently using a fetoscope (a modified stethoscope attached to a headpiece) or a Doppler (ultrasound) device, or continuously with an electronic fetal monitor applied externally or internally Question: Category 1 Fetal Heart Rate Answer: Category 1 Normal: Baseline 110 -160 bpm Baseline variability moderate Present or absent accelerations Present or absent early decelerations No late or variable decelerations Can be monitored with intermittent auscultation during labor Question: Category 2 Fetal Heart Rate Answer: Category 2 Indeterminate: Not predictive of abnormal fetal acid -base status, but requires evaluation and continued surveillance Fetal tachycardia (over 160) Fetal bradycardia (less than 110) not accompanied by absent baseline variability Absent baseline va riability not accompanied by recurrent decelerations Minimal or marked variability Recurrent late decelerations with moderate baseline variability Recurrent variable decelerations accompanied by minimal or moderate baseline variability, overshot, or should ers Prolonged decelerations over 2 min but less than 10 min Question: Category 3 Fetal Heart Rate Answer: Category 3 Abnormal: Abnormal fetus acid -base status, requires intervention Fetal bradycardia (less than 110) Recurrent late decelerations Recurrent variable decelerations (absent or declining) Sinusoidal Pattern (smooth, undulating baseline)
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