nur 221 exam 2 questions with verified answers 202
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NUR 221 Exam 2 Questions With Verified
Answers 2024/2025
Absent FHR variability
amplitude range undetected
Minimal FHR variability
1-5 bpm
Moderate FHR variability
6-25 bpm what we want
Marked FHR variability
>25 bpm
What is Leopolds maneuver?
Purpose: to determine presentation and position of fetus and aid in knowing where to position FHR
monitor
Method: explain procedure to pt, have woman empty bladder, wash hands, stand beside, facing
woman's head
4 maneuvers
What is normal FHR?
110-160 bpm
newborn is the same
bradycardia FHR and causes
<110 bpm
due to perfusion issues, body is in distress
Tachycardia FHR and causes
>160 bpm
if mom is tachy too could be due to infection
What is tachysystole?
greater than 5 contractions in 10 minutes and there is fetal tachycardia or late decelerations
When is the only time the baby is being perfused while in labor?
at rest (between contractions)
Frequency of contractions are measured from the...
peak of one contraction to the peak of the next contraction (or beginning to beginning)
Duration of contractions are measured from the...
start to finish of one contraction
,Intensity of contractions
strength of contraction at its peak (mild, moderate, strong)
How can you tell the intensity of a contraction by feeling?
cheek= resting
nose= mild
chin= moderate
forehead= strong
What is TOCO?
For uterine activity palpate uterus for contraction
Apply over fundus- make sure there is contact
GOES ON TOP
tells frequency and duration of contractions
Accelerations in FHR
an apparent, abrupt increase in the FHR above baseline.
-Greater than or equal to 32 weeks gestation
-The increase from onset to peak in <30 seconds
-The peak must be at least 15 bpm and last at least 15 seconds
-If <32 weeks gestation at least 10 bpm for 10 seconds
This is a normal good finding... Just document and continue to monitor.
Early Decelerations - Fetal Heart Rate
have a shape that is symmetrical, with a gradual decrease and return of FHR to baseline in association
with a contraction
-Means Head compression-normal labor process
**gradual decrease
**mirror image of contraction
JUST OBSERVE-prepare for delivery, document normal labor
nadir
the lowest point after the onset of an early/late deceleration and variable
Late decelerations - Fetal Heart Rate
have a shape that is symmetrical. with a gradual decrease and return of FHR to baseline in association
with a contraction
-is usually due to uteroplacental insufficiency and fetal hypoxia
-Although acidosis is not always present, may be associated with fetal acidosis
(EMERGENCY, THIS IS THE WORST DECEL)
-Intervention: POISON
Variable decelerations- Fetal Heart Rate
are an abrupt onset of decreased FHR below baseline that may occur with or after a contraction
-Is usually due to cord compression and may be associated with fetal acidosis.
, Intervention- Put mom on left side. Administer 10 L O2 nonrebreather
sinusoidal pattern- Fetal Heart Rate
differs from variability in that it is a smooth wave-like pattern of regular frequency and amplitude.
-Has cycle frequency of 3-5 minutes and lasts for 20 minutes of longer.
Intervention- Deliver fetus
POISON stands for
P- position change (to left side)
O- oxytocin off
I- increase IV rate (give extra fluids)
S- sterile vaginal exam
O- oxygen (10 L nonrebreather)
N- notify MD or CNM
Baseline FHR
Average FHR in 10 minute window. Does not include accelerations or decelerations and it must be in
between contractions. There must be at least 2 minutes of identifiable baseline.
Prolonged deceleration- Fetal heart rate
greater than 15 bpm and lasts 2-10 minutes from onset to return to baseline
-a prolonged decel that lasts >10 minutes is considered a change in baseline
Kick counts (fetal movement counting)
How many kicks in a 1 hour period of time
should be the same time each day
should be after eating
don't do it when the baby is sleeping
- notify dr. if less than 10 kicks in 1 hour period
Non-stress test (NST)
-ultra sound record movement, doppler measures fetal HR, assess fetal well being
-Reactive if 2 or more acceleration with 15bpm lasting 15 seconds for 20 min with return to baseline
-if less than 32 weeks 10 bpm lasting 10 seconds
-if the test is nonreactive the patient should have a biophysical profile (BPP)
Biophysical Profile (BPP)
uses a real-time ultrasound for visualization of physical and physiological characteristics of a fetus.
5 variables assessed
1. Fetal breathing
-Score 2- at least one episode of fetal breathing movements of at least 30 second duration in a 30
minute observation
-Score 0- Absent fetal breathing or less than 30 seconds in 30 minutes
2. Fetal movements
-Score 2- at least 3 trunk/limb movements in 30 minutes
-Score 0- Fewer than 3 episodes of trunk/limb movements
3. Fetal tone
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