1 awhonn fetal heart monitoring basics questions w
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Basic Fetal Heart Monitoring
Basic Fetal Heart Monitoring
Basic Fetal Heart Monitoring
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1 AWHONN Fetal Heart monitoring basics
a) Frequency
b) Duration - ANS-Which contraction characteristics can be assessed with a
tocodynamometer?
a) Frequency
b) Duration
c) Intensity
Uterus - ANS-All Fetuses of mothers in labor experience an interruption of the
oxygenation pathway at which point?
a) Throughout labor and delivery unless the use of a more accurate method is clearly
indicated - ANS-The FHR can be monitored using doppler ultrasound?
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 - ANS-What is the normal range for FHR base line 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 hemoglobin in RBC's to
bloodstream in uterus. Uterus to spiral arteries to placenta to intervillous space to travel
via simple diffusion into the villi. The capillaries to the umb. vein to the fetus.
The umb. artery sends waste (CO2) to the intervillous space to the mothers venous
system. - ANS-Trace the flow of oxygen from mother to fetus and back.
,lateral recumbent or semi-Fowler's - ANS-By what % does maternal cardiac output
increase above the non-pregnant state and what position helps this uteroplacental blood
flow?
>5 contractions in 10 min (more frequently than Q 2 min) averaged over 30 min window.
Caused by oxytocin, aminoinfusion or in rare cases spontaneously. - ANS-Define
tachysystole contractions and the cause of.
Maintaining mat. volume, mat. positioning, intravenous hydration. Decreasing 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. - ANS-List interventions for
tachysystole contractions.
higher conc. to lower concentration.
1.Oxygen from maternal (higher) to fetal compartment (lower) to fetal hgb then
transported to fetal tissue.
2. CO2 returns to intervillous space by passive diffusion and is removed by the mat.
venous system. - ANS-Describe passive diffusion as related to the maternal placental
fetal system.
Place her in lateral position, & increase IV fluids. If no improvement may need to give
epi to increase vascular tone. - ANS-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 - ANS-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 higher O2 and nutrition
content is delivered to the vital organs (brain and heart) to tolerate the stress of labor. -
ANS-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 - ANS-detail the umbilical cord
A decrease of blood flow and O2 delivery to fetus & increases CO2 level in fetus.
Transient cord compression can be common in labor. Variable FHR decel's is frequently
associated with cord compression. - ANS-Define cord compression.
May lead to hypoxemia and fetal acidemia. The depth of variable deceleration's is not
enough to determine degree. Evaluate oxygenation through baseline heart rate
characteristics through rate, variability and presence or absence of accelerations. -
ANS-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 fetus relies completely
on its oxygen reserve (an aerobic challenge that is not an issue for a health fetus. -
ANS-Explain transient interruptions in fetal oxygen supple during labor.
Chronic deficiency of placenta function, usually from an interruption of oxygenation
pathway due to abruption, mat. hypo or hypertension or other issues. Infant is not
tolerant of contractions. Can result in fetal grow restrictions (FGR) - ANS-Define
Uteroplacental insufficiency (UPI)
Assess baseline FHR
Determine rhythms (regular vs irregular)
ID accelerations and deceleration's but not the type of deceleration (early/late/variable)
The fetal heartbeat is best heard over the fetal back. - ANS-Auscultation 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 hands, feet, elbows,
and knees - ANS-Leopold's Maneuvers
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