NURS 450 Exam 3 Practice Questions
and Correct Answers
Why measure fetal heart rate? ✅fetal heart rate changes may indicate lack of oxygen
to fetus or excessive bleeding affecting the fetus
-Goals: reduce neonatal death, and avoid neurologic/brain injury
When is measuring fetal heart rate necessary? ✅1. Signs of fetal distress
2. Epidural analgesia
3. Labor induction
What is electronic fetal monitoring? ✅measures the fetal heart rate and uterine
contractions
2 options:
- External vs internal
-Intermittent vs continuous
Ultrasound transducer/Doppler ✅-external monitoring
-records the fetal heart rate
-gives printed record of heart rate and contractions, and makes heart sounds audible
Tocodynamometer ✅-external monitoring
-records the frequency and duration of the contractions
-gives printed record of heart rate and contractions, and makes heart sounds audible
Fetal scalp electrode (FSE) ✅-internal monitoring
-attached to the baby's scalp to record the electrical conduction of the fetal heart
-requires rupture of membranes
Intrauterine pressure catheter (IUPC) ✅-internal monitoring
-requires rupture of membranes
-thin tube inserted inside the uterine cavity to measure duration, frequency, and strength
of uterine contractions
Internal vs external methods ✅-may be used interchangeably
Advantages of fetal monitoring for the mother ✅-constant feedback on fetal heart rate
may be reassuring
-visible evidence of uterine contractions when the woman has an epidural and cant feel
them
-permanent record of fetal heart rate and uterine contractions
Disadvantages of fetal monitoring for the mother ✅-restricts position and movement
, -may cause unnecessary interventions
-machine becomes focus of attention
-possible need for early rupture of membrane
-possible infection
Advantages of fetal monitoring for the baby ✅-may detect risk to baby's health during
labor
Disadvantages of fetal monitoring for the baby ✅-possible infection from internal
monitoring
-possible fetal distress from artificial rupture of membranes of FSE insertion
-possible unnecessary interventions such as assisted or surgical delivery
Intermittent auscultation ✅-listening to the fetal heart at regular intervals using a
handheld Doppler
-alternative to continuous electronic FHR monitoring
-determined over one to two minutes at intervals of 5-30 minutes depending on the
stage of labor
-leads to fewer interventions
Continuous electronic fetal monitoring ✅-monitoring both the fetal heart rate and
contractions continuously
-mother must stay in bed
-no evidence of improved outcomes
-significantly increases chances for a c-section or forceps delivery
-not recommended for low risk women in labor
-beneficial for high risk patients (preeclampsia, growth restriction, type 1 diabetes,etc)
continuous vs intermittent ✅-neither achieve the goals (reduced neonatal death, brain
injury)
-one doesn't perform better than the other
-continuous electronic fetal monitoring led to higher surgical rates without any neonatal
benefit
Normal fetal heart range ✅110-160 BPM
Leopold's maneuver ✅A way to determine the position of the fetus inside the woman's
uterus
External version ✅A procedure used to turn a fetus from a breech position into a head
down position before labor begins
Fetal kick counts ✅-Fetal movement decreased with low oxygen intake
-Counting fetal movement helps to determine if the fetus is getting enough oxygen
-Indicator of fetal well-being
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