NUR 221 Exam 2 Questions With Verified Answers 2024/2025
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NUR 221
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NUR 221
NUR 221 Exam 2 Questions With Verified Answers 2024/2025
Daily Fetal Movement Count (DFMC)
KICK COUNT
-at home, non invasive, inexpensive
-frequently monitors fetus who has complications related to fetal oxygenation
-Decreased fetal Movement = HYPOXEMIA
DFCM how to
count once a day for 6...
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NUR 221 Exam 2 Questions With Verified
Answers 2024/2025
Daily Fetal Movement Count (DFMC)
KICK COUNT
-at home, non invasive, inexpensive
-frequently monitors fetus who has complications related to fetal oxygenation
-Decreased fetal Movement = HYPOXEMIA
DFCM how to
count once a day for 60 minutes
or
count fetal activity two or three times daily(AFTER MEALS/ BEFORE BEDTIME) for 2 hours or until 10
movements are counted
or
all fetal movements in a 12 hour period each day until minimum of 10 counts
IF DECREASED FETAL ACTIVITY
-nonstress test is performed
DFCM safety alert
-baby should always be moving
Decreased movement
-baby may be asleep during fetal sleep cycle
-if woman is taking medications that depress CNS
-drinking alcohol
-smoking
DO NOT DECREASE AS WOMEN NEARS TERM
Maternal and fetal indications for antepartum testing
-Diabetes
-hypertension
-preeclampsia
-systemic lupus
-renal disease
-cyanotic heart disease
-fetal growth restriction
-Oligohydramnios
-late-term/post term gestation
-previous still birth
-decreased fetal movement
Biophysical profile
REAL TIME ULTRASOUND/ PHYSICAL EXAM
USED IN LATE SECOND or THIRD TRIMESTER
-noninvasive assessment of fetus based on acute or chronic fetal disease
INCLUDES
-Amniotic fluid volume (reflects adequacy of placental function)
-Fetal breathing movement
-fetal movements
-fetal tone
-nonstress test (FHR)
REFLECT CNS
,Biophysical profile scoring
FETAL BREATHING MOVEMENTS (FBM)
score 2 = one episode of breathing movement of at least 30 second duration in 30 min observation
score 0= less than 30 second duration in 30 min
FETAL MOVEMENT
score 2= at least 3 movements in 30 mins
score 0= less than 3 movements in 30 mins
FETAL TONE
score 2= 1 episode of active extension with return flexion
score 0= absence of movement
AMNIOTIC FLUID VOLUME
score 2= deepest pocket > 2 cm
score 0= deepest pocket <2 cm
NONSTRESS TEST
Score 2= reactive
Score 0= nonreactive
BPP scoring
8-10 NORMAL
Modified biophysical profile (mBPP)
shortens testing time
amniocentesis
at or after 15 weeks gestation
-obtain amniotic fluid (contains fetal cells)
-needle is inserted into uterus fluid is drawn through syringe
AVOID 13-14 WEEKS OF GESTATION (high risk of pregnancy loss/fluid leakage/clubfoot( fetal talipes
equinovarus))
amniocentesis indications
prenatal diagnosis of
-genetic disorders
-congenital anomalies
-neural tube defects
-assessment of pulmonary maturity
-fetal hemolytic disease
Genetic concern/indications for use of amniocentesis
families with certain characteristics have increase risk of child with genetic disorders
-Older maternal age (age 35 or greater
-Older paternal age (40-50 years)
-parents who have or carry sickle cell anemia, Tay-sachs disease, cystic fibrosis
-women with prior child structural birth defects
-structural defect identified by ultrasound
-women with prior child chromosomal abnormality
AFP levels
High AFP levels in amniotic fluid help confirm diagnosis of NTD such as Spina bifida/ anencephaly/
abdominal wall defect such as omphalocele
RESULTS FROM INCREASED LEAKAGE OF CEREBROSPINAL/ABDOMINAL FLUID INTO AMNIOTIC FLUID
Fetal lung maturity
Examined by Amniocentesis (amniotic fluid)
Non-stress test (NST)
FIRST STEP= LEAST INVASIVE
-normal fetus produce heart patterns in response to (FHR/contractions/movements/stimulation)
-Normal= reactive
-fetus who do not produce normal test results area not compromised/ they fail to exhibit
accelerations ( due to sleep state)
-performed fast and in outpatient setting/ noninvasive
NST procedure
seated in reclining chair/ semi-fowler position
-recorded using doppler transducer
-Tocodynamometer is applied to detect contractions/movement (external contraction monitor)
-traced for signs of fetal activity/ concurrent accelerations of FHR
-if no movement women may be asked to press button when movement is felt
Completed in 10-15 minutes
Vibroacoustic stimulation (buzzing) may be used if fetus is sleep (wakes up fetus)
reactive NST following vibroacoustic stimulation is reliable for predicting fetal well-being
Interpretation of NST
either reactive (normal) or nonreactive (bad)
if test does not meet criteria in 40 minutes Biophysical profile is performed
, repeated twice weekly for remainder of pregnancy
Vibroacoustic stimulation (VAS)
tests FHR
-performed with NST
-buzz/stimulate fetus
-fetus monitored for 10-20 minutes before stimulation for baseline FHR
-activated for 3 seconds or less on maternal abdomen over fetal head
Hypertension in pregnancy
Three most common types
-gestational hypertension
-preeclampsia
-chronic essential hypertension (before pregnancy)
Gestational hypertension
systolic 140 or more/ diastolic 90 or more
-RECORDED ON TWO SEPARATE OCCASIONS AT LEAST 4 HOURS APART AFTER 20 WEEKS GESTATION
IN WOMEN WITH PREVIOUSLY NORMAL BP
-resolves after giving birth or 6-12 months to resolve
-may go on to develop preeclampsia
Preeclampsia
hypertension and proteinuria develop after 20 weeks gestation
in women who never had either
-symptoms can develop after giving birth
-leading cause of mortality/morbidity
diagnosis of preeclampsia
eliminated from criteria
-amount of proteinuria
-oliguria
-IUGR
Diagnosis: in absence of proteinuria
-hypertension
-thrombocytopenia
-impaired liver function
-persistent upper right quadrant/ epigastric pain
unresponsive to medication
-progressive renal insufficiency
-pulmonary edema
-cerebral symptoms (headache) not responding to analgesia
Eclampsia
onset of seizure activity/ coma in woman with preeclampsia
-can occur before during or after brith
-can occur 48 hour postpartum (mother may be home by then)
Chronic hypertension
present before pregnancy
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