Fetal Assessment During Labor
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Questions and Answers

Which condition is indicated by the acronym 'P' in the VEAL CHOP mnemonic?

  • Persistent Hypotension
  • Pulmonary Complications
  • Placental Issue/Distress (correct)
  • Preeclampsia

    • What must be true for continuous internal monitoring to be initiated?

  • Client must be in a standing position
  • Oxytocin must be administered
  • Cervix must be dilated to at least 2-3 cm (correct)
  • Maternal diabetes must be present

    • What is a significant disadvantage of continuous internal monitoring?

  • Membranes must be ruptured (correct)
  • Prevents misinterpretation of FHR patterns
  • It allows immediate fetal response assessment
  • Improves maternal motion during labor

    • Which of the following interventions is NOT recommended for managing maternal hypotension during labor?

    <p>Increase oxytocin administration</p> Signup and view all the answers

    What is an advantage of continuous internal monitoring?

    <p>It offers early detection of abnormal FHR patterns</p> Signup and view all the answers

    Where should fetal heart tones be assessed in a vertex presentation?

    <p>Below the umbilicus in the right or left lower quadrant</p> Signup and view all the answers

    What is a critical consideration for patient positioning during Leopold maneuvers?

    <p>A rolled towel should be placed under the right or left hip</p> Signup and view all the answers

    Which fetal heart rate range is considered normal?

    <p>110 -- 160 beats per minute</p> Signup and view all the answers

    What is a possible intervention for variable decelerations?

    <p>Reposition the client</p> Signup and view all the answers

    What can cause late decelerations in fetal heart rate?

    <p>Uteroplacental insufficiency</p> Signup and view all the answers

    What is a disadvantage of continuous electronic fetal monitoring?

    <p>Not suitable for patients with HIV</p> Signup and view all the answers

    Which of the following describes variable decelerations?

    <p>Associated primarily with umbilical cord compression</p> Signup and view all the answers

    What fetal heart rate finding represents good variability?

    <p>Strong variability</p> Signup and view all the answers

    What potential complication is associated with continuous internal monitoring?

    <p>Fetal trauma</p> Signup and view all the answers

    Which of the following interventions is NOT advised in cases of maternal hypotension?

    <p>Administer oxytocin</p> Signup and view all the answers

    What does the 'O' in the VEAL acronym indicate?

    <p>OK; Now Worries</p> Signup and view all the answers

    Which of the following is a disadvantage of continuous internal monitoring?

    <p>Requires ruptured membranes</p> Signup and view all the answers

    Which maternal condition is associated with a heightened risk during pregnancy?

    <p>Preeclampsia</p> Signup and view all the answers

    What is a primary intervention for addressing variable deceleration?

    <p>Reposition the client</p> Signup and view all the answers

    In what scenario is continuous electronic fetal monitoring contraindicated?

    <p>If the mother is diagnosed with HIV</p> Signup and view all the answers

    What does a late deceleration in fetal heart rate indicate?

    <p>Uteroplacental insufficiency</p> Signup and view all the answers

    What should be done when assessing fetal heart tones for a breech presentation?

    <p>Assess above the umbilicus</p> Signup and view all the answers

    Which of the following could cause variable deceleration?

    <p>Short umbilical cord</p> Signup and view all the answers

    What is the recommended position for a mother undergoing Leopold maneuvers?

    <p>Lying supine with a pillow under the head and knees slightly flexed</p> Signup and view all the answers

    What is a key intervention for addressing maternal hypotension during labor?

    <p>Put client in a side lying position</p> Signup and view all the answers

    What is a significant risk associated with continuous internal monitoring?

    <p>Potential risk of infection</p> Signup and view all the answers

    Which condition can lead to complications such as fetal trauma during labor?

    <p>Misinterpretation of FHR patterns</p> Signup and view all the answers

    What does the 'V' in the VEAL acronym specifically refer to?

    <p>Variable deceleration</p> Signup and view all the answers

    What maternal condition is closely associated with the potential for placental issues?

    <p>Maternal diabetes</p> Signup and view all the answers

    What should be considered for fetal heart tones assessment in a breech presentation?

    <p>They should be assessed above the umbilicus.</p> Signup and view all the answers

    What is an appropriate client positioning during Leopold maneuvers?

    <p>Supine with a pillow under the head and knees slightly flexed.</p> Signup and view all the answers

    Which fetal heart rate finding indicates strong variability?

    <p>FHR fluctuating widely without a pattern.</p> Signup and view all the answers

    What intervention is appropriate in case of variable deceleration due to umbilical cord compression?

    <p>Reposition the client.</p> Signup and view all the answers

    What can cause late decelerations during fetal monitoring?

    <p>Uteroplacental insufficiency.</p> Signup and view all the answers

    Which method is recommended for monitoring fetal heart rate during contractions?

    <p>Continuous electronic fetal monitoring.</p> Signup and view all the answers

    What fetal heart rate range is considered abnormal for a healthy fetus?

    <p>160 - 180 BPM.</p> Signup and view all the answers

    Which condition is a contraindication for continuous electronic fetal monitoring?

    <p>Maternal HIV infection.</p> Signup and view all the answers

    Study Notes

    Fetal Assessment During Labor

    • Leopold Maneuvers: Used to determine fetal lie, presentation, attitude, and descent.
    • Presenting Part: Part of the fetus that enters the pelvis first.
    • Fetal Lie: Relationship of the fetal spine to the maternal spine (longitudinal or transverse).
    • Fetal Attitude: Relationship of fetal body parts to each other (flexed, extended).
    • Degree of Descent: How far the presenting part has descended in the pelvis.
    • Vertex presentation: Fetal head is the presenting part; fetal heart tones should be assessed below client's umbilicus, in the right or left lower quadrant.
    • Breech presentation: Buttocks or feet are the presenting part; fetal heart tones should be assessed above client's umbilicus in the right or left upper quadrant.
    • Empty Bladder: Essential for accurate assessment of fetal position and presentation.
    • Positioning: Positioning of the client (supine with knees slightly flexed, a pillow under the head, and a towel placed under the hip to displace the uterus).
    • Palpation: Physical examination of the abdomen to assess fetal position.
    • Fetal Heart Rate (FHR): Assessment of the fetal heart rate for normal findings.
    • Documentation: Document maternal and fetal response to labor.

    Continuous Electronic Fetal Monitoring (FHR)

    • FHR range: 110-160 bpm.
    • Advantages: Early detection of abnormal FHR patterns, accurate assessment of FHR, accurate assessment of uterine contractions, allowing greater maternal movement.
    • Disadvantages: Can't be utilized on patients with HIV, membranes must be ruptured, cervix dilated to at least 2-3 cm, potential risk of injury, risk of infection.
    • Indications, considerations, and ongoing care: Preparing the patient, monitoring during labor, and follow up considerations.

    Fetal Assessment: External/Internal Monitoring During Labor

    • Early decelerations: Fetal head compression during contractions; no intervention necessary.
    • Variable decelerations: Umbilical cord compression; reposition the client, discontinue oxytocin, administer supplemental oxygen, perform vaginal exam, consider amnioinfusion.
    • Late decelerations: Uteroplacental insufficiency; Put client on side lying position, give IV fluids, discontinue oxytocin, elevate client legs, notify provider, prepare for vaginal birth or Cesarean birth.
      • Causes of late decelerations: Uteroplacental insufficiency; hypotension, placenta previa, abruptio placentae, uterine tachysystole with oxytocin, preeclampsia, late or post term pregnancy, maternal diabetes, etc..
    • Variability: Fluctuations of the baseline FHR; good/strong or bad/ could be baby sleeping.

    Considerations

    • FHR after contractions: Slowing of FHR after contractions: possible uteroplacental insufficiency.
    • Aseptic technique: Essential to prevent maternal/fetal infection.
    • Maternal/fetal infection: Possible complications of prolonged or mismanaged labor.
    • Fetal trauma: Possible complication during labor and delivery, and important to note potential problems.
    • Supine hypotension: A possible problem that can occur when the client is in a supine position.

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    Related Documents

    Fetal Assessment During Labor Chapter 13 PDF

    Description

    This quiz covers the essential concepts of fetal assessment during labor, including Leopold Maneuvers, fetal presentations, and fetal heart tone assessments. Understand the significance of fetal lie, attitude, and descent in relation to effective labor management. Ideal for nursing students and healthcare professionals preparing for obstetric practice.

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