Questions and Answers
What is the first goal in the treatment of variable decelerations caused by cord compression?
Which of the following nursing interventions is specifically aimed at alleviating pressure from a compressed umbilical cord?
In the VEAL CHOP POOS mnemonic, what does 'VEAL' correspond to regarding fetal heart rate patterns?
What characterizes Category II fetal heart rate patterns?
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What is an appropriate nursing action if variable decelerations are identified during labor?
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What characterizes Category III Fetal Heart Rate (FHR) patterns?
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Which deceleration is associated with a slow return to baseline and is a critical concern?
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What is the most appropriate nursing intervention for tachysystole?
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Which of the following statements regarding FHR variability is true?
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In the context of fetal heart rate monitoring, what defines a recurrent late deceleration?
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Which fetal heart monitoring method is considered the most accurate for detecting fetal heart characteristics?
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What is the normal range for baseline fetal heart rate?
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How is contraction intensity most accurately measured?
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What represents an effective contraction using Montevideo units (MVU)?
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In a breech presentation, where is the fetal heart rate best assessed on the maternal abdomen?
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What is the definition of tachysystole in the context of uterine activity?
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What is the role of the tocodynamometer (toco) in fetal monitoring?
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Which of the following interventions is not appropriate for managing tachysystole?
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What is defined as the highest point of a contraction during a fetal heart rate event?
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Which condition is identified when the fetal heart rate exceeds 160 bpm over a 10 minute strip?
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What does an absence of variability in fetal heart rate indicate?
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Late decelerations in fetal heart rate are characterized by their timing in relation to contractions. When do they occur?
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Which of the following describes the type of fetal heart rate variability that occurs when the FHR fluctuates between 6 and 25 bpm?
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What maternal condition is commonly associated with fetal bradycardia, where the fetal heart rate falls below 110 bpm?
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What is classified as a visually apparent abrupt increase in fetal heart rate above the baseline?
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Which type of variability indicates that both branches of the central nervous system are functioning and the fetus is receiving adequate oxygen?
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What is the primary cause of delayed deceleration in fetal heart rate (FHR) during labor?
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Which nursing intervention is NOT appropriate in the case of delayed deceleration due to uteroplacental insufficiency?
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Which statement about early decelerations of FHR is accurate?
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Variable decelerations in FHR are typically characterized by which of the following?
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What is a common intervention for managing uteroplacental insufficiency during labor?
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Which of the following describes the pathophysiology behind early decelerations of the FHR?
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During which type of deceleration does the nadir and recovery coincide with the contraction phase?
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How is uteroplacental insufficiency exacerbated during labor?
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Study Notes
Fetal Heart Monitoring Overview
- Ultrasonography measures fetal heart rate (FHR) via an external belt on the maternal abdomen.
- Tocotransducer monitors contraction frequency and duration, not intensity, by being placed on the fundus of the uterus.
- Intrauterine pressure catheter (IUPC) measures contraction intensity in mm Hg, effective contractions range from 50-70 mm Hg.
- Fetal spiral electrode (FSE) provides the most accurate assessment of FHR, used internally when external methods are inadequate.
- Montevideo units (MVU) assess effective labor by calculating the sum of uterine pressure changes during contractions, with 250 MVU considered effective.
Uterine Activity
- Normal uterine activity features up to 5 contractions in 10 minutes, lasting 60-90 seconds each.
- Tachysystole is characterized by more than 5 contractions in 10 minutes; management includes stopping Pitocin, hydration, and repositioning.
Fetal Heart Rate (FHR) Norms
- Average baseline FHR ranges from 110-160 bpm.
- The assessment of FHR over a 10-minute segment is crucial. Use 5 bpm increments for averaging.
- Understanding FHR strips includes recognizing contraction (bottom strip) and FHR (top strip) with time segments clearly marked.
FHR Variability
- Variability indicates interactions between the sympathetic and parasympathetic nervous systems; it is a sign of adequate fetal oxygenation.
- Types of variability:
- Absent: undetectable variability
- Minimal: < 5 bpm
- Moderate: 6-25 bpm
- Marked: > 25 bpm
Accelerations and Decelerations
- Accelerations: increases in FHR by at least 15 bpm lasting 15 seconds, or 10 bpm for 10 seconds pre-32 weeks.
Types of Decelerations
- Late Decelerations: occur after the contraction peak indicating uteroplacental insufficiency. Management involves improving placental blood flow.
- Early Decelerations: gradual decreases coinciding with contractions due to head compression; typically benign.
- Variable Decelerations: abrupt decreases often due to umbilical cord compression; management focuses on relieving cord pressure.
FHR Pattern Interpretation
- Category I: Normal FHR (110-160 bpm), moderate variability, may have early decelerations, does not need intervention.
- Category II: Indeterminate FHR needing further evaluation; could manifest as tachycardia/bradycardia or variable decelerations.
- Category III: Abnormal FHR signaling an adverse physiological response; includes absent variability and recurrent late decelerations requiring intervention.
Important Mnemonic
- VEAL CHOP POOS: Useful for remembering the types of FHR decelerations and their causes.
Exam Preparation Points
- Understand the different types of decelerations; causes and nursing interventions required for each.
- Familiarize with identifying deceleration types through scenario-based understanding.
- Recognize the terminology: acme (highest point of contraction) and nadir (lowest point of deceleration).
- Learn about tachysystole and its required interventions for effective management.
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Description
This quiz explores fetal heart rate (FHR) monitoring techniques, focusing on ultrasound and tocodynamometry. It covers how to properly position monitoring devices based on fetal presentation and the significance of accurate FHR assessment. Test your knowledge on these essential prenatal monitoring methods!
