Podcast
Questions and Answers
What is the primary function of the ultrasound in fetal heart monitoring?
In which presentation is the fetal heart rate best assessed in the lower quadrant of the maternal abdomen?
What is considered an effective contraction intensity measured by the IUPC?
What represents a normal uterine activity pattern during labor?
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What intervention is appropriate if tachysystole occurs?
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What measurement indicates effective labor in terms of Montevideo units (MVU)?
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The Fetal Spiral Electrode (FSE) is primarily used for which purpose?
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How is the baseline fetal heart rate defined?
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What is the primary goal of treatment for cord compression during labor?
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Which of the following interventions is NOT recommended for alleviating cord compression?
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In the context of FHR patterns, which category indicates a favorable physiological response with no need for intervention?
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What does the presence of variable decelerations typically indicate?
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Which of the following patterns is indicative of requiring further evaluation in fetal heart rate monitoring?
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What does the term 'acme' refer to in the context of contractions?
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What is the threshold for tachycardia in a fetal heart rate strip?
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Which of the following maternal causes can contribute to bradycardia?
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What type of variability is indicated by a flat line in fetal heart rate monitoring?
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How is an acceleration in fetal heart rate defined before 32 weeks of gestation?
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What is the interpretation of late decelerations in fetal heart rate monitoring?
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What does a 'marked' variability indicate in fetal heart rate patterns?
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Which of the following is NOT a fetal cause of tachycardia?
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What is a characteristic of a fetal heart rate (FHR) that categorizes it as Category III?
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Which of the following is a defining feature of recurrent variable decelerations?
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Which nursing intervention is appropriate for managing tachysystole in a patient receiving Pitocin?
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What would you expect to find during the acme phase of a deceleration?
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Which condition is indicated by the absence of accelerations after fetal stimulation?
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What best describes the timing of the nadir in decelerations associated with uteroplacental insufficiency?
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Which of the following is NOT a nursing intervention for managing uteroplacental insufficiency?
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What is the underlying cause of early decelerations in fetal heart rate?
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What defines variable decelerations in fetal heart rate monitoring?
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What is a correct nursing consideration for managing early decelerations during labor?
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What is the primary goal of nursing interventions for uteroplacental insufficiency?
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Which statement is true about variable decelerations?
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Why is left lateral positioning recommended for improving placental blood flow?
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Study Notes
Fetal Heart Monitoring Methods
- Ultrasound: External device on maternal abdomen measuring fetal heart rate (FHR); best assessed on fetal back.
- Tocotransducer: External device measuring contraction frequency and duration; does not assess intensity.
- Intrauterine Pressure Catheter (IUPC): Measures contraction intensity in mm Hg; effective contractions range from 50-70 mm Hg.
- Fetal Spiral Electrode (FSE): Internal device for accurate fetal heart rate monitoring; used when external devices are inadequate.
- Montevideo Units (MVU): Measurement of effective labor by subtracting baseline from peak uterine pressure over 10 minutes; effective labor is 250 MVU.
Uterine Activity
- Normal Uterine Activity: 5 contractions in 10 minutes; contractions every 2-3 minutes lasting 60-90 seconds.
- Tachysystole: More than 5 contractions in 10 minutes; interventions include stopping Pitocin, hydration, repositioning, and administering terbutaline.
Fetal Heart Rate Norms
- Baseline FHR: Average FHR during a 10-minute segment; normal range is 110-160 bpm.
- Read strips: 10 boxes represent 10 minutes; upper strip shows FHR, lower strip shows uterine contractions.
Fetal Heart Rate Interpretations
- Tachycardia: FHR exceeds 160 bpm; maternal causes include infection, dehydration, or anxiety; fetal causes include hypoxia or anemia.
- Bradycardia: FHR below 110 bpm; maternal causes include analgesics or cord compression; fetal causes include hypoxia or congenital heart block.
Variability
- Definition: Irregular fluctuations in baseline FHR indicating adequate fetal oxygenation.
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Types of Variability:
- Absent: Undetectable variability.
- Minimal: < 5 bpm variability.
- Moderate: 6-25 bpm variability.
- Marked: > 25 bpm variability.
Accelerations
- Sudden increase in FHR above baseline; defined as “15 by 15” (15 bpm increase lasting at least 15 seconds) after 32 weeks; “10 by 10” before 32 weeks.
Decelerations
- Late Decelerations: Decrease in FHR occurring after the peak of a contraction; caused by uteroplacental insufficiency; nursing interventions involve improving placental blood flow.
- Early Decelerations: Gradual decrease in FHR coinciding with contractions; benign response to head compression.
- Variable Decelerations: Abrupt decreases in FHR unrelated to contractions; most common due to cord compression; treatment focuses on relieving cord compression.
FHR Interpretation Patterns (VEAL CHOP)
- Category I: Normal FHR indicating favorable physiological response; baseline 110-160 bpm, moderate variability, presence of early decelerations but no late or variable decelerations.
- Category II (Indeterminate): Further evaluation needed; may present with tachycardia or bradycardia, absent or minimal variability, certain patterns of decelerations.
- Category III (Abnormal): Unfavorable physiological response; requires intervention; indicators include bradycardia, absent variability, recurrent late or variable decelerations.
Exam Preparation
- Focus on understanding early, late, and variable decelerations, including their causes and nursing interventions.
- Be able to identify type of deceleration from scenarios, understand concepts of acme and nadir, and interpret different FHR category strips.
- Know tachysystole and corresponding interventions (i.e. stopping Pitocin, repositioning).
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Description
Explore various methods of fetal heart rate monitoring, including ultrasound and tocodynamometry. Learn how these techniques are used in clinical practice to assess fetal well-being during pregnancy. This quiz will test your knowledge on the placement and assessment of fetal heart rate based on different presentations.
