Fetal Heart Monitoring Methods
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Fetal Heart Monitoring Methods

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Questions and Answers

What is the primary function of the ultrasound in fetal heart monitoring?

  • Assesses uterine pressure
  • Measures contraction intensity
  • Measures fetal heart rate (FHR) (correct)
  • Detects fetal heart characteristics
  • In which presentation is the fetal heart rate best assessed in the lower quadrant of the maternal abdomen?

  • Transverse presentation
  • Oblique presentation
  • Cephalic presentation (correct)
  • Breech presentation
  • What is considered an effective contraction intensity measured by the IUPC?

  • 30-50 mm Hg
  • 50-70 mm Hg (correct)
  • 40-60 mm Hg
  • 70-90 mm Hg
  • What represents a normal uterine activity pattern during labor?

    <p>5 contractions in 10 minutes</p> Signup and view all the answers

    What intervention is appropriate if tachysystole occurs?

    <p>Administer IV hydration</p> Signup and view all the answers

    What measurement indicates effective labor in terms of Montevideo units (MVU)?

    <p>250 MVU</p> Signup and view all the answers

    The Fetal Spiral Electrode (FSE) is primarily used for which purpose?

    <p>To measure fetal heart rate accurately</p> Signup and view all the answers

    How is the baseline fetal heart rate defined?

    <p>The average FHR over a 10-minute segment</p> Signup and view all the answers

    What is the primary goal of treatment for cord compression during labor?

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

    Which of the following interventions is NOT recommended for alleviating cord compression?

    <p>Reassuring the patient that no action is needed</p> Signup and view all the answers

    In the context of FHR patterns, which category indicates a favorable physiological response with no need for intervention?

    <p>Category I</p> Signup and view all the answers

    What does the presence of variable decelerations typically indicate?

    <p>Umbilical cord compression</p> Signup and view all the answers

    Which of the following patterns is indicative of requiring further evaluation in fetal heart rate monitoring?

    <p>Consistent late decelerations</p> Signup and view all the answers

    What does the term 'acme' refer to in the context of contractions?

    <p>The highest point of a contraction</p> Signup and view all the answers

    What is the threshold for tachycardia in a fetal heart rate strip?

    <p>Exceeds 160 bpm</p> Signup and view all the answers

    Which of the following maternal causes can contribute to bradycardia?

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

    What type of variability is indicated by a flat line in fetal heart rate monitoring?

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

    How is an acceleration in fetal heart rate defined before 32 weeks of gestation?

    <p>Increase by at least 10 bpm for 10 seconds</p> Signup and view all the answers

    What is the interpretation of late decelerations in fetal heart rate monitoring?

    <p>Visually apparent decrease occurring after the acme</p> Signup and view all the answers

    What does a 'marked' variability indicate in fetal heart rate patterns?

    <p>Variability greater than 25 bpm</p> Signup and view all the answers

    Which of the following is NOT a fetal cause of tachycardia?

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

    What is a characteristic of a fetal heart rate (FHR) that categorizes it as Category III?

    <p>Baseline bradycardia and absent variability</p> Signup and view all the answers

    Which of the following is a defining feature of recurrent variable decelerations?

    <p>They may be accompanied by either minimal or moderate variability.</p> Signup and view all the answers

    Which nursing intervention is appropriate for managing tachysystole in a patient receiving Pitocin?

    <p>Discontinue Pitocin and reposition the patient.</p> Signup and view all the answers

    What would you expect to find during the acme phase of a deceleration?

    <p>A peak in deceleration before the nadir.</p> Signup and view all the answers

    Which condition is indicated by the absence of accelerations after fetal stimulation?

    <p>A concerning abnormal finding</p> Signup and view all the answers

    What best describes the timing of the nadir in decelerations associated with uteroplacental insufficiency?

    <p>It occurs after the contraction has ended.</p> Signup and view all the answers

    Which of the following is NOT a nursing intervention for managing uteroplacental insufficiency?

    <p>Administer Pitocin.</p> Signup and view all the answers

    What is the underlying cause of early decelerations in fetal heart rate?

    <p>Head compression.</p> Signup and view all the answers

    What defines variable decelerations in fetal heart rate monitoring?

    <p>Abrupt decrease that may or may not correlate with contractions.</p> Signup and view all the answers

    What is a correct nursing consideration for managing early decelerations during labor?

    <p>Monitoring fetal heart rate is sufficient.</p> Signup and view all the answers

    What is the primary goal of nursing interventions for uteroplacental insufficiency?

    <p>Improve placental blood flow.</p> Signup and view all the answers

    Which statement is true about variable decelerations?

    <p>They can occur independently of uterine contractions.</p> Signup and view all the answers

    Why is left lateral positioning recommended for improving placental blood flow?

    <p>It reduces the pressure on the umbilical cord.</p> Signup and view all the answers

    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.
    • 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.

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