Podcast
Questions and Answers
What is the minimum duration of interpretable data required to determine baseline FHR?
What is the minimum duration of interpretable data required to determine baseline FHR?
- 1 minute
- 2 minutes (correct)
- 5 minutes
- 30 seconds
A baseline FHR of 170 bpm would be classified as which of the following?
A baseline FHR of 170 bpm would be classified as which of the following?
- Normal
- Variable
- Tachycardia (correct)
- Bradycardia
Which FHR variability range is considered normal?
Which FHR variability range is considered normal?
- Minimal (1-5 bpm)
- Marked (26+ bpm)
- Moderate (6-25 bpm) (correct)
- Absent (0 bpm)
According to the three-tier FHR categories, what does a Category I tracing indicate?
According to the three-tier FHR categories, what does a Category I tracing indicate?
Which of the following is a characteristic of Category III FHR tracings?
Which of the following is a characteristic of Category III FHR tracings?
Which type of FHR deceleration is often associated with umbilical cord compression?
Which type of FHR deceleration is often associated with umbilical cord compression?
What is the first intervention that should be implemented when observing late decelerations?
What is the first intervention that should be implemented when observing late decelerations?
What is the priority nursing intervention for a prolonged deceleration?
What is the priority nursing intervention for a prolonged deceleration?
What is the primary cause of early decelerations in fetal heart rate?
What is the primary cause of early decelerations in fetal heart rate?
A sinusoidal FHR pattern is considered:
A sinusoidal FHR pattern is considered:
What does the term 'effacement' refer to in the context of cervical changes during labor?
What does the term 'effacement' refer to in the context of cervical changes during labor?
Cervical dilation is measured in:
Cervical dilation is measured in:
Ideally, what fetal attitude is preferred for vaginal delivery?
Ideally, what fetal attitude is preferred for vaginal delivery?
Which cardinal movement involves the fetal head passing through the pelvic inlet?
Which cardinal movement involves the fetal head passing through the pelvic inlet?
During which cardinal movement does the fetal occiput rotate anteriorly?
During which cardinal movement does the fetal occiput rotate anteriorly?
What physiological process is indicated by the cardinal movement of flexion?
What physiological process is indicated by the cardinal movement of flexion?
Which of the following interventions is LEAST appropriate for variable decelerations?
Which of the following interventions is LEAST appropriate for variable decelerations?
What is the duration criterion that distinguishes a prolonged deceleration from other types of decelerations?
What is the duration criterion that distinguishes a prolonged deceleration from other types of decelerations?
Which of the following findings would classify an FHR tracing as Category II?
Which of the following findings would classify an FHR tracing as Category II?
A laboring patient's FHR tracing shows a pattern of accelerations lasting >15 seconds and peaking >15 bpm above the baseline. What is the MOST appropriate nursing action?
A laboring patient's FHR tracing shows a pattern of accelerations lasting >15 seconds and peaking >15 bpm above the baseline. What is the MOST appropriate nursing action?
After internal rotation, what cardinal movement allows the fetal head to be born?
After internal rotation, what cardinal movement allows the fetal head to be born?
Following delivery of the fetal head, which cardinal movement occurs next?
Following delivery of the fetal head, which cardinal movement occurs next?
Which of the following FHR patterns definitively requires intrauterine resuscitation measures?
Which of the following FHR patterns definitively requires intrauterine resuscitation measures?
Dino, a medical student, is asked to describe Category II fetal heart rate tracings in detail. He notes that these tracings are 'Indeterminate'. Which of the following could be a characteristic of this tracing?
Dino, a medical student, is asked to describe Category II fetal heart rate tracings in detail. He notes that these tracings are 'Indeterminate'. Which of the following could be a characteristic of this tracing?
Which of the following decelerations typically requires no intervention?
Which of the following decelerations typically requires no intervention?
In fetal monitoring, which baseline variability pattern is defined as a fluctuation range of 1-5 bpm?
In fetal monitoring, which baseline variability pattern is defined as a fluctuation range of 1-5 bpm?
During a complicated labor, a sinusoidal pattern is observed on the fetal heart rate monitor. This rare abnormal fetal heartbeat pattern is a sign of:
During a complicated labor, a sinusoidal pattern is observed on the fetal heart rate monitor. This rare abnormal fetal heartbeat pattern is a sign of:
A woman is in labor, and the healthcare provider determines that the fetus is in the occiput posterior (OP) position. What cardinal movement is MOST likely to be affected or prolonged as a result of this malposition?
A woman is in labor, and the healthcare provider determines that the fetus is in the occiput posterior (OP) position. What cardinal movement is MOST likely to be affected or prolonged as a result of this malposition?
A seasoned nurse is teaching a group of new graduate nurses about fetal heart rate (FHR) monitoring and the importance of recognizing different patterns. She explains that certain FHR patterns require immediate intervention to prevent potential fetal compromise. According to the nurse, which of the following FHR patterns would necessitate the MOST urgent intervention?
A seasoned nurse is teaching a group of new graduate nurses about fetal heart rate (FHR) monitoring and the importance of recognizing different patterns. She explains that certain FHR patterns require immediate intervention to prevent potential fetal compromise. According to the nurse, which of the following FHR patterns would necessitate the MOST urgent intervention?
In a rare obstetrical emergency, a previously healthy 28-year-old primigravida at term presents with sudden onset of prolonged fetal bradycardia and a sinusoidal FHR pattern after attempted external cephalic version (ECV). Despite immediate tocolysis and maternal repositioning, the abnormal FHR patterns persist. What is the MOST likely underlying cause of these findings, and what is the NEXT BEST step in management?
In a rare obstetrical emergency, a previously healthy 28-year-old primigravida at term presents with sudden onset of prolonged fetal bradycardia and a sinusoidal FHR pattern after attempted external cephalic version (ECV). Despite immediate tocolysis and maternal repositioning, the abnormal FHR patterns persist. What is the MOST likely underlying cause of these findings, and what is the NEXT BEST step in management?
Flashcards
Baseline FHR
Baseline FHR
Average FHR over 10 minutes, excluding changes; must have 2 minutes of interpretable data.
Fetal Tachycardia
Fetal Tachycardia
FHR greater than 160 bpm.
Fetal Bradycardia
Fetal Bradycardia
FHR less than 110 bpm.
Periodic FHR Changes
Periodic FHR Changes
Signup and view all the flashcards
Episodic FHR Changes
Episodic FHR Changes
Signup and view all the flashcards
FHR Variability
FHR Variability
Signup and view all the flashcards
Absent FHR Variability
Absent FHR Variability
Signup and view all the flashcards
Minimal FHR Variability
Minimal FHR Variability
Signup and view all the flashcards
Moderate FHR Variability
Moderate FHR Variability
Signup and view all the flashcards
Marked FHR Variability
Marked FHR Variability
Signup and view all the flashcards
Category I FHR
Category I FHR
Signup and view all the flashcards
Category II FHR
Category II FHR
Signup and view all the flashcards
Category III FHR
Category III FHR
Signup and view all the flashcards
Acceleration
Acceleration
Signup and view all the flashcards
Variable Decelerations
Variable Decelerations
Signup and view all the flashcards
Early Decelerations
Early Decelerations
Signup and view all the flashcards
Late Decelerations
Late Decelerations
Signup and view all the flashcards
Prolonged Deceleration
Prolonged Deceleration
Signup and view all the flashcards
Sinusoidal Pattern
Sinusoidal Pattern
Signup and view all the flashcards
Cervical Dilation
Cervical Dilation
Signup and view all the flashcards
Cervical Effacement
Cervical Effacement
Signup and view all the flashcards
Engagement
Engagement
Signup and view all the flashcards
Descent
Descent
Signup and view all the flashcards
Flexion
Flexion
Signup and view all the flashcards
Internal Rotation
Internal Rotation
Signup and view all the flashcards
Extension
Extension
Signup and view all the flashcards
Restitution
Restitution
Signup and view all the flashcards
External Rotation
External Rotation
Signup and view all the flashcards
Expulsion
Expulsion
Signup and view all the flashcards
Study Notes
Fetal Heart Rate (FHR) Monitoring
- Baseline FHR is the average heart rate over a 10-minute segment, excluding periodic or episodic changes, marked variability, or segments differing by more than 25 bpm; requires at least 2 minutes of interpretable data.
- Tachycardia is a baseline FHR greater than 160 bpm.
- Bradycardia is a baseline FHR less than 110 bpm.
- Periodic FHR changes occur with contractions.
- Episodic FHR changes do not occur with contractions.
FHR Variability
- FHR variability refers to irregular fluctuations in the baseline FHR with a frequency of two cycles per minute or more.
- Absent variability: 0 bpm fluctuation.
- Minimal variability: 1-5 bpm fluctuation.
- Moderate variability: 6-25 bpm fluctuation, considered normal.
- Marked variability: 26+ bpm fluctuation.
FHR Categories
- Category I (Normal): FHR 110-160 bpm, moderate variability (6-25 bpm), no late or variable decelerations; early decelerations or accelerations may be present or absent.
- Category II (Indeterminate): Includes bradycardia without absent variability, tachycardia, minimal or absent variability without recurrent decelerations, marked variability (26+ bpm), absence of accelerations with fetal stimulation, and periodic or episodic decelerations.
- Category III (Abnormal): Includes absent baseline FHR variability accompanied by recurrent late decelerations, recurrent variable decelerations, bradycardia, or a sinusoidal pattern.
Accelerations
- Accelerations should last for 15 seconds and increase 15 bpm from baseline.
Decelerations
- Variable decelerations are abrupt, appear as V/U/W shapes, and indicate cord compression; manage by changing position, administering O2 to the mother, and increasing IV fluids.
- Early decelerations occur with head compression, with FHR decreasing before the peak of a contraction and recovering before it ends; no treatment needed, may perform a vaginal exam.
- Late decelerations indicate uteroplacental insufficiency, with FHR decreasing AFTER the peak of a contraction and recovering after the contraction ends; treat by stopping Pitocin, administering oxygen (8-10 L), repositioning, increasing IV fluids, and considering amnioinfusion.
- Prolonged decelerations involve a decrease of at least 15 bpm lasting more than 2 minutes but less than 10 minutes; manage by starting oxygen, having the mother lay on her left side, stopping Pitocin, increasing IV fluids, and considering an emergent cesarean if no recovery to baseline.
- Sinusoidal pattern is a rare, abnormal fetal heartbeat with a rapid bounce pattern and requires emergency intrauterine resuscitation.
Cervical Changes During Labor
- During labor, the cervix dilates (opens) from 0-10 cm and effaces (thins out).
- Medications like misoprostol or dinoprostone may be given if the cervix is not effacing or dilating.
Fetal Position & Cardinal Movements During Labor
- Ideal fetal position is head down with general flexion, tucking the chin to the chest to present the suboccipitobregmatic diameter.
- Engagement: Fetal head reaches the pelvic inlet.
- Descent: Fetal head moves through the pelvis.
- Flexion: Infant's chin moves to chest.
- Internal Rotation: Occiput rotates anteriorly.
- Extension: Infant's chin lifts up.
- Restitution and External Rotation: Realignment and rotation of the shoulders.
- Expulsion: Baby is delivered.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.