Fetal Heart Rate Monitoring Basics
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Questions and Answers

What does a high APGAR score indicate for a newborn?

  • The newborn requires immediate medical intervention
  • The newborn is likely to have congenital issues
  • The newborn is in good health (correct)
  • The newborn is underweight
  • Which method is NOT a form of external fetal heart rate monitoring?

  • Wireless monitoring
  • Continuous electrical fetal monitoring (CEFM)
  • Doppler ultrasound
  • Intrauterine pressure catheter (IUPC) (correct)
  • What is the purpose of fetal heart rate monitoring during labor?

  • To determine the gender of the fetus
  • To continuously assess fetal pain levels
  • To interpret and assess fetal oxygenation (correct)
  • To measure uterine contractions exclusively
  • Which of the following statements about internal fetal monitoring is TRUE?

    <p>It requires a fetal/internal scalp electrode to be attached.</p> Signup and view all the answers

    What factor is essential before performing internal fetal heart rate monitoring?

    <p>Membranes must be ruptured</p> Signup and view all the answers

    Which condition would contraindicate the use of internal fetal monitoring?

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

    How is variability in fetal heart rate interpreted?

    <p>As a sign of effective placental function</p> Signup and view all the answers

    Which of the following components is NOT included in the APGAR score?

    <p>Gestational age</p> Signup and view all the answers

    In what way does the use of cord blood gases assist in assessing newborn status?

    <p>It assesses oxygenation and acid-base balance.</p> Signup and view all the answers

    What is a common risk factor for pregnant individuals with diabetes during the third trimester?

    <p>Increased insulin needs</p> Signup and view all the answers

    Which of the following is a sign of preeclampsia that requires monitoring?

    <p>Blood pressure readings of at least 140/90</p> Signup and view all the answers

    What potential implication might arise from a diagnosis of twin pregnancies concerning delivery methods?

    <p>Increased likelihood of cesarean deliveries if fetuses are sharing placentas</p> Signup and view all the answers

    Which lab evaluation is essential for diagnosing preeclampsia?

    <p>Platelet count</p> Signup and view all the answers

    What fetal risk is significantly associated with uncontrolled diabetes during pregnancy?

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

    What action should be considered if a pregnant individual shows severe features of preeclampsia?

    <p>Immediate induction of labor if less than 34 weeks gestation</p> Signup and view all the answers

    What is considered a normal fetal heart rate (FHR) baseline range?

    <p>110-160 bpm</p> Signup and view all the answers

    How is an acceleration in fetal heart rate defined?

    <p>An increase of ≥ 15 bpm for at least 15 seconds</p> Signup and view all the answers

    What characteristic defines bradycardia in fetal heart rate monitoring?

    <p>A baseline below 110 bpm</p> Signup and view all the answers

    What is indicated if the baseline fetal heart rate changes occur in relation to uterine contractions?

    <p>Periodic changes</p> Signup and view all the answers

    Which variability level is considered reassuring for fetal well-being?

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

    What does a variable deceleration in fetal heart rate typically indicate?

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

    What condition is indicated by a failure of fetal head descent during labor?

    <p>Second stage arrest disorder</p> Signup and view all the answers

    What is the typical response that occurs in a fetus that is experiencing hypoxia during labor?

    <p>Decreased fetal heart rate variability</p> Signup and view all the answers

    What measurement defines a change in baseline fetal heart rate that occurs in ≥ 50% of uterine contractions?

    <p>Recurrent changes</p> Signup and view all the answers

    What assessment is critical to evaluate fetal well-being after delivery?

    <p>Cord blood gases analysis</p> Signup and view all the answers

    What is the correct order of the four phases of life concerning women’s health?

    <p>Adolescence à Childbearing years à Peri-menopause à Post-menopause/geriatric</p> Signup and view all the answers

    Which of the following is NOT one of the five P’s of taking a health history?

    <p>Pain history</p> Signup and view all the answers

    Which combination of conditions must be met for the lactational amenorrhea method of birth control to be effective?

    <p>Baby is under 6 months, mother is amenorrheic, and mother practices exclusive breastfeeding</p> Signup and view all the answers

    Which of the following is not a long-acting reversible contraception (LARC) method available in the United States?

    <p>Birth control pill</p> Signup and view all the answers

    What is the primary mechanism of the Copper IUD (Paragard) in preventing pregnancy?

    <p>Changing sperm function to prevent fertilization</p> Signup and view all the answers

    At what stage of pregnancy is gestational diabetes typically diagnosed?

    <p>Second trimester between 24-28 weeks</p> Signup and view all the answers

    What symptom is commonly associated with gestational diabetes?

    <p>Increased thirst</p> Signup and view all the answers

    How long can hormonal IUDs work effectively?

    <p>Up to 3-5 years, depending on the type</p> Signup and view all the answers

    What is the function of progestin released by hormonal IUDs?

    <p>To prevent ovulation and thicken cervical mucus</p> Signup and view all the answers

    What defines the lactational amenorrhea method as a form of birth control?

    <p>It is effective only if exclusive breastfeeding is practiced before menstruation returns</p> Signup and view all the answers

    Which symptom is NOT typically associated with respiratory distress syndrome (RDS) in neonates?

    <p>Cyanosis around the lips</p> Signup and view all the answers

    What is the primary cause of patent ductus arteriosus (PDA) in newborns?

    <p>Failure of the ductus arteriosus to close</p> Signup and view all the answers

    When is meconium aspiration syndrome most likely to occur?

    <p>In postmature newborns born after 41 weeks’ gestation</p> Signup and view all the answers

    What is a common sign of breastfeeding jaundice?

    <p>Delayed passage of meconium stool</p> Signup and view all the answers

    Which principle is NOT included in the five principles of discharge teaching?

    <p>Right Location</p> Signup and view all the answers

    What role does prolactin play in lactogenesis?

    <p>Stimulates the production of milk</p> Signup and view all the answers

    Excessive levels of which hormones are known to suppress lactation?

    <p>Estrogen and progesterone</p> Signup and view all the answers

    What is a defining characteristic of respiratory distress syndrome (RDS)?

    <p>Underdeveloped alveoli</p> Signup and view all the answers

    At what age does the ductus arteriosus typically close in a newborn?

    <p>After a few hours to up to 96 hours</p> Signup and view all the answers

    Which of the following actions is NOT recommended for managing breastfeeding jaundice?

    <p>Supplement with glucose water</p> Signup and view all the answers

    Study Notes

    Fetal Heart Rate Monitoring

    • The Apgar score is a standardized assessment for infants after delivery, measuring respiratory effort, heart rate, muscle tone, reflex activity, and color.
    • The primary goal of external fetal heart rate monitoring is to assess fetal oxygenation and prevent significant fetal acidemia.
    • External fetal heart rate monitoring can be continuous or intermittent, measuring the baseline, variability, accelerations, and decelerations.
    • Internal fetal heart rate monitoring is an intervention specific for troubleshooting measures, requiring the rupture of membranes and placement of a fetal scalp electrode and an intrauterine pressure catheter.
    • Cord blood gases are collected after birth to help determine the severity of hypoxia in labor.
    • A normal fetal heart rate baseline is 110-160 bpm for 10 minutes or more, with moderate variability considered the most reassuring status.
    • Accelerations are visually apparent abrupt increases in fetal heart rate above baseline, lasting at least 15 bpm for 15 seconds but less than 2 minutes.
    • Early decelerations mirror the contraction, with the nadir coinciding with the peak of the uterine contraction.
    • Variable decelerations are abrupt decreases in fetal heart rate, with a baseline to nadir in less than 60 seconds.

    Labor & Delivery

    • Induction of labor involves prompting the uterus to contract during pregnancy before labor starts on its own to facilitate a vaginal birth.
    • Second-stage arrest disorder occurs when there is a failure of fetal head descent after 2 hours of pushing for multips or 3 hours of pushing for nullips.
    • Different fetal presentations may lead to dystocia, including breech presentation, transverse lie, and shoulder dystocia.

    Newborn Complications

    • Respiratory distress syndrome is a life-threatening lung disorder characterized by small, underdeveloped alveoli and insufficient pulmonary surfactant.
    • Signs and symptoms of respiratory distress syndrome include tachypnea, gray or dusky skin, and lethargy.
    • A patent ductus arteriosus occurs when the ductus arteriosus remains open after birth, normally closing within a few hours of birth.
    • Signs and symptoms of PDA include tachycardia, tachypnea, recurrent apnea, and bounding pulses.
    • Meconium aspiration syndrome is respiratory failure induced when meconium fluid enters the lungs.
    • Breastfeeding jaundice is hyperbilirubinemia associated with breastfeeding, often due to ineffective breastfeeding or delayed passage of meconium stool.

    Women's Health

    • Women's health is typically categorized into four phases: adolescence, childbearing years, peri-menopause, and post-menopause/geriatric.
    • The five P's of taking a health history include partners, practices, protection from STIs, past history of STIs, and pregnancy intention.
    • The lactational amenorrhea method of birth control involves using breastfeeding as contraception, requiring the infant to be under 6 months old, the mother to be amenorrheic, and exclusive or quasi-exclusive breastfeeding on demand.
    • Long-acting reversible contraception includes IUDs (copper or hormonal) and hormone implants.

    Pregnancy Complications

    • Gestational diabetes is diagnosed between 24-28 weeks of pregnancy and managed with diet, exercise, and potentially medication like Metformin or insulin.
    • Twin pregnancies often result in preterm delivery and cesarean birth, depending on factors like shared placentas, sacs, and fetal presentations.
    • Preeclampsia is characterized by new onset hypertension after 20 weeks of pregnancy along with proteinuria.
    • Severe preeclampsia is characterized by BP >160/110 along with vision changes, low platelet count, and abnormal liver or kidney function tests.
    • The management of preeclampsia involves fetal monitoring, BP medications, and potentially anticonvulsants. Induction of labor may be considered depending on the severity of the condition.

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    Description

    This quiz covers essential concepts in fetal heart rate monitoring, including the Apgar score, external and internal monitoring techniques, and evaluation of fetal oxygenation. Test your knowledge on the characteristics of a normal fetal heart rate and the significance of accelerations and decelerations during labor.

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