Intrapartum Fetal Assessment Quiz

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Questions and Answers

What is the primary purpose of fetal monitoring during labor?

To assess how the fetus is tolerating labor (correct)

To monitor maternal blood pressure

To determine the effectiveness of contractions

To measure the duration of labor

Which condition is NOT a cause of compromised fetal oxygen supply?

Maternal hypotension

Umbilical cord compression

Fetal hypovolemia (correct)

Uterine hypertonicity

What does the presence of abnormal FHR patterns indicate?

Possible fetal hypoxemia (correct)

Effective uterine contractions

Normal fetal health

Improving fetal circulation

When is continuous fetal monitoring most recommended?

For high-risk pregnancies only (C) Signup and view all the answers

What does tachysystole refer to during labor?

Excessive contractions (C) Signup and view all the answers

Which type of monitoring allows for more freedom of movement during labor?

Intermittent external monitoring (D) Signup and view all the answers

What characterizes the fetal heart rate (FHR) baseline?

The average rate excluding variability and periodic changes (B) Signup and view all the answers

What is an indication of placental compromise during labor?

Reduction in blood flow due to uterine hypertonicity (C) Signup and view all the answers

What should be assessed when monitoring uterine activity?

Frequency, duration, and intensity of contractions (A) Signup and view all the answers

Which fetal monitoring technique can provide a continuous tracing of the fetal heart rate?

Electronic fetal monitoring (B) Signup and view all the answers

What is the defining heart rate for bradycardia in fetal heart rate monitoring?

Below 110 bpm (A) Signup and view all the answers

Which of the following is a common cause of fetal tachycardia?

Maternal infection (D) Signup and view all the answers

What does moderate variability in fetal heart rate indicate?

Adequate fetal oxygenation (B) Signup and view all the answers

How are early decelerations characterized in relation to uterine contractions?

Occur with the contractions (B) Signup and view all the answers

What distinguishes variable decelerations from other forms of deceleration?

They have an abrupt decrease in FHR (D) Signup and view all the answers

What intervention is indicated for late decelerations caused by placental insufficiency?

Execute intervention to address insufficiency (D) Signup and view all the answers

Which of the following is NOT a sign of fetal distress?

Early decelerations (D) Signup and view all the answers

When should a cesarean section be prepared for in the context of fetal heart rate monitoring?

When prolonged decelerations occur (A) Signup and view all the answers

Which factor increases the likelihood of decreased variability in fetal heart rate?

Medications causing CNS depression (B) Signup and view all the answers

What does an acceleration in fetal heart rate indicate?

Fetal well-being (D) Signup and view all the answers

What is the typical response to identify and address fetal heart rate indicating cord compression?

Change maternal position (D) Signup and view all the answers

What is the duration required for a deceleration to be classified as prolonged?

More than 2 minutes but less than 10 (D) Signup and view all the answers

In the context of fetal heart rate variability, what does a sleep cycle indicate?

Decreased variability (A) Signup and view all the answers

Study Notes

Intrapartum Fetal Assessment

Labor is a time of physiological stress for the fetus.
Fetal oxygen supply must be maintained to prevent fetal compromise.
Fetal monitoring is crucial to determine how the fetus is tolerating labor.
Non-reassuring or abnormal fetal heart rate (FHR) patterns indicate potential fetal compromise.
Early identification allows for interventions to improve fetal oxygenation and prevent complications.

Fetal Oxygen Supply Compromises

Changes in maternal blood flow (hypertension, hypotension, hypovolemia) affect fetal blood flow.
Umbilical cord compression, placental separation/abruption, or head compression can impact fetal circulation.
Placental compromise (hypertonic uterus or placental deterioration) reduces blood flow.
Abnormal FHR patterns are linked to fetal hypoxia and metabolic acidosis.

Monitoring Methods

Intermittent monitoring involves periodic assessment (e.g., before, during, after contractions).
- Suitable for low-risk pregnancies, allowing for greater movement.
Continuous monitoring provides a continuous tracing.
- Necessary for high-risk pregnancies or when fetal status changes.
External monitoring uses a device that is applied externally.
- Measures uterine activity by tocodynamometer or fetal heart rate via ultrasound.
Internal monitoring involves inserting a device directly into the mother's body.
- Intrauterine pressure catheter (IUPC) monitors contractions, and fetal scalp electrode (FSE) measures FHR (needs an intact membrane).

Uterine Activity Assessment

Uterine activity is assessed by frequency, duration, intensity, and resting tone.
Tachysystole is defined as more than 5 contractions in 10 minutes averaged over a 30-minute window.

Fetal Heart Rate (FHR) Patterns

Baseline FHR: Average rate over a 10-minute period, excluding periodic changes, and baseline fluctuations larger than 25 bpm.
- Normal baseline is 110–160 bpm.
- Bradycardia: FHR below 110 bpm, could indicate fetal cardiac issues, maternal hypoglycemia/hypothermia, or infections.
- Tachycardia: FHR above 160 bpm, often due to maternal fever, infections, or fetal anemia.
Variability is the fluctuation in FHR.
- Absent variability is rare, and problematic.
- Moderate variability is a sign of physiological well-being
- Marked variability shows good oxygen status in the baby.
- Minimal variability means something is affecting the baby's normal rhythm (a concern).
Accelerations: Increases in FHR above the baseline, often in response to fetal movement or uterine contractions.
- Typically indicate well-oxygenated fetus
Decelerations: Decreases in FHR below the baseline.
- Early decelerations: Associated with fetal head compression during uterine contractions, usually benign.
- Late decelerations: Occur after the start of the contraction and indicate placental insufficiency.
- Variable decelerations: Abrupt, short, and unpredictable decreases in the FHR. These may indicate umbilical cord compression.
- Prolonged decelerations: Lasts more than 2 minutes and suggests significant fetal compromise.

Fetal Distress

Signs of fetal distress include FHR outside the normal range, lack of variability, recurrent decelerations, or prolonged decelerations.
Nursing interventions include monitoring maternal and fetal status, repositioning the patient, adjusting medications and fluid administration, preparing for a C-section.

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Description

Test your knowledge on intrapartum fetal assessment and monitoring. This quiz covers fetal oxygen supply, potential complications during labor, and monitoring methods for fetal well-being. Understand the importance of early identification of abnormal fetal heart rate patterns.