Obstetric Fetal Heart Rate Monitoring Quiz

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Questions and Answers

What characterizes variable decelerations in fetal heart rate?

Associated with fetal movement.

Heart rate shows a U-shaped or V-shaped pattern. (correct)

Occurs only during uterine contractions.

Heart rate gradually decreases over 30 seconds.

Which strategy involves changing the mother's position to improve fetal oxygen supply?

Oxygen administration

Amnioinfusion

Scalp stimulation

Position change (correct)

Which fetal presentation is unlikely to cause dystocia?

Large fetal head

Cephalic position (correct)

Breach position

Face presentation

What does a Bishop Score assess in labor?

Cervical readiness for labor Signup and view all the answers

In which situation would labor augmentation be contraindicated?

Fetal intolerance to contractions Signup and view all the answers

Which intervention is typically used to manage hypotonic contractions?

Intravenous fluid administration Signup and view all the answers

What is a primary advantage of vacuum-assisted delivery over forceps?

Easier application for healthcare providers Signup and view all the answers

Which of the following is NOT a method of labor induction?

Nutritional supplements Signup and view all the answers

Which condition may lead to uterine dystocia?

Multi-fetal gestation Signup and view all the answers

What is a common nursing intervention for hypertonic contractions?

Promoting rest and sleep Signup and view all the answers

What is a fetal risk associated with shoulder dystocia?

Brachial plexus injury Signup and view all the answers

What complication could arise from a cesarean birth due to organ injury?

Bladder damage Signup and view all the answers

What is the primary purpose of maintaining a neutral thermal environment for a newborn?

To minimize energy expenditure Signup and view all the answers

Which indicator suggests that a newborn might be experiencing hypoglycemia?

Abnormal temperature regulation Signup and view all the answers

Which nursing role is essential in monitoring during an unscheduled cesarean birth?

Fetal heart rate monitoring Signup and view all the answers

What contraindication might prevent the use of epidural anesthesia?

Low platelet count Signup and view all the answers

What is vernix caseosa known for in neonates?

It protects the skin during gestation Signup and view all the answers

What is considered an appropriate weight loss for an infant in the first week of life?

5-10% of body weight Signup and view all the answers

What is a primary nursing responsibility in the immediate postoperative care of a cesarean birth?

Monitoring for infection signs Signup and view all the answers

What distinguishes physiological jaundice from pathological jaundice in newborns?

Timing of appearance after birth Signup and view all the answers

What characteristic is associated with umbilical cord prolapse?

Fetal heart rate decelerations Signup and view all the answers

Which nursing action is critical in assessing for congenital hip dislocation in newborns?

Performing the Ortolani maneuver Signup and view all the answers

What nursing intervention is vital after administering anesthesia in a cesarean section?

Positioning to reduce pressure on major blood vessels Signup and view all the answers

What is a possible consequence of accidental injection of anesthetic agent?

Acute respiratory distress Signup and view all the answers

Why is it important to monitor the respiratory function of a newborn?

They are at risk for apnea due to underdeveloped systems Signup and view all the answers

What changes in stool and urine output are expected for a newborn in the first few days of life?

Increase in urine output and transition of stool color Signup and view all the answers

What maternal risk factors are associated with shoulder dystocia?

Symphysis pubis separation Signup and view all the answers

Which symptom is indicative of disseminated intravascular coagulation (DIC)?

Prolonged bleeding Signup and view all the answers

Which of the following is a common intervention for pain management in postpartum patients?

Monitoring for side effects of medications Signup and view all the answers

What is a potential consequence of not adequately monitoring blood glucose levels in a newborn?

Increased risk of neurological damage Signup and view all the answers

What is a primary consequence of neonatal macrosomia during childbirth?

Uterine atony leading to hemorrhage Signup and view all the answers

Which condition is characterized by the abnormal position of the placenta that may lead to increased bleeding?

Placenta previa Signup and view all the answers

What condition can lead to postpartum hemorrhage due to retained placental tissue?

Subinvolution of the uterus Signup and view all the answers

Which symptom is characteristic of postpartum depression as opposed to 'baby blues'?

Persistent feelings of worthlessness Signup and view all the answers

Which of the following is a sign of respiratory distress syndrome in a neonate?

Grunting sounds Signup and view all the answers

What is the role of the feeding plan in discharge teaching for new parents?

Guiding effective breastfeeding or formula feeding Signup and view all the answers

What is a typical upper limit for the weight of a fetus categorized as macrosomia?

4000 grams Signup and view all the answers

What major hormone is primarily responsible for initiating lactogenesis after childbirth?

Prolactin Signup and view all the answers

Which of the following is a common factor affecting uterine tone post-delivery?

Parity of the mother Signup and view all the answers

Which of the following accurately describes the risk associated with polyhydramnios during pregnancy?

Increased fetal weight Signup and view all the answers

What reflex involves the newborn sucking when their lips are touched?

Sucking reflex Signup and view all the answers

At what age is the second dose of the Hepatitis B vaccine typically administered to newborns?

1-2 months Signup and view all the answers

Which of the following is a key focus in postpartum assessment?

Monitoring vital signs Signup and view all the answers

What type of lochia is observed from day 1 to 3 postpartum?

Lochia rubra Signup and view all the answers

What condition should be monitored closely in the maternal urinary system after childbirth?

Bladder distention Signup and view all the answers

Which nursing action is essential for preventing bladder distention postpartum?

Encouraging early voiding Signup and view all the answers

What common issue may occur due to pressure during childbirth?

Hemorrhoids Signup and view all the answers

What indicates a possible problem during postpartum assessment of the uterus?

Uterus is shifted to the left Signup and view all the answers

Which type of lochia is characterized by a pink or brown color?

Lochia serosa Signup and view all the answers

What factor is a risk for postpartum hemorrhage?

Prolonged labor Signup and view all the answers

Study Notes

Variable Deceleration

Sudden drop in fetal heart rate, often associated with umbilical cord compression.
Occurs regardless of uterine contractions, lasting less than 30 seconds.
Appearance typically resembles a V or U shape, indicating fetal stress.
Requires immediate intervention, such as left lateral position or amnioinfusion to relieve cord pressure.

Fetal Heart Rate (FHR) Tracing Categories

Category I: Normal, reassuring patterns, associated with good fetal outcomes.
Category II: Intermediate, may require monitoring and further evaluation.
Category III: Abnormal patterns indicating potential fetal distress, requiring immediate intervention.

Assessment of Uterine Activity

Involves monitoring contractions for frequency, duration, and intensity.
Helps evaluate labor progress and fetal well-being.

Intrauterine Resuscitation Strategies

Position Change: Lateral positioning increases uteroplacental perfusion and oxygen supply.
IV Bolus: Administering fluids enhances maternal circulation, especially in hypotension.
Amnioinfusion: Injecting sterile fluid alleviates cord compression by increasing amniotic fluid.
Oxygen Administration: Providing oxygen to the mother improves fetal oxygenation.
Adjust Uterine Activity: Reducing uterine hyperstimulation allows for better fetal oxygen supply.
Scalp Stimulation: Gentle stimulation can indicate fetal responsiveness, signaling well-being.

Uterine Dystocia

Refers to abnormal labor progression due to ineffective contractions.

Nursing Interventions for Hypertonic Contractions

Promote rest and sleep to restore normal labor pattern.
Administer prescribed analgesics.
Provide warm baths or a calming environment for relaxation.
Encourage fluid intake to prevent dehydration.

Interventions for Hypotonic Contractions

Assess uterine activity regularly.
Encourage ambulation or positional changes.
Administer IV fluids to enhance maternal fluid status.
Use oxytocin as prescribed to strengthen contractions.

Difference Between Stage Arrest Disorders

First Stage Arrest: Lack of cervical dilation after an appropriate duration of labor.
Second Stage Arrest: No progress in fetal descent after 2-3 hours of pushing despite head being engaged.

Fetal Presentations Leading to Dystocia

Macrosomia or large fetal head.
Abnormal fetal positions (e.g., face, brow, or breech).
Multiple gestations.
Fetal anomalies.

Methods of Labor Induction

Administration of prostaglandins.
Mechanical methods (e.g., balloon catheter).
Intact or artificial rupture of membranes.
Oxytocin administration.
Nipple stimulation.

Bishop Score

Measures cervical readiness for labor based on dilation, effacement, station, consistency, and position.

Indications and Contraindications for Labor Augmentation

Indications: Ineffective contractions, slow labor progression, and arrest of labor.
Contraindications: Fetal distress or structural issues like uterine scarring.

Advantages of Vacuum-Assisted vs. Forceps Delivery

Easier application with less required skill.
Generally requires less anesthesia.
Lower risk of maternal soft tissue damage.
Reduced risk of fetal injury compared to forceps.

Maternal Risks Associated with Shoulder Dystocia

Severe perineal lacerations.
Separation of the symphysis pubis.
Sphincter injuries.
Risk of infection.
Bladder injury.
Postpartum hemorrhage.

Fetal Risks Associated with Shoulder Dystocia

Compression of the fetal neck.
Brachial plexus injury.
Fractures of the clavicle or humerus.
Asphyxia and hypoxia.

Umbilical Cord Prolapse

Occurs when the umbilical cord slips ahead of or beside the presenting part during labor.

Disseminated Intravascular Coagulation (DIC)

Complex disorder characterized by the overactivation of coagulation leading to the formation of blood clots throughout the small vessels, potentially causing hemorrhage.

Role of Nurse in Unscheduled Cesarean Birth

Notify anesthesia and newborn teams of the emergency.
Continuously monitor fetal heart rate for signs of distress.
Administer oxygen to mother if fetal oxygenation is compromised.
Monitor maternal vital signs.
Start IV fluids and conduct blood work, such as CBC.
Insert Foley catheter post-anesthesia or as needed.
Provide emotional support to parents during the procedure.

Intraoperative Complications of Cesarean Birth

Risk of hemorrhage, potentially leading to hypovolemic shock.
Potential for organ injury during surgery.
Respiratory depression from anesthesia.
Low blood pressure from anesthesia impacting fetal oxygen supply.
Accidental injection of anesthetic into the bloodstream.

Contraindications for Epidural or Spinal Anesthesia

Low platelet count due to conditions like preeclampsia.
Local infections at the injection site.
Uncorrected hypovolemia.
Spinal abnormalities affecting needle placement.
Sepsis.

Nursing Role in Intraoperative Care

Ensure proper maternal positioning to avoid compressing major vessels.
Continue fetal heart rate monitoring until surgical prep is complete.
Assist with surgical instrument counts and catheter insertion.
Prepare newborn resuscitation equipment.

Immediate Postoperative Care After Cesarean Birth

Monitor vital signs regularly, especially for signs of distress.
Assess uterine involution and vaginal discharge.
Manage pain effectively, monitoring for side effects of medications.
Encourage deep breathing and coughing exercises.
Support skin-to-skin contact and initiate breastfeeding.
Promote early ambulation to prevent complications.

Physiologic Care of the Neonate

Maintain Body Heat: Protect newborn from hypothermia by keeping them warm.
Maintain Respiratory Function: Monitor for signs of respiratory distress; initiate necessary interventions.
Decrease Risk of Infection: Maintain cleanliness and proper hand hygiene to protect newborns.
Provide Nutrition and Hydration: Assist with feeding to ensure adequate caloric intake.

Hypoglycemia in Neonates

Symptoms include jitteriness, hypotonia, lethargy, apnea, and temperature instability.
Nursing actions involve checking blood glucose levels, maintaining thermal stability, and initiating feeding.

Purpose of Vitamin K Injection

Administered to prevent potential bleeding disorders due to low vitamin K levels in newborns.

Newborn Stool and Urine Output Changes

Passage of meconium in the first few days, transitioning to yellow feces by day four.
Increased urine output over the first few days, with typical output ranging from 15 to 60 mL/kg daily.

Appropriate Weight Loss for Infants in the First Week

An infant can lose up to 7-10% of their birth weight within the first week.

Congenital Hip Dislocation Assessment

Focus on physical examination techniques to detect hip instability or dislocation.

Vernix Caseosa

Protective, cheese-like substance covering the skin of newborns, providing moisture protection and anti-infective properties.

Physiologic vs. Pathologic Jaundice

Physiologic jaundice appears 2-3 days post-birth, usually resolving within 1-2 weeks.
Pathologic jaundice occurs within 24 hours and may indicate underlying health issues.

Newborn Reflexes

Sucking Reflex: Response to oral stimulation.
Moro Reflex: Startle response characterized by arm extension and retraction.
Palmar Grasp Reflex: Grasping motion when the palm is stimulated.
Startle Reflex: Reaction to sudden noise or movement.

Common Vaccinations for Newborns

Hepatitis B vaccine administered within the first 1-2 days.
Erythromycin eye ointment to prevent infections from gonorrhea or chlamydia.

Postpartum Assessment Components

Vital signs monitoring for abnormalities indicating potential complications.
Psychosocial evaluation for emotional well-being of the mother.
Breast assessment for issues furthering breastfeeding.
Uterine size and location checks for complications.
Lochia evaluation for signs of infection or complications.
Perineum examination for healing and injury.
Lower extremities check for swelling or thrombosis.

Postpartum Changes in Gastrointestinal System

Constipation and hemorrhoids are common; interventions include hydration and stool softeners.

Uterine Involution Process

Process of the uterus returning to its pre-pregnancy size and condition after childbirth.

Types of Lochia

Lochia Rubra: Bright red discharge for the first 1-3 days.
Lochia Serosa: Pink or brown discharge from days 4-10.
Lochia Alba: Yellowish-white discharge occurring after day 10.

Maternal Urinary System Management Postpartum

Encourage early voiding to prevent bladder distention.
Record input/output to monitor urinary function.
Watch for UTI symptoms if catheterization is performed.

Risk Factors for Postpartum Hemorrhage

Macrosomia, placenta previa, multiple gestations, history of prior surgeries, polyhydramnios, and history of PPH present higher risks.

Causes of Postpartum Hemorrhage

Uterine atony, retained placental tissue, trauma, and coagulation disorders.

Distinguishing Postpartum Depression from "Baby Blues"

"Baby blues" are temporary emotional changes occurring shortly after birth, while postpartum depression is more severe and persistent, impacting daily functioning.

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Description

This quiz focuses on fetal heart rate (FHR) monitoring, including the definitions and differences between Category I, II, and III tracings. It also covers uterine activity assessment and intrauterine resuscitation strategies. Test your knowledge on essential concepts in obstetrics concerning fetal wellbeing.