Assessment of fetal well-being
58 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary purpose of a Nonstress Test (NST)?

  • To predict the onset of labor
  • To assess fetal heart rate in relation to fetal movement (correct)
  • To evaluate the effectiveness of maternal medications
  • To measure maternal blood pressure during labor

Which of the following is NOT a disadvantage of the Nonstress Test?

  • High rate of false non-reactive results
  • Maternal medications may affect results
  • Requires invasive procedures (correct)
  • Fetal sleep cycles can blunt response

During which gestational weeks is the NST typically recommended for clients with diabetes mellitus?

  • 28 to 32 weeks (correct)
  • 24 to 28 weeks
  • 32 to 36 weeks
  • 20 to 24 weeks

What qualifying acceleration indicates a reactive NST result after 32 weeks gestation?

<p>FHR accelerates at least 15 bpm for 15 seconds (A)</p> Signup and view all the answers

Which symptom suggests the consideration of an NST?

<p>Decreased fetal movement (A)</p> Signup and view all the answers

What is the recommended action if no fetal movements are detected during an NST?

<p>Use vibroacoustic stimulation to stimulate the fetus (C)</p> Signup and view all the answers

What does a nonreactive NST result necessitate?

<p>Further assessment such as a contraction stress test (C)</p> Signup and view all the answers

Which condition is NOT a potential indication for performing an NST?

<p>Healthy fetal growth with no concerns (A)</p> Signup and view all the answers

What is the primary purpose of performing amniocentesis?

<p>To aspirate amniotic fluid for analysis (C)</p> Signup and view all the answers

What should be done prior to the amniocentesis procedure to minimize risks?

<p>Empty the bladder (B)</p> Signup and view all the answers

Which of the following is NOT a potential indication for amniocentesis?

<p>History of allergies in the mother (B)</p> Signup and view all the answers

During the intraprocedure phase of amniocentesis, what is an important step for nursing actions?

<p>Document baseline vital signs and fetal heart rate (D)</p> Signup and view all the answers

What feeling should the client expect during the needle insertion for amniocentesis?

<p>Slight pressure (D)</p> Signup and view all the answers

What is the ideal time frame for collecting amniotic fluid to measure alpha-fetoprotein (AFP)?

<p>15 to 20 weeks (A)</p> Signup and view all the answers

Which of the following is a nursing action to prepare the client for ultrasound during amniocentesis?

<p>Assist the client into a supine position (A)</p> Signup and view all the answers

How can high maternal AFP levels be evaluated?

<p>Through amniotic fluid analysis (A)</p> Signup and view all the answers

What is the main purpose of using ultrasound during pregnancy?

<p>To visualize internal organs and assess fetal well-being (D)</p> Signup and view all the answers

Which type of ultrasound is preferred for obtaining accurate information in early pregnancy?

<p>Transvaginal ultrasound (C)</p> Signup and view all the answers

What is the significance of using Doppler ultrasound during pregnancy?

<p>To assess maternal-fetal blood flow and detect issues like IUGR (A)</p> Signup and view all the answers

Which of the following is NOT a potential diagnosis for ultrasound use during pregnancy?

<p>Diagnosing mental health issues in the mother (B)</p> Signup and view all the answers

Which procedure can ultrasound complement in the evaluation of placental maturation?

<p>Amniocentesis (D)</p> Signup and view all the answers

What is the most appropriate indication for performing a transvaginal ultrasound?

<p>Evaluating obesity-related complications in early pregnancy (D)</p> Signup and view all the answers

What is a primary requirement for external abdominal ultrasound to be effective?

<p>Patient must have a full bladder (D)</p> Signup and view all the answers

Which ultrasound type can display fetal movements in a video format?

<p>Four-dimensional ultrasound (A)</p> Signup and view all the answers

What is the primary purpose of percutaneous umbilical blood sampling (PUBS)?

<p>To obtain fetal blood from the umbilical cord (A)</p> Signup and view all the answers

What indication necessitates the use of PUBS?

<p>Assessing fetal chromosomal disorders (B)</p> Signup and view all the answers

Which of the following nursing actions should be taken after performing PUBS?

<p>Monitor fetal heart rate (B)</p> Signup and view all the answers

Which complication is associated with PUBS?

<p>Amniotic fluid emboli (C)</p> Signup and view all the answers

What does a lecithin/sphingomyelin (L/S) ratio of 2:1 signify?

<p>Fetal lung maturity (A)</p> Signup and view all the answers

What is a common area to monitor for complications after PUBS?

<p>Vaginal discharge (B)</p> Signup and view all the answers

What does the absence of phosphatidylglycerol (PG) indicate?

<p>Respiratory distress risk (D)</p> Signup and view all the answers

Which finding would suggest a high risk for fetal chromosomal disorders?

<p>High levels of alpha-fetoprotein (D)</p> Signup and view all the answers

What is a key indication for using chorionic villus sampling (CVS)?

<p>It assesses a portion of the developing placenta. (A)</p> Signup and view all the answers

Which of the following is a disadvantage of chorionic villus sampling (CVS)?

<p>It is associated with an increased risk of fetal anomalies. (D)</p> Signup and view all the answers

At what gestational age is chorionic villus sampling ideally performed?

<p>Between 10 and 13 weeks of gestation. (C)</p> Signup and view all the answers

What does the quad marker screening primarily assess?

<p>It measures the levels of specific hormones and proteins. (D)</p> Signup and view all the answers

What abnormal result in maternal serum alpha-fetoprotein (MSAFP) levels may indicate Down syndrome?

<p>Low levels of AFP. (B)</p> Signup and view all the answers

What is a recommended nursing action prior to performing chorionic villus sampling (CVS)?

<p>Obtain informed consent from the client. (D)</p> Signup and view all the answers

Which hormone is NOT typically assessed in quad marker screening?

<p>Insulin (B)</p> Signup and view all the answers

What is an important step to take before undergoing maternal serum alpha-fetoprotein (MSAFP) testing?

<p>Clients should discuss their medical history with the nurse. (D)</p> Signup and view all the answers

What is the purpose of the nipple-stimulated contraction test?

<p>To assess fetal tolerance to the stress of labor (D)</p> Signup and view all the answers

What is a contraindication for the oxytocin-stimulated contraction test?

<p>Confirmed placenta previa (A)</p> Signup and view all the answers

Which finding indicates a negative contraction stress test (CST)?

<p>At least three contractions with no late decelerations (B)</p> Signup and view all the answers

In the nipple-stimulated contraction test, how should the client respond when a contraction begins?

<p>Stop the stimulation immediately (B)</p> Signup and view all the answers

What defines tachysystole during labor?

<p>Contractions lasting longer than 90 seconds (A)</p> Signup and view all the answers

Which scenario could indicate a positive CST?

<p>Late decelerations with 50% or more of the contractions (A)</p> Signup and view all the answers

What is an example of an ongoing nursing action during the contraction tests?

<p>Monitor for contractions longer than 90 seconds after stimulation (B)</p> Signup and view all the answers

Which condition is considered a high-risk pregnancy warranting contraction testing?

<p>Gestational diabetes mellitus (D)</p> Signup and view all the answers

What should be done if hyperstimulation occurs during the oxytocin-stimulated contraction test?

<p>Administer tocolytics as prescribed (C)</p> Signup and view all the answers

What client preparation is necessary before conducting the CST?

<p>Document baseline fetal heart rate and movements for 10-20 minutes (D)</p> Signup and view all the answers

What is the purpose of having a client maintain a full bladder before an abdominal ultrasound?

<p>To improve sound wave reflection for better image quality (B)</p> Signup and view all the answers

During a transvaginal ultrasound, what equipment is necessary for probe insertion?

<p>A protective covering for the vaginal probe (A)</p> Signup and view all the answers

Which score on a biophysical profile indicates normal fetal assessment?

<p>8 - 10 (D)</p> Signup and view all the answers

What is a requirement for scoring the fetal breathing movements in a biophysical profile?

<p>One episode lasting more than 30 seconds (A)</p> Signup and view all the answers

Which presentation is NOT considered a risk factor for fetal distress?

<p>Increased fetal movement (D)</p> Signup and view all the answers

What is the point value assigned for the absence of gross body movements in a biophysical profile?

<p>0 points (A)</p> Signup and view all the answers

What type of gel is used for vaginal probes during transvaginal ultrasound?

<p>Water-soluble gel (D)</p> Signup and view all the answers

What does a nonreactive nonstress test indicate in relation to the biophysical profile?

<p>Potential fetal distress or hypoxia (B)</p> Signup and view all the answers

Flashcards

Ultrasound Types

Different ultrasound methods for visualizing the fetus and mother.

External Abdominal Ultrasound

A non-invasive procedure using a transducer on the abdomen. Best used after the first trimester.

Transvaginal Ultrasound

An invasive procedure. A probe is put into the vagina and gives more detail. Useful for first trimester clients or clients who are obese.

Doppler Ultrasound

Non-invasive. Studies maternal-fetal blood flow, useful for IUGR/pregnancies with problems.

Signup and view all the flashcards

Ultrasound Indications

Reasons why an ultrasound might be done during pregnancy, including detecting abnormalities and gestational age.

Signup and view all the flashcards

Client Presentation (ultrasound)

Reasons a client might need an ultrasound, like vaginal bleeding or decreased fetal movements.

Signup and view all the flashcards

Fetal Well-being Assessment

Evaluation methods to verify the status of the fetus during pregnancy

Signup and view all the flashcards

Gestational Age

Determining the fetus's age of development using a physical measurement done during a scan.

Signup and view all the flashcards

Full Bladder for Ultrasound

A full bladder helps stabilize the uterus and improves sound wave reflection, leading to better image quality during an abdominal ultrasound.

Signup and view all the flashcards

Ultrasound Gel

Ultrasound gel is applied to the abdomen during a scan to help transmit sound waves and create clearer images.

Signup and view all the flashcards

Transvaginal Ultrasound Probe

A specialized probe inserted into the vagina, covered with a protective sheath, to provide detailed images of the uterus and fetus.

Signup and view all the flashcards

Biophysical Profile (BPP)

A prenatal assessment that combines a non-stress test with real-time ultrasound to evaluate fetal well-being.

Signup and view all the flashcards

Indications for BPP

A BPP is indicated when there are concerns about fetal health, such as a nonreactive non-stress test, suspected low or high amniotic fluid, or signs of fetal oxygen deprivation.

Signup and view all the flashcards

FHR Reactivity in BPP

A reactive fetal heart rate (FHR) during a BPP is considered normal and shows the fetus is responding to stimuli.

Signup and view all the flashcards

Fetal Breathing Movements in BPP

Fetal breathing movements are assessed during a BPP to evaluate fetal well-being. At least one episode of breathing for 30 seconds or more within 30 minutes is considered normal.

Signup and view all the flashcards

Fetal Tone in BPP

Fetal tone assessed in a BPP helps determine the fetus's muscle strength and ability to move. At least one episode of extension and flexion is normal.

Signup and view all the flashcards

NST

A noninvasive test that monitors fetal heart rate (FHR) in response to fetal movement.

Signup and view all the flashcards

NST Procedure

A Doppler transducer and a tocotransducer are attached to the client's abdomen. The client presses a button when they feel fetal movement.

Signup and view all the flashcards

NST Disadvantages

Can have false results, fetal sleep can affect the outcome, fetal immaturity, maternal medications, and nicotine use can interfere.

Signup and view all the flashcards

NST Indications

Used in the third trimester to assess fetal CNS integrity and to check for fetal death risk in clients with diabetes.

Signup and view all the flashcards

NST Reactive

FHR accelerates by 15 bpm (10 bpm before 32 weeks) for 15 seconds (10 seconds before 32 weeks) two or more times in 20 minutes.

Signup and view all the flashcards

NST Nonreactive

Test doesn't show the required accelerations in 20 minutes, indicating further assessment (CST or BPP) is needed.

Signup and view all the flashcards

Vibroacoustic Stimulation

Using a sound source (like a laryngeal stimulator) to wake up the fetus. Applied for 3 seconds on the mother's abdomen, over the fetal head.

Signup and view all the flashcards

NST Duration

Typically takes 20-30 minutes.

Signup and view all the flashcards

Nipple-stimulated Contraction Test

A test that involves lightly stimulating the nipples to trigger contractions, allowing doctors to assess fetal heart rate responses under stress.

Signup and view all the flashcards

Oxytocin's Role in CST

During a Nipple-stimulated Contraction Test, the stimulation releases oxytocin, a hormone that causes uterine contractions.

Signup and view all the flashcards

What Makes a CST Valid?

A Nipple-stimulated Contraction Test requires at least three contractions within 10 minutes, each lasting 40-60 seconds, for analysis.

Signup and view all the flashcards

Why Avoid Tachysystole?

Uterine tachysystole (excessive contractions) can be dangerous for both the mother and fetus, so it is avoided during the test.

Signup and view all the flashcards

Oxytocin-stimulated Contraction Test (OCT)

A test that involves administering oxytocin intravenously to induce contractions and assess the fetal response.

Signup and view all the flashcards

OCT Risks

Contractions started with oxytocin can be difficult to stop and may lead to preterm labor.

Signup and view all the flashcards

OCT Contraindications

Conditions like placenta previa, preterm labor, and multiple gestations make an Oxytocin-stimulated Contraction Test unsafe.

Signup and view all the flashcards

Negative CST Result

A normal finding during a Nipple-stimulated Contraction Test where no late decelerations in fetal heart rate occur during contractions.

Signup and view all the flashcards

Positive CST Result

An abnormal finding indicating uteroplacental insufficiency, where late decelerations occur during at least 50% of contractions.

Signup and view all the flashcards

Major CST Complication

A potential complication of the Nipple-stimulated Contraction Test is preterm labor.

Signup and view all the flashcards

Amniocentesis

A procedure where amniotic fluid is extracted from the uterus using a needle under ultrasound guidance for various prenatal diagnoses.

Signup and view all the flashcards

Amniocentesis Indications

Reasons for performing amniocentesis include a previous birth with a chromosomal anomaly, family history of neural tube defects, or prenatal diagnosis of genetic disorders.

Signup and view all the flashcards

Amniocentesis Pre-Procedure

The nurse explains the procedure, obtains informed consent, and instructs the client to empty their bladder beforehand.

Signup and view all the flashcards

Amniocentesis Intra-Procedure

The nurse obtains baseline vital signs and FHR, assists the client into a supine position, and prepares for ultrasound localization.

Signup and view all the flashcards

Amniotic Fluid Analysis

Amniotic fluid can be analyzed for alpha-fetoprotein (AFP) levels, which can detect neural tube defects, chromosomal disorders, or fetal abnormalities.

Signup and view all the flashcards

AFP Levels & Pregnancy

High maternal AFP levels may indicate fetal abnormalities, while low AFP levels may indicate neural tube defects.

Signup and view all the flashcards

Lung Maturity Assessment

Amniotic fluid can be analyzed to determine the maturity of the fetal lungs, often done before premature delivery.

Signup and view all the flashcards

Fetal Hemolytic Disease

Amniocentesis can be used to diagnose and monitor fetal hemolytic disease, where fetal blood is being destroyed.

Signup and view all the flashcards

PUBS Procedure

A procedure for extracting fetal blood from the umbilical cord using a fetoscope and ultrasound guidance.

Signup and view all the flashcards

PUBS Indications

Reasons for performing PUBS include determining fetal blood type, anemia screening, and diagnosing fetal chromosomal disorders, infections, or altered fetal acid-base balance.

Signup and view all the flashcards

PUBS Complications

Possible complications of PUBS include cord laceration, preterm labor, hematoma, and fetomaternal hemorrhage.

Signup and view all the flashcards

Fetal Lung Maturity

Tests for fetal lung maturity are done in pregnancies under 37 weeks, especially with membrane rupture, preterm labor, or complications requiring cesarean birth. These tests assess the fetus's lung readiness for extrauterine life.

Signup and view all the flashcards

L/S Ratio

The Lecithin/Sphingomyelin (L/S) ratio in amniotic fluid indicates fetal lung maturity. A 2:1 ratio is typically mature, while a 2.5:1 or 3:1 ratio is needed for diabetic mothers.

Signup and view all the flashcards

PG Absence

Absence of Phosphatidylglycerol (PG) in amniotic fluid is associated with a risk of respiratory distress in the newborn.

Signup and view all the flashcards

Rh Isoimmunization Risk

After PUBS, Rh-negative mothers need Rho(D) immune globulin to prevent potential Rh isoimmunization, a condition that can harm future pregnancies.

Signup and view all the flashcards

Post-PUBS Nursing Actions

After PUBS, nurses monitor fetal heart rate, administer medications, ensure proper support, and report any signs of complications like fever, bleeding, or contractions.

Signup and view all the flashcards

CVS Timing

Chorionic villus sampling is ideally performed between 10 and 13 weeks of gestation.

Signup and view all the flashcards

Quad Marker Screening

A blood test that assesses the likelihood of fetal birth defects by analyzing four specific proteins in the mother's blood.

Signup and view all the flashcards

Maternal Serum Alpha-Fetoprotein (MSAFP)

A blood test that screens for neural tube defects in the fetus.

Signup and view all the flashcards

MSAFP High Levels

High levels of maternal serum alpha-fetoprotein may indicate a neural tube defect or an open abdominal defect in the fetus.

Signup and view all the flashcards

MSAFP Low Levels

Low levels of maternal serum alpha-fetoprotein may indicate Down syndrome in the fetus.

Signup and view all the flashcards

Full Bladder for CVS

Drinking fluids and avoiding urination before CVS is crucial as a full bladder helps stabilize the uterus for the procedure.

Signup and view all the flashcards

More Like This

Pregnancy and Fetal Aging Assessment Quiz
3 questions

Pregnancy and Fetal Aging Assessment Quiz

LuckyNephrite9013 avatar
LuckyNephrite9013
Fetal Assessment During Labor
33 questions

Fetal Assessment During Labor

DetachableHydra avatar
DetachableHydra
Pregnancy and Fetal Assessment Overview
30 questions

Pregnancy and Fetal Assessment Overview

emmamac avatar
emmamac
Intrapartum Fetal Assessment Quiz
23 questions

Intrapartum Fetal Assessment Quiz

SteadfastNurture2569 avatar
SteadfastNurture2569
Use Quizgecko on...
Browser
Open
Browser
Browser