NUR 221 Exam 2 Study Guide PDF
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Hondros College
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Summary
This study guide covers high-risk maternal and fetal monitoring. It includes information on fetal heart rate patterns, contractions, and complications during labor, such as decelerations and hypertensive disorders. The document also includes a practice exam for obstetrics and maternal health.
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Week 4 Study Guide: High-Risk Maternal and Fetal Monitoring Fetal Monitoring and Assessment Daily Fetal Movement Count (DFMC) Also known as: Kick count. Decreased fetal movement: Can indicate hypoxemia. Protocols for DFMC: Count activity once per day for 60 minutes. Count ac...
Week 4 Study Guide: High-Risk Maternal and Fetal Monitoring Fetal Monitoring and Assessment Daily Fetal Movement Count (DFMC) Also known as: Kick count. Decreased fetal movement: Can indicate hypoxemia. Protocols for DFMC: Count activity once per day for 60 minutes. Count activity after meals or before bedtime for 2 hours or until 10 movements are felt. Count for 12 hours or until 10 movements are felt. Non-Stress Test (NST) Purpose: Widely used to evaluate fetal status. An adequately oxygenated fetus should show accelerated fetal heart rate (FHR) in response to fetal movement. Procedure: Positioning: Avoid the supine position. The recommended positions are reclining chair, left-tilted semi-Fowler's, or side-lying. Electronic Fetal Monitoring (EFM) to obtain data. ○ The mother is given a button to push when she feels fetal movement. NST Results Interpretation: Reactive (Normal): At least two accelerations of FHR by 15 beats or more over 20 minutes. For preterm fetuses (160 bpm. ○ Bradycardia: 25 bpm (may be due to drug use). FHR Changes: Accelerations and Decelerations FHR Accelerations: Increase from baseline by at least 15 bpm lasting 15 seconds but less than 2 minutes. Decelerations: Early Decelerations: Caused by head compression. No intervention is necessary. Variable Decelerations: Caused by cord compression. Position changes may help relieve pressure on the umbilical cord. Administer oxygen and possibly amnioinfusion for severe decelerations. Late Decelerations: Caused by uteroplacental insufficiency. These are the most ominous and require immediate intervention. ○ Interventions: Oxygen, lateral position, increase IV fluids, discontinue oxytocin, and prepare for possible emergency cesarean. Prolonged Decelerations: A deceleration lasting more than 2 minutes but less than 10 minutes. ○ Commonly associated with uterine hyperstimulation. ○ Interventions: POISON — Position change (left side), Oxytocin off, Increase IV fluids, Steril Vaginal Exam. Assessing Contractions and Uterine Activity Contractions: Frequency: Time from the beginning of one contraction to the beginning of the next. Duration: Length of each contraction (measured in seconds). Tachysystole: More than 5 contractions in 10 minutes, which can deprive the fetus of oxygen. Fetal Heart Rate Patterns and Monitoring Fetal Tachycardia: FHR >160 bpm for 10 minutes or longer. May indicate maternal fever, fetal sepsis, hypoxemia, or drugs. ○ Ominous signs if accompanied by late decelerations, severe variable decelerations, or decreased variability. Fetal Bradycardia: FHR
