1. T/F: Corticosteroid administration may cause an increase in FHR. The non-stress test should be conducted for at least 20 minutes. 3.Time noted, for example that a patient was monitored for a certain number of minutes or hours through the course of the stay. The basis of the nonstress test is that in a well oxygenated ,non acidemic fetus, the fetal heart rate will periodically undergo acceleration. According to NICHD terminology, variability can be accurately accessed, B. Visually, by determining the amplitude of the FHR change in bpm from the baseline, When looking at the fetal heart rate, the most important characteristic to determine the absence of metabolic acidemia is, Sinusoidal pattern can be documented when, B. You must know how to identify early decelerations, late decelerations, and variable decelerations. Baseline FHR variability is determined in what amount of time, excluding accelerations and decelerations? At how many weeks gestation should FHR variability be normal in manner? Deceleration that occurs after the start of the contraction, caused by fall in O2 to the fetus; Non stress test → 20 minutes of noninvasive fetal monitoring. • The non-stress test (NST) is the most widely used method to assess fetal well being. How CTG works. What fetal heart rate characteristics can be determined with auscultation? Late decelerations mean that your baby might have problems during normal labor. This is a little wire placed under the fetal skin on the sculpt. Select all that apply. Your first intervention should be to, Resuscitation measures improves the baby's variability, but the FHR is still not reactive. T/F: It is an appropriate intervention to perform fetal scalp stimulation during a deceleration. B. This is interpreted as. The most prevalent risk factor associated with fetal death before the onset of labor is: Which of the following is NOT used for antepartum fetal surveillance? T/F: In the context of moderate variability, late decelerations are considered neurogenic in origin and are typically amenable to intrauterine resuscitation techniques directed towards maximizing uterine blood flow. Which of the following is not a type of supraventricular dysrhythmia? Vibroacoustic Stimulation (VAS): A non-invasive method of evoking a reactive NST in fetuses found to be in a The testing results are either reactive or nonreactive. Found insideA portable, pocket-sized manual based on the world's leading obstetrics text-revised and updated! "This is a comprehensive review of pregnancy complications in an easy to access format. No decelerations (except occasional variable decelerations, infrequent early . Reactive occurs if there are 2 or more accelerations in a 20 min period. A Category I FHR tracing requires which of the following? As the FHR increases, the myocardium consumes _____ oxygen. Although an association existed with nuchal cord location found at delivery, no association existed between these variable decelerations and fetal heart rate decelerations during labor, low . A woman receives terbutaline for an external version. Is it a prolapsed cord? Your baby's heart rate gets slower (decelerates) and stays slow after the contraction (late decelerations). Which of the following is the least likely explanation? Before ___ weeks of gestation, an increase in FHR that peaks at least 10 bpm above the baseline and lasts at least 10 seconds is considered an acceleration. This is not. Which medications used with preterm labor can affect the FHR characteristics? The fetal heart rate should increase or accel with movement. We use cookies to help provide and enhance our service and tailor content and ads. (III-B) 3. A patient receiving oxytocin has 17 contractions in 30 minutes. A nurse is caring for a pregnant client in labor and notices the fetal heart rate has decelerations that start after the contraction starts. What characterizes a preterm fetal response to stress? Which assessment or intervention would be least appropriate in a patient whose FHR tracing revealed tachycardia and a prolonged deceleration? Found insideThis practical manual promotes an evidence-based paradigm of fetal heart rate monitoring during labour, moving away from the traditional 'pattern-based' interpretation to physiology-based interpretation. (Cheat Sheet), 04.06 Disseminated Intravascular Coagulation (DIC), 04.09 Hydatidiform Mole (Molar pregnancy), 07.04 Abruptio Placentae (Placental abruption), 08.01 Postpartum Physiological Maternal Changes, 10.01 Initial Care of the Newborn (APGAR). The “P” is placental insufficiency”. For a contraction stress test to be interpretable, you must have a minimum of: A negative contraction stress test is one in which: c. There are no fetal heart rate late decelerations with the contractions, According to AWHONN, the normal baseline Fetal Heart Rate (FHR) is. • Decelerations are not uncommon on NSTs and with an incidence up to 18% their significance is difficult to interpret (Dawes 1982). _______ denotes a decrease in oxygenation of the fetal tissues. When the placenta covers the cervical os, this is called, An additional placental lobe is defined as, During periods of fetal tachycardia, FHR variability is usually diminished due to, A. (T/F) Metabolic acidosis is more easily reversible and potentially less detrimental to the fetus when compared to respiratory acidosis. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage. T/F: Adequacy of uterine resting tone measured by an IUPC should be validated by palpation. (T/F) Contractions during a contraction stress test (CST) may be spontaneous or induced with oxytocin or nipple stimulation. asked Aug 6 in Nursing by Fmart. In addition, you must know what is causing each type of deceleration, such as uteroplacental insufficiency or umbilical cord compression. A. pH 7.17, PO2 22, PCO2 70, HCO3 24, BE -5, Cord blood gases from one of the umbilical arteries best represent, A modified biophysical profile (mBPP) is considered normal if, B. NST is reactive and the amniotic fluid index (AFI) is greater than 5 cm. For a patient at 38 weeks' gestation with a BPP score of 6, select the most appropriate course of action. Now let’s look at some of this monitoring. Intermittent auscultation for the low-risk patient, Supporting the parents decision to choose no extraordinary measures on their baby who is about to deliver at 24 3/7 weeks gestation despite the nurses personal opinion is an example of. T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect accelerations and decelerations from the baseline, and can clarify double-counting of half-counting of baseline rate. Late deceleration is a gradual decrease in fetal heart rate after a uterine contraction. T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. C. Often leads to ventricular tachycardia (VT). A contraction stress test (CST) is done. A deceleration from 145bpm down to 100bpm lasting 12 minutes may be defined as a. All of the following are likely causes of prolonged decelerations except: _______ decelerations occur with less than 50% of contractions. A type 1 excludes note is a pure excludes. T/F: All fetal monitors contain a logic system designed to reject artifact. While a nonstress test can offer reassurance about your baby's health, it can cause anxiety, too. The fetal heart rate or FHR is normally determined via the Fetal Non-Stress Test (NST/FNST). Never good! A. Amniotic fluid, fetal breathing, fetal movement, fetal tone. FHTs with recurrent variable decelerations, no accelerations, and minimal variability would be categorized as, FHTs with absent variability and bradycardia would be categorized as, FHTs with moderate variability, no accelerations, and early decelerations would be categorized as, FHTs with accelerations, no decelerations, and minimal variability would be categorized as, FHTs with absent variability and no accelerations or decelerations would be categorized as, Absence of accelerations following fetal stimulation (i.e. Also, the writing of questions sets up a perfect stage for exam-studying later. The first paper on the history of fetal heart rate monitoring takes us back to the beginning of fetal surveillance and provides an introduction to the different aspects of fetal observation which are covered later in this volume. Next are early decelerations and these are associated with a contractions that cause head compression as we are close to delivery. T/F: Variability can be determined with the fetoscope. This is when there are abrupt decreases in the fetal heart rate and occurs because of cord compression. You inform the physician that you are not comfortable starting oxytocin based on maternal history, SVE, and FHR tracing. Fetal blood has a _______ hemoglobin concentration compared to adults. Which of the following is not commonly caused by administration of indomethacin? Elements of a malpractice claim include all of the following except. A. Fetal hemoglobin is higher than maternal hemoglobin, Baroreceptors respond mainly to changes in, Stimulation of the sympathetic nervous system causes the fetal heart rate to. The primary assumption when using EFM is that _____ produces physiological changes that can be detected by changes in the FHR. The time from onset to nadir is less than. The "overshoot" FHR pattern is highly predictive of, A key point regarding the occurrence of tachysystole is that, B. What might increase fetal oxygen consumption? What’s beyond them? In comparison to maternal blood, the affinity of fetal blood for oxygen is, The process that requires energy to accomplish the passage of substances within the intervillous space is, C. Oxygenated blood from the placenta to the fetus, Fetal hypoxia is best described as a condition of, Stimulation of the parasympathetic nervous system causes the FHR to, Chemoreceptors respond mainly to changes in, The fetus responds to a significant drop of PO2 by. To be considered reactive, a nonstress test must have: d. 2 fetal heart rate accelerations in a 20 minute window. T/F: The external toco is usually placed over the uterine fundus to pick up contractions. Which of the following best describes a condition in which there is decreased oxygen in the tissues? Perfusion, safety, and clinical Judgment will be concepts for fetal monitoring. Which of the following is false regarding electronic fetal monitoring of twins? Further assess fetal oxygenation with scalp stimulation. In-depth debate on choice of intermittent or continuous electronic fetal heart rate monitoring enables correct identification of the appropriate method Updated references and recommendations from latest national guidelines ensure readers ... Which of the following actions should the nurse perform? 247 patients with risk of uteroplacental insufficiency were monitored by 434 oxytocin challenge tests (OCT) and non-stress-tests (NST). An examination of 908 fetal heart rate tests of 418 consecutive patients revealed brief variable decelerations in more than 50.7% of the patients. Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous system? T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped in warm water to make cleaning easier. Which statement describes normal uterine activity? scalp stimulation) is categorized as, FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as, FHTs with minimal variability and a baseline of 95bpm would be categorized as, FHTs with a baseline of 170bpm, moderate variability, and no accelerations or decelerations would be categorized as, FHTs with a baseline 135bpm, moderate variability, accelerations, and one late deceleration would be categorized as. C. Tell the physician that you decline to start the oxytocin, and notify the physician that you are activating your chain of command. _______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon dioxide (PCO2) values. Select all that apply. - 태아심박동을 조절하는 중추신경계의 기능 을 본다. Stimulating the vagus nerve typically produces: What initially causes a chemoreceptor response? A nonstress test (NST) is a screening test used in pregnancy to assess fetal status by means of the fetal heart rate and its responsiveness. B. I would like to answer your questions about continuous monitoring and give you some information about why continuous monitoring is recommended. internal monitoring), Notify provider of potential cause, interventions, mother and baby’s response and prepare for further potential intervention, Press button on the monitor when you feel the baby move during a NST, That Time I Dropped Out of Nursing School. In a patient whose CST reveals late decelerations with three out of the four induced contractions, which of the following would be the least appropriate plan for treatment? C. Decrease or discontinue oxytocin infusion. B. 5 Steps to Writing a (kick ass) Nursing Care Plan, Dear Other Guys, Stop Scamming Nursing Students, The S.O.C.K. _______ FHR patterns are those that are not associated with uterine contractions. For a patient at 35 weeks' gestation with a BPP score of 4, select the most appropriate course of action. T/F: Amnioinfusion may be an appropriate intervention for patients with oligohydramnios in the prevention of the development of variable decelerations. (The biophysical profile allows a more thorough evaluation of fetal well-being and has the potential to significantly reduce the false-positive rate of the non-stress test (NST) and contraction . All of the following could likely cause minimal variability in FHR except. Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is typically present in _______. T/F: Meconium-stained amniotic fluid is an indication for amnioinfusion. C. The mother counts the number of movements over a specified length of time. "The non-stress test is a special test we like to perform in some moms who are considered to have a high-risk pregnancy or when she develops problems during her pregnancy," says Ob/Gyn Edward . Explain what early declarations are, and what causes them. What affect does magnesium sulfate have on the fetal heart rate? T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of adequate fetal oxygenation. The provider arrives on the unit and states that she will remain on the floor, and writes orders to start oxytocin. T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns with absent variability. The initial nursing action is to: The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. How long may a standard NST be extended in a term gestation if reactivity is not initially demonstrated? _______ variability warrants cesarean section delivery. Evaluation of the FHR over at least a 10-min window, An EFM tracing with absent variability and no decelerations would be classified as, An EFM tracing with absent variability and intermittent late decelerations would be classified as, Interpretation and classification of FHR patterns are based on predictability of fetal status, Amnioinfusion is an appropriate measure for, C. Recurrent variable decelerations unresolved by position changes, Baroreceptors respond to changes in fetal, Fetal scalp stimulation is appropriate in the context of, Maternal oxygen administration is appropriate in the context of, B. We want to see accelerations and good variability. Or is the reason from mom. Found insideActocardiogram: Analysis of Fetal Motion and Heart Rate is a concise guide to this method of simultaneously tracing foetal heart rate and movement using a single probe, by Kazuo Maeda from the Tottori University Medical School, Yonago, ... You suspect that there could be chronic fetal asphyxia because the score is below, When using a fetal scalp electrode (FSE), you notice an abnormally low FHR on the monitor. Extrinsic factors affecting the FHR include, When the umbilical vessels traverse the membranes to the placenta without any cord protection, this is called. Materials and methods: A total of 1055 NST lasting 30 min were performed in 368 autochthonous mothers with low-risk pregnancies. - 절차방법 : This is interpreted as, A contraction stress test (CST) is performed. Include nursing interventions for a patient experiencing late decelerations. With complete umbilical cord occlusion, the two umbilical arteries also become occluded, resulting in sudden fetal hypertension, stimulation of the baroreceptors, and a sudden _______ in FHR. Which of the following is not commonly caused by nifedipine administration? The normal mean value range for arterial pH is, The normal mean value range for arterial PCO2 is, The normal mean value range for arterial bicarbonate (HCO3) is, The normal mean value range for arterial base deficit is, The normal mean value range for arterial PO2 is. 2. T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. Baroreceptors influence _____ decelerations with moderate variability. Uterine tachysystole is observed when there are. (Mnemonic), OB Non-Stress Test Results 4.Signature and authentication. Call the physician to arrange for a BPP or CST. -Antepartum Non-Stress Test (NST) (20minute trace) is either "reactive" or "non-reactive".-Intra-partum (Cardiotocography) CTG is either "reassuring" or "non-reassuring" Reassuring trace: Basal FHR is between 120-160 bpm. Infection is a risk anytime something from outside is entering the uterus. early deceleration in fetal heart rate monitoring, a transient decrease in heart rate that coincides with the onset of a uterine contraction. Nonreactive is when there is less than 2 accelerations in a 20 min period. A better way to learn maternal and newborn nursing! This unique presentation provides tightly focused maternal-newborn coverage in a highly structured text T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns of moderate to severe late decelerations. Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. An examination of 908 fetal heart rate tests of 418 consecutive patients revealed brief variable decelerations in more than 50.7% of the patients. A nurse is caring for a pregnant client who is in labor. Which of the following best describes this phenomenon? Begum F, Buckshee K. Foetal compromise by spontaneous foetal heart rate deceleration in reactive non-stress test and decreased amniotic fluid index. Make sure you check out the resources attached to this lesson and review the mnemonic VEAL-CHOP.. Now, go out and be your best selves today. This is a short reference on the physiologic benefits, instrumentation, application and interpretation of fetalheart rate monitoring. The Nonstress Test (NST) Background . A nonstress test is relatively short, lasting about 20 to 40 minutes. T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. A nonstress test (NST) is nonreactive after 40 minutes. Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. In a patient with oxytocin-induced tachysystole with normal fetal heart tones, which of the following should be the nurse's initial intervention? C. Range visually detectable but

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