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NRN 102 (CH 17)
CCAC NRN 102 Fetal Assessment During Labor
| Questi | Answer |
|---|---|
| What must be maintained during labor to prevent fetal compromise and promote newborn health after birth? | Fetal oxygen supply |
| What does reassuring FHR include? | Normal baseline rate of 110 - 160 beats/min, moderate variability, presence of accelerations, absence of decelerations |
| What does a nonreassuring FHR pattern include? | Baseline FHR rate of less than 110 or more than 160 beats/min, absent or persistently minimal variability, recurrent late or variable decelerations, bradycardia |
| What is the purpose of electronic FHR monitoring? | The ongoing assessment of fetal oxygenation. |
| What is the goal of electronic monitoring? | To detect fetal hypoxia and metabolic acidosis during labor so that interventions to resolve the problem can be implemented in a timely manner before permanent damage or death occurs. |
| What does the tocotransducer measure? | Uterine activity transabdominally |
| What is baseline FHR? | the average rate during a 10 minute segment that excludes accelerations, decelerations, and periods of marked variability |
| Waht is baseline variability? | The fluctuations in the baseline FHR that are irregular in amplitude and frequency. |
| What are the classifications of variability? | Absent or undetectable, minimal (<5 beats/min), Moderate (6 to 25 beats/min), Marked (>25 beats/min) |
| What are accelerations reliable in predicting? | Absence of fetal metabolic acidemia |
| What must occur before an intrauterine pressure catheter can be used? | Rupture of membranes |
| What is the rule for determining an acceleration? | 15 beats/min above the baseline for 15 sec |
| Early deceleration | gradual decrease and return to baseline associated with contractions. |
| Caused by fetal head compression | Early decelerations |
| Late decelerations | gradual decrease and return to baseline associated with contractions with the lowest point after the peak of the contraction |
| usually indicate uteroplacental insufficency | Late decelerations |
| Prolonged deceleration | deceleration of FHr from the baseline of at least 15 beats/min lasting more than 2 min but less than 10 min. |
| Recurrent decelerations | occur with more than 50% of contractions |
| abrupt decleration and return to baseline of 15 beats/min or more lasting more than 15 sec but less than 2 minutes. | Variable decelerations |
| caused by compression of the umbilical cord | variable deceleration |
| List some causes of variable decelerations | maternal position with cord between fetus and maternal pelvis, cord around the fetal neck, arm, or body, short cord, knot in cord, prolapsed cord |
| What is your priority intervention with variable or late decelerations? | Change maternal position |
| What are the three priority interventions in order in intrauterine resusitation? | 1) open the maternal and fetal vasculature system (position change) 2) increase blood volume (open IV) 3) optimize oxygenation to the circulating blood volume (administer O2) |
| What is amnioinfusion? | Infusion of room temperature isotonic fluid into the uterine cavity through a double lumen IUPC when the amniotic fluid volume is low. |
Created by:
JayneAnn
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