ATI Capstone Maternal Newborn Assessment
() Question and Answer A+
Verified
• vertex presentation -✓✓Fetal heart tones should be assessed below the mother's
umbilicus in either the right or left lower quadrant of the abdomen
• breech presentation -✓✓Fetal heart tones should be assessed above the mother's
umbilicus in either the right- or left-upper quadrant of the abdomen.
• considerations -✓✓- ask the client to empty the bladder before beginning the
assessment
- place client in supine position with a pillow under the head, and have both knees
flexed
- place a small , rolled towel under the client's right or left hip to displace the
uterus off the major blood vessels to prevent supine hypotensive syndrome
• intermittently auscultate during the latent phase -✓✓- every 30-60 minutes
• intermittently auscultate during the active phase -✓✓- every 15-30 minutes
• intermittently auscultate during the second stage -✓✓- every 5-15 minutes
• indications for leopold maneuvers -✓✓- determine active labor
- rupture of membranes spontaneously or artificially
- preceding and subsequent to ambulation
- prior to following administration of or a change in medication analgesia
- at peak action of anesthesia
- following vaginal examination
- following expulsion of an enema
- after urinary catheterization
- abnormal or excessive uterine contractions
• normal FHR -✓✓110-160 w/ increases and decreases from baseline
,• continuous electronic fetal monitoring -✓✓- accomplished by securing an
ultrasound transducer over the clients abdomen, which records the FHR pattern
and a tocotransducer on the fundus that records the uterine contraindications
• indications for electronic fetal monitoring -✓✓- multiple gestations
- oxytocin infusion
- placenta previa
- fetal bradycardia
- maternal complications
- intrauterine growth restriction
- post-date gestation
- active labor
- meconium stained amniotic fluid
- abruptio placentae
- abnormal nonstress test or contraction stress test
- abnormal uterine contractions
- fetal distress
• Three Tier System -✓✓- fetal monitoring system with FHR interpretation system
• - category 1 -✓✓- baseline FHR of 110-160 /min
- baseline FHR variability: moderate
- accelerations present or absent
- early decelerations: present or absent
- variable/late decelerations: absent
• Category 2 -✓✓- tracings include all FHR tracings not categorized as category 1
or 3.
- baseline rate (tachycardia, bradycardia not accompanied by absent baseline
variability)
- baseline FHR variability (minimal baseline variability, absent baseline variability
not accompanied by recurrent decelerations, marked baseline variability)
- episodic or periodic decelerations ( prolonged FHR decel equal or greater than 2
min but less than 10 min, recurrent late decelerations w/ moderate baseline
variability, recurrent variable decels w/ minimal or moderate baseline variability
- variable decels w/ additional characteristics including overshoots, shoulders, or
slow return to baseline FHR
, • category 3 -✓✓- FHR tracings include either sinusoidal pattern, absent baseline
FHR variability (recurrent late/variable decels, bradycardia)
- increment, acme, decrement
• increment uterine contractions -✓✓- beginning of the contraction as intensity is
increasing
• adme uterine contractions -✓✓- peak intensity of the contraction
• - decrement uterine contractions -✓✓- the decline of the contraction intensity as
contraction is ending
• accelerations -✓✓- Variable transitory increase in the FHR above baseline
• causes of accelerations -✓✓- healthy fetal/placental exchange
- vaginal exam
- fundal pressure
- intact CNS response to fetal movement
- uterine contractions
- fetal scalp stimulation
• nursing interventions for accelerations -✓✓- be reassuring
- no interventions required
- indicate reactive nonstress test
• fetal bradycardia -✓✓- FHR less than 110/min for 10 min or more
• causes of fetal bradycardia -✓✓- uteroplacental insufficiency
- umbilical cord prolapse
- materanl hypotension
- prolonged umbilical cord compression
- anesthetic medications
- fetal congenital heart block
- viral infections
- maternal hypoglycemia
- fetal heart failure
- maternal hypothermia
() Question and Answer A+
Verified
• vertex presentation -✓✓Fetal heart tones should be assessed below the mother's
umbilicus in either the right or left lower quadrant of the abdomen
• breech presentation -✓✓Fetal heart tones should be assessed above the mother's
umbilicus in either the right- or left-upper quadrant of the abdomen.
• considerations -✓✓- ask the client to empty the bladder before beginning the
assessment
- place client in supine position with a pillow under the head, and have both knees
flexed
- place a small , rolled towel under the client's right or left hip to displace the
uterus off the major blood vessels to prevent supine hypotensive syndrome
• intermittently auscultate during the latent phase -✓✓- every 30-60 minutes
• intermittently auscultate during the active phase -✓✓- every 15-30 minutes
• intermittently auscultate during the second stage -✓✓- every 5-15 minutes
• indications for leopold maneuvers -✓✓- determine active labor
- rupture of membranes spontaneously or artificially
- preceding and subsequent to ambulation
- prior to following administration of or a change in medication analgesia
- at peak action of anesthesia
- following vaginal examination
- following expulsion of an enema
- after urinary catheterization
- abnormal or excessive uterine contractions
• normal FHR -✓✓110-160 w/ increases and decreases from baseline
,• continuous electronic fetal monitoring -✓✓- accomplished by securing an
ultrasound transducer over the clients abdomen, which records the FHR pattern
and a tocotransducer on the fundus that records the uterine contraindications
• indications for electronic fetal monitoring -✓✓- multiple gestations
- oxytocin infusion
- placenta previa
- fetal bradycardia
- maternal complications
- intrauterine growth restriction
- post-date gestation
- active labor
- meconium stained amniotic fluid
- abruptio placentae
- abnormal nonstress test or contraction stress test
- abnormal uterine contractions
- fetal distress
• Three Tier System -✓✓- fetal monitoring system with FHR interpretation system
• - category 1 -✓✓- baseline FHR of 110-160 /min
- baseline FHR variability: moderate
- accelerations present or absent
- early decelerations: present or absent
- variable/late decelerations: absent
• Category 2 -✓✓- tracings include all FHR tracings not categorized as category 1
or 3.
- baseline rate (tachycardia, bradycardia not accompanied by absent baseline
variability)
- baseline FHR variability (minimal baseline variability, absent baseline variability
not accompanied by recurrent decelerations, marked baseline variability)
- episodic or periodic decelerations ( prolonged FHR decel equal or greater than 2
min but less than 10 min, recurrent late decelerations w/ moderate baseline
variability, recurrent variable decels w/ minimal or moderate baseline variability
- variable decels w/ additional characteristics including overshoots, shoulders, or
slow return to baseline FHR
, • category 3 -✓✓- FHR tracings include either sinusoidal pattern, absent baseline
FHR variability (recurrent late/variable decels, bradycardia)
- increment, acme, decrement
• increment uterine contractions -✓✓- beginning of the contraction as intensity is
increasing
• adme uterine contractions -✓✓- peak intensity of the contraction
• - decrement uterine contractions -✓✓- the decline of the contraction intensity as
contraction is ending
• accelerations -✓✓- Variable transitory increase in the FHR above baseline
• causes of accelerations -✓✓- healthy fetal/placental exchange
- vaginal exam
- fundal pressure
- intact CNS response to fetal movement
- uterine contractions
- fetal scalp stimulation
• nursing interventions for accelerations -✓✓- be reassuring
- no interventions required
- indicate reactive nonstress test
• fetal bradycardia -✓✓- FHR less than 110/min for 10 min or more
• causes of fetal bradycardia -✓✓- uteroplacental insufficiency
- umbilical cord prolapse
- materanl hypotension
- prolonged umbilical cord compression
- anesthetic medications
- fetal congenital heart block
- viral infections
- maternal hypoglycemia
- fetal heart failure
- maternal hypothermia
