NURS 2145 Test 2 QUESTIONS AND ANSWERS

NURS 2145 Test 2 Why do contractions decrease the blood supply to the fetus? Correct Answer: Compression on the blood vessels Sign of hyperventilation Correct Answer: tingling Intervention for hyperventilation Correct Answer: Slow down breathing by breathing into a bag or cupped hands Why do you want a woman on her back? Correct Answer: Inferior vena cava compression The parasympathetic nervous system _________ FHR Correct Answer: decreases The sympathetic nervous system ____________ FHR Correct Answer: increases How to promote adequate fetal oxygenation? Correct Answer: Mask, not on back, reposition When would you report if the fetus isn't moving? Correct Answer: 4x in 30 min or 10x in 1 hr Purpose of Leopold's Maneuver Correct Answer: To determine presentation and position of fetus and aid in location of fetal heart sounds First maneuver Correct Answer: Determines presenting part Where do you palpate the 1st maneuver? Correct Answer: Uterine fundus Second maneuver Correct Answer: Determines where fetal back is located How to perform second maneuver Correct Answer: Hold left hand steady on side of uterus while palpating opposite side of uterus w/right hand Third maneuver Correct Answer: Confirms presenting part is engaged How to perform third maneuver Correct Answer: Palpate suprapubic area Fourth maneuver Correct Answer: Determines whether the head is flexed or extended How to perform fourth maneuver Correct Answer: Place hands on sides of uterus with fingers pointed toward the pelvic outlet. Let fingers slide downward and feel for cephalic prominence FHR is affected by Correct Answer: Position, size, and movement of the fetus How does internal fetal monitoring differ from EFM Correct Answer: Can see intensity and strength When should you read the FHR baseline Correct Answer: In between contractions Factors that influence variability Correct Answer: Narcotics, prematurity, fetal sleep, decreased O2 of the fetal CNS, abnormalities in fetal CNS, heart, or both Minimal variability Correct Answer: 5pm or fewer Moderate variability Correct Answer: 6-25 bpm Marked variability Correct Answer: 25 bpm VEAL CHOP Correct Answer: Variability, Early decelerations, Accelerations, Late decelerations. Compressed cord, Head compression, Oxygen activity, Uteroplacental insuffiency A good acceleration Correct Answer: 15 bpm over 15 seconds Describe early decelerations Correct Answer: FHR drops as contraction rises; mirror the UC, gradual, consistent pattern Interventions for early decelerations Correct Answer: VE exam and set up room. Get ready for delivery Describe late decelerations Correct Answer: FHR drops after UC; subtle, recurrent Interventions for late decelerations Correct Answer: Start O2 by mask 8-12 L, woman on side, increase IV fluids, turn off Pitocin, Notify MD, call anesthesia for C/S room Describe variable deceleartions Correct Answer: Abrupt onset and offset, sharp dip, occurs at any time, not consistent; U,V,or W shape Intervention for variable decelerations Correct Answer: Maternal position change Category 1 Correct Answer: 110-160 bpm, moderate variability, normal, routine care Category 2 Correct Answer: Bradycardia w/variability, tachycardia, minimal or marked variability, late and early decels Category 3 Correct Answer: Absent variability, recurrent late decels, recurrent variable decels, bradycardia, sinusoidal pattern; abnormal Resting tone goal Correct Answer: 20 mmHg Braxton Hicks Correct Answer: Painless, irregular contractions Ballottement Correct Answer: A tap on the cervix during VE may cause fetus to rise and rebound CHadwick's sign Correct Answer: Cervis is bluish color, extends to vagina and labia Goodell's sign Correct Answer: Softening of the cervix