NSG 3500 EXAM QUESTIONSAND ANSWERS A+
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Fetal Heart Rate (FHR)
110-160
Variation of fetal heart
Absent (no fluctuations/flat),minimal (5 bpm variation), moderate (6-25 bpm variation),
marked (>25 bpm variation)
you want to see moderate
A sedated baby could show
minimal variability
marked variability in FHR
>25 bpm
indication of distress
Accelerations in FHR
Transient increase in FHR (15x15) for term and 10x 10 minimum for PT
32 weeks and lower should be about 10x10
32 weeks and higher should be about 15x15
What happens if there are no accelerations
Distressed baby
Decelerations in FHR
Periodic decrease in FHR
could be an indication of a problem
VEAL CHOP
V- Variable C- Cord Comphression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placenta
Periodic decelerations
Decelerations of fetal heart rate associated with uterine contractions.
episodic decelerations
drops in the FHR not associated with uterine contractions
causes for accelerations
- spontaneous fetal movement
- during a vaginal exam
- electrode application
- fetal reaction to external sounds
- fetal scalp stimulation
- breech presentation
- occiputposterior position
,- uterine contractions
- fundal pressure
- abdominal palpation
accelerations are
normal and signifies fetal well being
Types of decelerations
early, late, variable
Early decelerations
everything lines up perfectly
head is being compressed on.
the baby is in the canal and is ready to come out
PREPARE FOR DELIVERY
Late decelerations
at peak of contraction, baby's heart rate start to drop. Shifted to the right of the
contraction.
Placental insufficiency.
Not giving the baby oxygen
baby's "oxygen supply" starts running out if continual late decels occur
Variable decelerations
Sharp decline and incline
cord compression
baby can press on their own cord
prolapsed cord through the cervix (emergency situation) do not take hand out until baby
comes out because if you let go, the cord will compress again
you can add fluid to the amniotic sac
Prolonged deceleration
A visually apparent decrease (may be either gradual or abrupt) in FHR of at least 15
beats/min below the baseline and lasting more than 2 minutes but less than 10 minutes
Sinusoidal FHR pattern
A specific fetal heart rate pattern that is described as a smooth, sine-wave like
undulating pattern with a cycle frequency of 3-5bpm that continues for at least 20min or
more.
PNS &SNS not communicating
#1 cause =Fetal anemia and loosing blood
*can also be meds- Butorphanol
, minutes to act
very rare
For decelerations, you can decrease
oxytocin
poof for late and variable decels
P-position change (left lateral)
O- oxytocin needs to be turned OFF
O- Oxygen needs to be ON
F- Fluids
- LATE: IV fluid bolus to increase BP for placenta
- VARIABLES: Amnioinfusion in uterus via IUPC
IUPC (intrauterine pressure catheter)
measures contraction frequency, duration, strength(in mm mercury).
The 5 P's of maternal and fetal mechanisms
-Power (pushing and contractions, urge to bear down, should not push if cervix is not
fully dilated)
-Passageway (Pelvis)
-Passenger (Baby)
-Passageway + Passenger (presentation)
-Psychosocial (how they feel about the other things, support when they go home, how
they feel about pregnancy)
Do not push if cervix is not fully dilated because
it could tear
the baby's head pushes against the cervix and can cause cervical swelling, contracting
the cervix
fetal lie
relationship of the long axis of the fetus to the long axis of the mother
Longitudinal (head first)
Transverse (Sideways)
Oblique (butt first)
fetal attitude
relationship of fetal parts to one another
is the head flexed or extended
ideal is when the head is flexed in
Extension increases the overall diameter going through the cervix
fetal presentation
the manner in which the fetus appears to the examiner during delivery
Cephalic: Vertex , military, brow, face
GRADED.Buy Quality Materials!
Fetal Heart Rate (FHR)
110-160
Variation of fetal heart
Absent (no fluctuations/flat),minimal (5 bpm variation), moderate (6-25 bpm variation),
marked (>25 bpm variation)
you want to see moderate
A sedated baby could show
minimal variability
marked variability in FHR
>25 bpm
indication of distress
Accelerations in FHR
Transient increase in FHR (15x15) for term and 10x 10 minimum for PT
32 weeks and lower should be about 10x10
32 weeks and higher should be about 15x15
What happens if there are no accelerations
Distressed baby
Decelerations in FHR
Periodic decrease in FHR
could be an indication of a problem
VEAL CHOP
V- Variable C- Cord Comphression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placenta
Periodic decelerations
Decelerations of fetal heart rate associated with uterine contractions.
episodic decelerations
drops in the FHR not associated with uterine contractions
causes for accelerations
- spontaneous fetal movement
- during a vaginal exam
- electrode application
- fetal reaction to external sounds
- fetal scalp stimulation
- breech presentation
- occiputposterior position
,- uterine contractions
- fundal pressure
- abdominal palpation
accelerations are
normal and signifies fetal well being
Types of decelerations
early, late, variable
Early decelerations
everything lines up perfectly
head is being compressed on.
the baby is in the canal and is ready to come out
PREPARE FOR DELIVERY
Late decelerations
at peak of contraction, baby's heart rate start to drop. Shifted to the right of the
contraction.
Placental insufficiency.
Not giving the baby oxygen
baby's "oxygen supply" starts running out if continual late decels occur
Variable decelerations
Sharp decline and incline
cord compression
baby can press on their own cord
prolapsed cord through the cervix (emergency situation) do not take hand out until baby
comes out because if you let go, the cord will compress again
you can add fluid to the amniotic sac
Prolonged deceleration
A visually apparent decrease (may be either gradual or abrupt) in FHR of at least 15
beats/min below the baseline and lasting more than 2 minutes but less than 10 minutes
Sinusoidal FHR pattern
A specific fetal heart rate pattern that is described as a smooth, sine-wave like
undulating pattern with a cycle frequency of 3-5bpm that continues for at least 20min or
more.
PNS &SNS not communicating
#1 cause =Fetal anemia and loosing blood
*can also be meds- Butorphanol
, minutes to act
very rare
For decelerations, you can decrease
oxytocin
poof for late and variable decels
P-position change (left lateral)
O- oxytocin needs to be turned OFF
O- Oxygen needs to be ON
F- Fluids
- LATE: IV fluid bolus to increase BP for placenta
- VARIABLES: Amnioinfusion in uterus via IUPC
IUPC (intrauterine pressure catheter)
measures contraction frequency, duration, strength(in mm mercury).
The 5 P's of maternal and fetal mechanisms
-Power (pushing and contractions, urge to bear down, should not push if cervix is not
fully dilated)
-Passageway (Pelvis)
-Passenger (Baby)
-Passageway + Passenger (presentation)
-Psychosocial (how they feel about the other things, support when they go home, how
they feel about pregnancy)
Do not push if cervix is not fully dilated because
it could tear
the baby's head pushes against the cervix and can cause cervical swelling, contracting
the cervix
fetal lie
relationship of the long axis of the fetus to the long axis of the mother
Longitudinal (head first)
Transverse (Sideways)
Oblique (butt first)
fetal attitude
relationship of fetal parts to one another
is the head flexed or extended
ideal is when the head is flexed in
Extension increases the overall diameter going through the cervix
fetal presentation
the manner in which the fetus appears to the examiner during delivery
Cephalic: Vertex , military, brow, face
