NUR 221 EXAM 2 Study Guide
Absent FHR variability
amplitude range undetected
Minimal FHR variability
1-5 bpm
Moderate FHR variability
6-25 bpm what we want
Marked FHR variability
>25 bpm
What is Leopolds maneuver?
Purpose: to determine presentation and position of fetus and aid in knowing where to position FHR
monitor
Method: explain procedure to pt, have woman empty bladder, wash hands, stand beside, facing
woman's head
4 maneuvers
What is normal FHR?
110-160 bpm
newborn is the same
bradycardia FHR and causes
,<110 bpm
due to perfusion issues, body is in distress
Tachycardia FHR and causes
>160 bpm
if mom is tachy too could be due to infection
What is tachysystole?
greater than 5 contractions in 10 minutes and there is fetal tachycardia or late decelerations
When is the only time the baby is being perfused while in labor?
at rest (between contractions)
Frequency of contractions are measured from the...
peak of one contraction to the peak of the next contraction (or beginning to beginning)
Duration of contractions are measured from the...
start to finish of one contraction
Intensity of contractions
strength of contraction at its peak (mild, moderate, strong)
How can you tell the intensity of a contraction by feeling?
cheek= resting
,nose= mild
chin= moderate
forehead= strong
What is TOCO?
For uterine activity palpate uterus for contraction
Apply over fundus- make sure there is contact
GOES ON TOP
tells frequency and duration of contractions
Accelerations in FHR
an apparent, abrupt increase in the FHR above baseline.
-Greater than or equal to 32 weeks gestation
-The increase from onset to peak in <30 seconds
-The peak must be at least 15 bpm and last at least 15 seconds
-If <32 weeks gestation at least 10 bpm for 10 seconds
This is a normal good finding... Just document and continue to monitor.
Early Decelerations - Fetal Heart Rate
have a shape that is symmetrical, with a gradual decrease and return of FHR to baseline in
association with a contraction
-Means Head compression-normal labor process
**gradual decrease
**mirror image of contraction
JUST OBSERVE-prepare for delivery, document normal labor
, nadir
the lowest point after the onset of an early/late deceleration and variable
Late decelerations - Fetal Heart Rate
have a shape that is symmetrical. with a gradual decrease and return of FHR to baseline in
association with a contraction
-is usually due to uteroplacental insufficiency and fetal hypoxia
-Although acidosis is not always present, may be associated with fetal acidosis
(EMERGENCY, THIS IS THE WORST DECEL)
-Intervention: POISON
Variable decelerations- Fetal Heart Rate
are an abrupt onset of decreased FHR below baseline that may occur with or after a contraction
-Is usually due to cord compression and may be associated with fetal acidosis.
Intervention- Put mom on left side. Administer 10 L O2 nonrebreather
sinusoidal pattern- Fetal Heart Rate
differs from variability in that it is a smooth wave-like pattern of regular frequency and amplitude.
-Has cycle frequency of 3-5 minutes and lasts for 20 minutes of longer.
Intervention- Deliver fetus
POISON stands for
P- position change (to left side)
Absent FHR variability
amplitude range undetected
Minimal FHR variability
1-5 bpm
Moderate FHR variability
6-25 bpm what we want
Marked FHR variability
>25 bpm
What is Leopolds maneuver?
Purpose: to determine presentation and position of fetus and aid in knowing where to position FHR
monitor
Method: explain procedure to pt, have woman empty bladder, wash hands, stand beside, facing
woman's head
4 maneuvers
What is normal FHR?
110-160 bpm
newborn is the same
bradycardia FHR and causes
,<110 bpm
due to perfusion issues, body is in distress
Tachycardia FHR and causes
>160 bpm
if mom is tachy too could be due to infection
What is tachysystole?
greater than 5 contractions in 10 minutes and there is fetal tachycardia or late decelerations
When is the only time the baby is being perfused while in labor?
at rest (between contractions)
Frequency of contractions are measured from the...
peak of one contraction to the peak of the next contraction (or beginning to beginning)
Duration of contractions are measured from the...
start to finish of one contraction
Intensity of contractions
strength of contraction at its peak (mild, moderate, strong)
How can you tell the intensity of a contraction by feeling?
cheek= resting
,nose= mild
chin= moderate
forehead= strong
What is TOCO?
For uterine activity palpate uterus for contraction
Apply over fundus- make sure there is contact
GOES ON TOP
tells frequency and duration of contractions
Accelerations in FHR
an apparent, abrupt increase in the FHR above baseline.
-Greater than or equal to 32 weeks gestation
-The increase from onset to peak in <30 seconds
-The peak must be at least 15 bpm and last at least 15 seconds
-If <32 weeks gestation at least 10 bpm for 10 seconds
This is a normal good finding... Just document and continue to monitor.
Early Decelerations - Fetal Heart Rate
have a shape that is symmetrical, with a gradual decrease and return of FHR to baseline in
association with a contraction
-Means Head compression-normal labor process
**gradual decrease
**mirror image of contraction
JUST OBSERVE-prepare for delivery, document normal labor
, nadir
the lowest point after the onset of an early/late deceleration and variable
Late decelerations - Fetal Heart Rate
have a shape that is symmetrical. with a gradual decrease and return of FHR to baseline in
association with a contraction
-is usually due to uteroplacental insufficiency and fetal hypoxia
-Although acidosis is not always present, may be associated with fetal acidosis
(EMERGENCY, THIS IS THE WORST DECEL)
-Intervention: POISON
Variable decelerations- Fetal Heart Rate
are an abrupt onset of decreased FHR below baseline that may occur with or after a contraction
-Is usually due to cord compression and may be associated with fetal acidosis.
Intervention- Put mom on left side. Administer 10 L O2 nonrebreather
sinusoidal pattern- Fetal Heart Rate
differs from variability in that it is a smooth wave-like pattern of regular frequency and amplitude.
-Has cycle frequency of 3-5 minutes and lasts for 20 minutes of longer.
Intervention- Deliver fetus
POISON stands for
P- position change (to left side)
