QUESTIONS AND DETAILED MATERNAL HEALTH
BREAKDOWN FULL REVIEW
◉ vertex presentation. Answer: Fetal heart tones should be assessed
below the mother's umbilicus in either the right or left lower
quadrant of the abdomen
◉ breech presentation. Answer: Fetal heart tones should be
assessed above the mother's umbilicus in either the right- or left-
upper quadrant of the abdomen.
◉ considerations. Answer: - 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. Answer: - every
30-60 minutes
,◉ intermittently auscultate during the active phase. Answer: - every
15-30 minutes
◉ intermittently auscultate during the second stage. Answer: - every
5-15 minutes
◉ indications for leopold maneuvers. Answer: - 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. Answer: 110-160 w/ increases and decreases from
baseline
◉ continuous electronic fetal monitoring. Answer: - 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. Answer: - 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. Answer: - fetal monitoring system with FHR
interpretation system
◉ - category 1. Answer: - 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. Answer: - 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. Answer: - FHR tracings include either sinusoidal
pattern, absent baseline FHR variability (recurrent late/variable
decels, bradycardia)
- increment, acme, decrement