Download Intermediate Fetal Monitoring Exam with Correct Answers and more Exams Community Corrections in PDF only on Docsity!
Intermediate Fetal Monitoring exam with correct
answers
Baseline Rate - CORRECT ANSWERS ✔✔-approximate mean FHR rounded to increments of 5bp during a 10 min segment
- duration must be at least 2 min. or the baseline for that period is indeterminate Bradycardia - CORRECT ANSWERS ✔✔baseline rate less than 110 bpm Tachycardia - CORRECT ANSWERS ✔✔baseline of greater than 160 bpm Baseline variability - CORRECT ANSWERS ✔✔fluctuations in baseline FHR that are irregular in amplitude and frequency Absent variability - CORRECT ANSWERS ✔✔amplitude range undetectable Minimal variability - CORRECT ANSWERS ✔✔amplitude range > undetectable but <5/min Moderate variability - CORRECT ANSWERS ✔✔amplitude ranges 6- bpm
Marked variability - CORRECT ANSWERS ✔✔amplitude range greater than 25 bpm Acceleration - CORRECT ANSWERS ✔✔visually apparent abrupt (< sec to peak) increase in FHR above baseline for less than 2 minutes -15bpmx15sec for 32 weeks and up -10bpmx10sec for less than 32 weeks Prolonged Acceleration - CORRECT ANSWERS ✔✔acceleration lasting longer than 2 minutes but less than 10 minutes. Early Deceleration - CORRECT ANSWERS ✔✔A visually apparent usually symmetrical gradual (more than 30 sec) decrease in FHR and return to baseline associated with a contraction -nadir occurs at the same time as the peak of the contraction Late Deceleration - CORRECT ANSWERS ✔✔visually apparent, usually symmetrical gradual decrease in FHR and return to baseline associate with a contraction -delayed in timing with the nadir occurring after the peak of the contraction Variable Deceleration - CORRECT ANSWERS ✔✔visually apparent abrupt decrease in FHR -decrease is 15 bpm lasting for more than 15 sec but less than 2 minutes
Category 2 - CORRECT ANSWERS ✔✔anything not in cat 1 or 3 -baseline bradycardia (not with absent variability) or tachycardia -minimal, marked, or absent (not with recurrent decels) variability -absence of induced accels after fetal stimulation -recurrent variables with minimal or moderate variability -prolonged decel 2-10 minutes long -recurrent lates with moderate variability Extrinsic Factors on Fetal Heart Patterns - CORRECT ANSWERS ✔✔outside the fetus -placenta -maternal utero-placental circulation -fetal-placental circulation -placental transfer -uterine blood flow -umbilical cord -amniotic fluid How do most things move across the placenta - CORRECT ANSWERS ✔✔by simple diffusion AFI and the Placenta - CORRECT ANSWERS ✔✔amniotic fluid volume is an indirect indicator of placental function
Intrinsic Influences on FHR - CORRECT ANSWERS ✔✔fetal homeostatic compensatory mechanisms -fetal circulation -ANS responses -baroreceptors -chemoreceptors -hormonal responses: redistribute blood flow Physiologic Stress of Contractions - CORRECT ANSWERS ✔✔- decrease in utero-placental blood flow -stasis in intervillous spaces fetus relies on reserves Systematic Assessment of Monitor Tracing - CORRECT ANSWERS ✔✔-baseline -variability -periodic/episodic changes -uterine activity: frequency, duration, intensity, resting tone Periodic - CORRECT ANSWERS ✔✔associated with contractions Episodic - CORRECT ANSWERS ✔✔not associated with contractions What do accelerations indicate? - CORRECT ANSWERS ✔✔normal fetal acid-base status -well oxygenated
Acid-base values - CORRECT ANSWERS ✔✔-pH: <7.10 acidosis -pCO2: >60 respiratory -BD: >12 (BE <-12) metabolic Fetoscope - CORRECT ANSWERS ✔✔detects heart sounds (baseline, rhythm, accels, decels) -verification of FHR arrhythmias Doppler - CORRECT ANSWERS ✔✔baseline, rhythm, accels, decels Interpreting Auscultation - CORRECT ANSWERS ✔✔-can determine CAT 1 and 2 -if CAT 2 put on EFM to determine variability What could indicate that you are tracing maternal pulse? - CORRECT ANSWERS ✔✔accelerations with the contractions Signal ambiguity - CORRECT ANSWERS ✔✔the fetal signal replaced by an alternate signal from the mother or another fetus How does a toco work? - CORRECT ANSWERS ✔✔detects changes in shape of abdomen resulting from uterine tension 5 Physiological Goals - CORRECT ANSWERS ✔✔1. support maternal coping and labor progress
- maximize uterine blood flow
- maximize umbilical circulation
- maximize oxygenation
- maintain appropriate uterine activity Why is emotional support important? - CORRECT ANSWERS ✔✔decreases catecholamine response and increases fetal oxygenation Interventions to maximize blood flow - CORRECT ANSWERS ✔✔- reduce anxiety/pain -maternal positioning (lateral) -hydration -medication to reduce uterine contractions (decrease pit or tocolytics) Interventions to maximize umbilical circulation - CORRECT ANSWERS ✔✔-maternal position -amnioinfusion (closely monitor resting tone) Interventions to maximize oxygenation - CORRECT ANSWERS ✔✔- maternal breathing -supplemental oxygen (cautious use, not 1st line, not for prophylactic use) Interventions to maintain appropriate uterine activity - CORRECT ANSWERS ✔✔-oxytocin -fluid bolus -position change
