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56 Cards in this Set

  • Front
  • Back
Fetoscope and doppler monitor FHR in what fashion?
hand-held devices
There are two versions of electronic FHR monitors. What are they?
external and internal
What type of electronic FHR monitor is most accurate?
Examples of external FHR monitors
U/S transducer + tacometer
Examples of internal FHR monitors
scalp electrode + intrauterine pressure catheter
scalp electrodes
intrauterine pressure catheter
Where is a U/S transducer placed to obtain FHR?
over the fetal back
Where is the tacometer place to obtain uterine contractions?
over the fundus
Describe the measures obtained with external FHR monitoring
long-term variability continuously or intermittently
Describe the measures obtained with internal FHR monitoring
long-term and short-term variability (more accurately) continuously
How is internal FHR monitoring obtained?
must have ROM
Where is the IUPC placed?
between the fetus and the abdominal wall
Where is the scalp electrode placed
on the fetal head
short-term, beat to beat variability, only seen with internal FHR monitoring
When is intermittent monitoring appropriate
low-risk pregnancies
When is continuous monitoring a more useful method
high risk women/fetus, fetal distress in labor
What 3 characteristics need to be assessed when taking a FHR
baseline, periodic changes, variability
When do we determine baseline FHR
measure between cx's
When do we measure periodic changes of FHR
measure during and after cx's
How do we measure variability of FHR
baseline and range
Define "penset"
uterine resting tone @ 20mmhg
FHR, tachycardia
FHR baseline >160 for duration of 10min or longer
Maternal causes of fetal tachycardia
fever, chorioamnionitis, drugs, hyperthyroidism, dehydration, anxietyF
Fetal causes of fetal tachycardia
early sign of fetal hypoxia, fetal anemia, asphyxia, infection, prematurity
FHR, bradycardia
FHR baseline < 110 for duration of 10min or longer
Causes of fetal bradycardia
late sign of fetal hypoxia, drugs, prolonged compression of umbilical cord, maternal hypotension, maternal supine hypotension, maternal hypothermiaW
Example of a drug that can result in fetal bradycardia
What causes maternal supine hypotension
weight and pressure of the gravid uterus on the inferior vena cava; decreases blood return to the heart which reduces CO and BP
What is know to occur before fetal death
fetal bradycardia
Define long-term variability
irregularity of FHR over 10min; waves or cycles from baseline
Define short-term variability
fluctuations of FHR from beat to beat
Types of variability
absent, minimal, moderate, marked
What does absent variability signify?
No CNS reactivity
Define minimal variability
undetected to < 5bpm
Define moderate variability
Define marked variability
> 25bpm
What level of variability is considered normal
moderate = average
Accelerations versus decelerations
increase/decrease in baseline of 15bpm for 15sec
What do accelerations and decelerations detect
fetal activity
What do accelerations in FHR indicate
fetal well being
What do decelerations in FHR indicate
may be benign or may be non-reassuring
Variable = Cord compression
Early = Head circumference
Accelerations = Ok
Late = Placental insufficiency
Early Decelerations
contractions and deceleration mirror each other
Variable Decelerations
visually abrupt decelerations independent of contractions; shaped like a "V," "U," or "W"
What are "shoulders" r/t FHR decelerations
may or may not accompany variable decelerations, sudden acceleration as a result of overcompensation
Late Decelerations
happens after contractions, slow drop and slow return
How frequently should we be assessing FHR during the latent phase of labor
How frequently should we be assessing FHR during the active phase of labor
How frequently should we be assessing FHR during the 2nd stage of labor
q5m or between cx's
Criteria for a "reassuring FHR"
baseline between 110-160, no decelerations or changes in baseline, accelerations w/ fetal movement, moderate variability (6-25bpm)
Tachycardia, bradycardia, decreased or absent variability, late decelerations, or severe variable decelerations are all signs of, what?
non-reassuring FHR pattern
Nursing management of FHR changes
if pit is infusing, turn of the pit; l. lateral position, increase IV fluids, O2 mask, notify provider
How much O2 should be administered via face mask?
Fetal stimulation, amniofusion, discourage valsalva maneuver, change maternal positions are all examples of, what?
other inventions when a non-reassuring FHR is detected
Define amniofusion
warm water inside vagina, baby floats off cord