fetal heart tracing quiz 10

Develop a plan, in the context of the clinical scenario, according to interpretation of the FHR. The transducer uses Doppler ultrasound to detect fetal heart motion and is connected to an FHR monitor. -2+Fetal Heart Rate increases in 20 minutes The American College of Obstetricians and Gynecologists (ACOG) states that with specific intervals, intermittent auscultation of the FHR is equivalent to continuous EFM in detecting fetal compromise.4 ACOG has recommended a 1:1 nurse-patient ratio if intermittent auscultation is used as the primary technique of FHR surveillance.4 The recommended intermittent auscultation protocol calls for auscultation every 30 minutes for low-risk patients in the active phase of labor and every 15 minutes in the second stage of labor.4 Continuous EFM is indicated when abnormalities occur with intermittent auscultation and for use in high-risk patients. B. Activate the organization's chain of command. Turn mother to her left side, Family Health (BSN2) Exam Three Sherpath/Quiz, ANTEPARTUM AND POSTPARTUM COMPLICATIONS QUIZ-, Julie S Snyder, Linda Lilley, Shelly Collins, Volume 1, Chapter 11 Human Lifespan Develop. Powered by. The incoming nurse is receiving a report regarding a laboring patient whose cervix is 7 cm dilated, who has a fetal spiral electrode in place, and who is receiving IV oxytocin for augmentation of labor. Yes, and the strip is reactive. The nurse is assessing the fetal monitor tracings of a patient in labor. The nurse is assessing a fetal monitor tracing and notes that the FHR baseline is 140-150 bpm with decreases to 120 bpm noted beginning after the contraction begins with return to baseline after the contraction ends. 140 145 Correct . Minimal. It indicates severe fetal anemia, as occurs in cases of Rh disease or severe hypoxia.24 It should be differentiated from the pseudosinusoidal pattern (Figure 11a), which is a benign, uniform long-term variability pattern. a streams response to precipitation. Results in this range must also be interpreted in light of the FHR pattern and the progress of labor, and generally should be repeated after 15 to 30 minutes. https://www.acog.org/Patients/FAQs/Fetal-Heart-Rate-Monitoring-During-Labor?IsMobileSet=false Which nursing intervention is necessary before a second trimester transabdominal ultrasound? The nurse is caring for a low-risk primipara at 40 weeks' gestation and in active labor. Bradycardia of this degree is common in post-date gestations and in fetuses with occiput posterior or transverse presentations.16 Bradycardia less than 100 bpm occurs in fetuses with congenital heart abnormalities or myocardial conduction defects, such as those occurring in conjunction with maternal collagen vascular disease.16 Moderate bradycardia of 80 to 100 bpm is a nonreassuring pattern. It involves using an electronic fetal monitor that records the fetal heart rate and the frequency and duration of uterine contractions. Table 4 lists recommended emergency interventions for nonreassuring patterns.4,14 These interventions should also be considered for ominous patterns while preparations for immediate delivery are initiated. Your doctor analyzes FHR by examining a fetal heart tracing according to baseline, variability, accelerations, and decelerations. The fetal heart rate undergoes constant and minute adjustments in response to the fetal environment and stimuli. For more information on the use, interpretation and management of patients based on Fetal Heart Tracings check out the resources below. Accelerations (A). Postdate gestation, preeclampsia, chronic hypertension and diabetes mellitus are among the causes of placental dysfunction. Baseline Rate (BRA; Online Table B). 2. Auscultation of the fetal heart rate (FHR) is performed by external or internal means. We also searched the Cochrane Library, Essential Evidence Plus, and Clinical Evidence. Challenge yourself every tracing collection is FREE! Interpretation of the FHR variability from an external tracing appears to be more reliable when a second-generation fetal monitor is used than when a first-generation monitor is used.3 Loss of variability may be uncomplicated and may be the result of fetal quiescence (rest-activity cycle or behavior state), in which case the variability usually increases spontaneously within 30 to 40 minutes.19 Uncomplicated loss of variability may also be caused by central nervous system depressants such as morphine, diazepam (Valium) and magnesium sulfate; parasympatholytic agents such as atropine and hydroxyzine (Atarax); and centrally acting adrenergic agents such as methyldopa (Aldomet), in clinical dosages.19. Maternal hypotension and uterine hyperstimulation may decrease uterine blood flow. Powered by. This content is owned by the AAFP. A.>6 contractions in 10 minutes averaged over twenty minutes B. What action by the nurse is most appropriate? The FHR normally exhibits variability, with an average change of 6 to 25 bpm of the baseline rate, and is linked to the fetal central nervous system. Abrupt increases in the FHR are associated with fetal movement or stimulation and are indicative of fetal well-being11 (Online Table B, Online Figure G). structured intermittent auscultation should be considered for low-risk labor because it statistically decreases cesarean and operative vaginal delivery rates without an increase in unfavorable outcomes associated with continuous monitor use and a high false-positive rate. Fetal monitoring Flashcards | Quizlet 9. Accelerations are transient increases in the FHR (Figure 1). Internal is more accurate, measuring the beat to beat time since it has direct contact with the fetus. Although detection of fetal compromise is one benefit of fetal monitoring, there are also risks, including false-positive tests that may result in unnecessary surgical intervention. Continuous electronic fetal monitoring has been shown to reduce the incidence of neonatal seizures, but there has been no beneficial effect in decreasing cerebral palsy or neonatal mortality. Scroll down for another when you're done. The searches included systematic reviews, meta-analyses, randomized controlled trials, and review articles. Accelerations represent a sudden increase in FHR of more than 15 bpm in bandwidth amplitude. Baseline of 140 - 150 with decelerations to 120 noted beginning with the contraction and returning to baseline by the end of the contraction. The NCC EFM Tracing Game is just one of the valuable tools in this digital EFM toolkit. The five components of the biophysical profile are as follows: (1) nonstress test; (2) fetal breathing movements (one or more episodes of rhythmic fetal breathing movements of 30 seconds or. Shows FHR as well as uterine contractions. -Relative: Multiple Gestation, History of classic cesarean section, -Negative (Normal): Adequate contractions, No concerning rate changes with contractions (no late decelerations) Determine whether accelerations or decelerations from the baseline occur. Select the answer that doesn't belong with the others: Clinically, loss of beat-to-beat variability is more significant than loss of long-term variability and may be ominous.18 Decreased or absent variability should generally be confirmed by fetal scalp electrode monitoring when possible. Hypoxia, uterine contractions, fetal head compression and perhaps fetal grunting or defecation result in a similar response.

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