FHR Evaluation
What are the 3 things we evaluate FHR for?
Baseline Variability Periodic Changes
What are the 4 things we evaluate uterine activity for?
Frequency
Duration
Intensity
Resting Tone
Define acceleration
Abrupt increase in FHR 15 beats above the baseline for 15 seconds
How many categories are listed for FHR interpretation
What is the priority intervention for a non-reassuring FHR pattern. Hint: What do have to do before we can fix it?
Identify the cause
How do you determine uterine frequency
From beginning of one to the beginning of the next
Define early deceleration and cause
Gradual decrease from baseline with onset to nadir > or equal to 30 seconds.
Cause: Fetal head compression No treatment necessary
What is the difference between prolonged acceleration and baseline change?
Prolonged are > 2min but less than 10 min
BL Change is > 10 min
What would your primary intervention be for variable decelerations
What are periodic changes - give 2 examples:
Accelerations and decelerations
How do you determine uterine intensity
palpation or IUPC
Define late deceleration and cause
delayed gradual decrease from baseline with onset to nadir > or equal to 30 seconds where onset, nadir and recovery occur after beginning, peak and end of contraction
Cause: Uteroplacental Insufficiency
What is the criteria for "Recurrent" decelerations
Occur with more than or equal to 50% of contractions in any 20 minute period
What is the optimal maternal position
left lateral
Name the 4 variability classifications
Absent
Minimal ( < 5 bpm)
Moderate (6-25 bpm)
Marked (> 25 bpm)
What is the uterine resting tone
Relaxation between ctx
Define variable deceleration and cause
abrupt decrease in FHR with onset to nadir < 30 seconds, > or equal to 15 bpm, lasting > equal to 15 seconds, and < 2 minutes
Cause: Cord Compression
Give 3 examples of a non-reassuring FHR
Late decels, prolonged decels, persistent variables, brady, tachy, lack of variability.
Name your 4 nursing interventions for intrauterine resuscitation
Position changes
Turn off pitocin
IVF bolus
Oxygen
What 2 patterns are a reliable prediction of the absence of fetal metabolic acidemia
Moderate variability and/or presence of accelerations
Define Tachysystole
More than 5 contractions in a 10 minute segment averages over a 30 minute period
T/F
Is the absence of accelerations or minimal to absent variability reliably predict the presence of fetal hypoxemia or metabolic acidemia?
FALSE
List the ways to do a systematic FHR interpretation
1. Is the BL normal
2. What is the variability
3. Are there accels or decels
List 4 goals of intrauterine resuscitation
Promote fetal oxygenation
Reduce uterine activity
Alleviate cord compression
Correct maternal hypotension