FHR Evaluation
Uterine Evaluation
Periodic Changes in FHR
Interpretation of FHR
Nursing Interventions
100

What are the 3 things we evaluate FHR for?

Baseline Variability Periodic Changes

100

What are the 4 things we evaluate uterine activity for?

Frequency

Duration

Intensity 

Resting Tone 

100

Define acceleration

Abrupt increase in FHR 15 beats above the baseline for 15 seconds

100

How many categories are listed for FHR interpretation 

3
100

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 

200
What is the normal FHR baseline?
110-160 bpm
200

How do you determine uterine frequency 

From beginning of one to the beginning of the next

200

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

200

What is the difference between prolonged acceleration and baseline change? 

Prolonged are > 2min but less than 10 min 

BL Change is > 10 min 

200

What would your primary intervention be for variable decelerations 

Change positions 
300

What are periodic changes - give 2 examples:

Accelerations and decelerations

300

How do you determine uterine intensity 

palpation or IUPC 

300

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 

300

What is the criteria for "Recurrent" decelerations 

Occur with more than or equal to 50% of contractions in any 20 minute period 

300

What is the optimal maternal position 

left lateral 

400

Name the 4 variability classifications

Absent 

Minimal ( < 5 bpm)

Moderate (6-25 bpm)

Marked (> 25 bpm)

400

What is the uterine resting tone 

Relaxation between ctx

400

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 

400

Give 3 examples of a non-reassuring FHR

Late decels, prolonged decels, persistent variables, brady, tachy, lack of variability.

400

Name your 4 nursing interventions for intrauterine resuscitation 

Position changes 

Turn off pitocin 

IVF bolus

Oxygen 

500

What 2 patterns are a reliable prediction of the absence of fetal metabolic acidemia 

Moderate variability and/or presence of accelerations 

500

Define Tachysystole 

More than 5 contractions in a 10 minute segment averages over a 30 minute period 

500

T/F 

Is the absence of accelerations or minimal to absent variability reliably predict the presence of fetal hypoxemia or metabolic acidemia? 

FALSE 

500

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 


500

List 4 goals of intrauterine resuscitation 


Promote fetal oxygenation 

Reduce uterine activity 

Alleviate cord compression 

Correct maternal hypotension