Advanced Fetal Monitoring With 100% Q&A….., Exams of Nursing

Download Advanced Fetal Monitoring With 100% Q&A….. and more Exams Nursing in PDF only on Docsity! Advanced Fetal Monitoring With 100% Q&A….. Cat 1 - CORRECT ANSWER--What category rules out fetal acidemia? Severe astha, cardiac issues, and ecclampic seizures - CORRECT ANSWER--What maternal conditions greatly impact fetal oxygenation? intervillous space - CORRECT ANSWER--Where does the exchange of O2 and nutrients take place? O2 enters the intervillous space via the maternal arteries, to the villi then the umbilical vein take the o2 blood to the fetus. The umbilical arteries take the deO2 blood from the baby through the villi and back to the mother - CORRECT ANSWER-- How is o2 blood transferred to the fetus? High to low concentration Mom to fetus for O2 Low to high concentration for CO2 so baby to mom - CORRECT ANSWER-- Diffusion Diffusion - CORRECT ANSWER--How is O2 transferred from mom to baby Carry O2 into intervillous space Are maximally dilated so they can not be increased - CORRECT ANSWER--Explain spiral arteries in placenta Maternal conditions like pre-e and cardiac disease Maternal hypotension Placental changes- abruptions, infections, edema, or smaller size Excessive uterine activity Vasoconstriction - CORRECT ANSWER--What are factors that can decrease uteroplacental blood flow? They are constricted which decreases blood flow - CORRECT ANSWER--What happens to the spiral arteries during pre-e? The aorta and vena cava get compressed (20 weeks) - CORRECT ANSWER--Why does the supine position cause decreased uteroplactenal blood flow? Blocks the sympathetic pathway Pooling of blood in the lower extremities decreases blood flow back to moms heart which decreases blood flow to the fetus - CORRECT ANSWER--Why does maternal hypotension happen after regional analgesia? 60% - CORRECT ANSWER--What percentage is uteroplacental blood flow decreased by during cxts? Environment to lungs to heart to vasculature to uterus to placenta to umbilical cord - CORRECT ANSWER--Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic) Limbs, kidneys, and descending aorta - CORRECT ANSWER--Where is the least O2 blood in the fetus? Umbilical vein and ductous venous - CORRECT ANSWER--Where is the most O2 blood in the fetus? Ductus venosus - CORRECT ANSWER--Connects the umbilical vein to the inferior vena cava, bypassing the liver Shunt that allows most O2 blood to fetal heart ductus venosus, foramen ovale, ductus arteriosus - CORRECT ANSWER--3 important shunts in fetal circulation Foramen Ovale - CORRECT ANSWER--connects the two atria in the fetal heart Allows O2 blood to flow through the heart and directly to the brain Ductus Arteriosus - CORRECT ANSWER--a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta 80-100 mL/kg - CORRECT ANSWER--What is a normal blood volume for a fetus at term? Increased heart rate - CORRECT ANSWER--What happens if you stimulate the sympathetic nervous system? Regulates the sympathetic - CORRECT ANSWER--What does the parasympathetic nervous system do? Increased heart rate - CORRECT ANSWER--What happens when catecholamines (sympathetic) get released? The sympathetic develops first so there is no parasympathetic to regulate the heart rate - CORRECT ANSWER--Why do pre-termers have increased heart rates? Acetylcholine is released which decreases the intrinsic heart rate Vagus stimulation - CORRECT ANSWER--What happens when the parasympathetic nervous system is stimulated? Protect Regulates BP - CORRECT ANSWER--What do baroreceptors do? Decreased FHR, BP and CO - CORRECT ANSWER--What effect do baroreceptors have on the fetus? Severe fetal anemia- ruptured vasa previa, TTTS, Rh isoimmunization Severe metabolic acidemia - CORRECT ANSWER--What are causes of sinusoidal pattens? Every 30 mins - CORRECT ANSWER--How often do you chart heart tones for a low risk pt from latent phase up to the 2nd stage (until pushing)? Ever 15 mins - CORRECT ANSWER--How often do you chart heart tones from the latent phase up until the second stage of labor with a high risk patient? 2 to 4 mu - CORRECT ANSWER--At what rate is exogenous oxytocin at for the mother during the first stage of labor? 3 mu - CORRECT ANSWER--At what rate is exogenous oxytocin at for the fetus during the first stage of labor? 10 to 15 minutes - CORRECT ANSWER--What is the biologic half-life of oxytocin? 30 to 60 minutes - CORRECT ANSWER--How long does it take to reach a steady state of plasma concentration for Pitocin? During the first stage of labor with recurrent they are both the cells that have not resolved with position changes - CORRECT ANSWER--When should an amnioinfusion be used? Late decelerations, active pushing, meconium, VBAC or TOLAC - CORRECT ANSWER--When should and amnioinfusion not be used? Maintain fetal physiologic reserve and maximize fetal oxygenation - CORRECT ANSWER--What is the main goal during the second stage of labor? Pushing is approximately 6 to 8 seconds and repeated four times - CORRECT ANSWER--What is open glottis pushing? Fergusons reflex - CORRECT ANSWER--Spontaneous urge to push during labor that occurs when the presenting part (of the fetus) reaches the pelvic floor; may occur without full cervical effacement Any type of bleeding - CORRECT ANSWER--What is a contraindication for terbutaline? 7.20-7.29 Greater than or equal to 7.10 - CORRECT ANSWER--What is normal pH in the umbilical artery? 49 to 56 Less than 60 - CORRECT ANSWER--What is the normal PCO2 for an umbilical artery? 22 to 24 greater than 22 - CORRECT ANSWER--What is the normal HCO3 in an umbilical artery? -2.7-(-3.6) Greater than -12 - CORRECT ANSWER--What is the normal BE for an umbilical artery? When there is a buildup of carbon dioxide in the fetus Can happen during cord compression - CORRECT ANSWER--What is respiratory acidemia? Decreased first Apgar then a normal APGAR - CORRECT ANSWER--What do normal Apgars look like for a baby with respiratory acidemia? The type of metabolism that takes place when there is no available oxygen so glucose is used where it is converted into lactic acid The base attempts to neutralize the lactic acid so there is usually a buildup of hydrogen ions Can lead to metabolic acidemia - CORRECT ANSWER--What is anaerobic metabolism? When the base gets depleted so there is a buildup of hydrogen ions in lactic acid within the fetus This decreases the pH within the fetus which can lead to possible cell death Continued decreased Apgars - CORRECT ANSWER--What is metabolic acidemia? Metabolic acidemia - CORRECT ANSWER--Decreased pH, normal PCO2, decreased HCO3, decreased BE Respiratory acidemia - CORRECT ANSWER--Decreased pH, increased PCO2, normal HCO3, normal BE When there is some oxygen but not enough so the base still gets depleted but not quite as much - CORRECT ANSWER--What is mixed acidemia? Mixed acidemia - CORRECT ANSWER--Decreased pH, increased PCO2, decreased HCO3, decreased BE When the vessels are not protected by whartons jelly - CORRECT ANSWER--What is velamentous insertion of the umbilical cord? Prior history, hypertension, cigarette smoking, cocaine use, or blunt abdominal trauma - CORRECT ANSWER--What are some risk factors of abruptio placenta? It is a sympathetic response so catecholamines like norepinephrine and epinephrine are released to recuperate - CORRECT ANSWER--Why is there if you tachycardic response after a prolonged decel? Can decrease variability and accelerations - CORRECT ANSWER--What do narcotics to you in regards to fetal heart rates? Pseudo sinusoidal patterns - CORRECT ANSWER--What can stadol and Nubian cause in fetal heart rates? Decrease variability and increased uterine activity - CORRECT ANSWER--What can cocaine cause in regards to uterine activity and fetal heart rates? Decrease variability for 48 hours - CORRECT ANSWER--What can betamethasone cause in regards to fetal heart rate? Increased fetal heart rate baseline and increase maternal heart rate - CORRECT ANSWER--What terbutaline cause? By sending and receiving US waves through the mothers abdomen When the waves are reflected from moving objects like the fetal heart the frequency changes slightly This change is then analyzed by the electronics inside the transducer and converted into audible beeps - CORRECT ANSWER--How do you fetal dopplers work? Convert FECG to fetal heart rate by measuring consecutive R to R wave intervals - CORRECT ANSWER--How do fetal scalp electrodes work? Increased caffeine intake - CORRECT ANSWER--What can cause an irregular rhythm in a fetus? Requires a risk benefit analysis Digoxin or other drugs like amiodarone - CORRECT ANSWER--What can be done to treat Fetal SVT? Maternal lupus - CORRECT ANSWER--What can cause a complete or third-degree heart block in a fetus? 50 to 70 bpm - CORRECT ANSWER--What ventricular rate in a fetus is associated with a complete or third-degree heart block? A pacemaker implantation - CORRECT ANSWER--How can a complete heart block be treated in a neonate? Hypoxemia can lead to shunting which leads to decreased renal perfusion which then causes a decrease in AFI - CORRECT ANSWER--How can hypoxemia lead to a decreased AFI in a fetus? CST - CORRECT ANSWER--What is the most accurate test for evaluating risk of fetal death within seven days of a reassuring test? 10 distinct movements in two hours - CORRECT ANSWER--What is a normal fetal movement count?