NUR 335 Exam 2
1. According to the Low risk without oxytocin fetal status assessment:
AWHONN, how - stage 1= 15-30 minutes once 4-5 cm dilated
often should you - stage 2= 5-15 minutes
assess FHR?
Low risk without oxytocin electronic FHR monitoring:
- stage 1: every 30 minutes once 4-5 cm dilated
- stage 2: every 30 minutes up until active pushing then every 15 minutes
Low risk with oxytocin electronic FHR monitoring:
- stage 1: every 15 minutes
- stage 2: every 15 minutes up until active pushing then every 5 minutes
2. What is the - Electronic: Use of the toco and FHR doppler to essentially perform an NST;
difference be- external and non-invasive devices that can be used any time after viability
tween electronic
fetal monitoring - Internal fetal monitoring: Use of an internal fetal scalp electrode which is attached
and internal fetal directly to the fetus, and can be paired with an intrauterine pressure catheter to get
monitoring? a more accurate assessment of FHR and contraction strength; requires membranes
to be ruptured
3. What are chorioamnionitis
some contraindi- active maternal genital herpes
cations for inter- HIV
nal fetal monitor- positive GBS test
ing? placental previa/undiagnosed vaginal bleeding
4. What qualifies an 15 beat per minute increase for 15 or more seconds
acceleration in
FHR?
5. What qualifies a 15 beat per minute decrease for 15 seconds or more
deceleration in
FHR?
, NUR 335 Exam 2
6. What are the re- Baseline: 110-160 bpm
quirements of a Variability: moderate (6-25 beat change within 1 box)
category 1 fetal Decelerations: can be absent or early
heart strip? Accelerations: absent or present
7. What are the re- Variability: absent variability (no change in heart rate) accompanied by any of the
quirements for a following findings
category 3 fetal
heart strip? Baseline: less than 110 beats per minute (bradycardia) OR sinusoidal pattern
Decelerations: recurrent late decelterations (nadir of deceleration occurs at end
of 50% or more of contractions seen) OR recurrent variable decelerations (nadir
occurs within 15 seconds of start of deceleration)
8. What are the re- Baseline: tachycardia, bradycardia without absent variability
quirements of a Variability: minimal (1-5 bpm change in one 10 second box), marked (>25 bpm
category 2 fetal change in one 10 second box), or absent (no bpm change) not accompanied by
heart strip? recurrent decelerations
Decelerations: Recurrent variable decels with minimal or moderate variability,
prolonged decels (2-10 minutes), recurrent late decles with moderate variability,
variable decels with slow return to baseline, overshoots, or shoulders
Accelerations: absent after fetal stimulation
9. How is uterine ac- frequency
tivity interpreted duration
in FHR monitor- intensity
ing? resting tone
relaxation between contractions
10. What is indicat- - indication: umbilical cord compression
ed when a fe- - causes: cord prolapse, nuchal cord, baby laying on cord
tal heart strip has - treatment: assess for cord prolapse (if found elevate presenting part and rush for
recurrent vari- c/s), reposition mom, administer amnioinfusion (cushion the cord), stop oxytocin,
, NUR 335 Exam 2
able decelera- administer oxygen (10L/min face mask), have mom push every other contraction,
tions? causes? every third compression, or temporarily stop pushing
treatment?
11. What is indicat- - indication: increased fetal intracranial pressure
ed when a fe- - causes: normal finding as fetus descends into the birth canal
tal heart strip has - treatment: prepare for delivery!
recurrent ear-
ly decelerations?
treatment?
12. What is in- - indication: placental insufficiency
dicated when - causes: DM, pre-e, HTN, hypotension, placental abruption, post-due baby
a fetal heart - treatment: position change (get off vena cava), stop oxytocin (or cervical ripening
strip has recur- agents), start oxygen (10L/min face mask), administer IV fluids to correct hypoten-
rent late decel- sion
erations? causes?
treatment?
13. What is indicat- - indication: cord compression or placental insufficiency
ed when a fe- - causes: tachysystole, hypotension, placental abruption, cord prolapse, severe
tal heart strip has cord compression, vagal stimulation, rapid fetal descent
recurrent pro- - treatment: POOF interventions, determine cause, if FHR becomes bradycardic it
longed deceler- is category 3 so delivery c/s may be indicated
ations? causes?
treatment?
14. What are some - maternal fever!! infection
causes of fetal - caffeine
tachycardia? - illicit drugs
- dehydration
- anemia
- early fetal hypoxemia
1. According to the Low risk without oxytocin fetal status assessment:
AWHONN, how - stage 1= 15-30 minutes once 4-5 cm dilated
often should you - stage 2= 5-15 minutes
assess FHR?
Low risk without oxytocin electronic FHR monitoring:
- stage 1: every 30 minutes once 4-5 cm dilated
- stage 2: every 30 minutes up until active pushing then every 15 minutes
Low risk with oxytocin electronic FHR monitoring:
- stage 1: every 15 minutes
- stage 2: every 15 minutes up until active pushing then every 5 minutes
2. What is the - Electronic: Use of the toco and FHR doppler to essentially perform an NST;
difference be- external and non-invasive devices that can be used any time after viability
tween electronic
fetal monitoring - Internal fetal monitoring: Use of an internal fetal scalp electrode which is attached
and internal fetal directly to the fetus, and can be paired with an intrauterine pressure catheter to get
monitoring? a more accurate assessment of FHR and contraction strength; requires membranes
to be ruptured
3. What are chorioamnionitis
some contraindi- active maternal genital herpes
cations for inter- HIV
nal fetal monitor- positive GBS test
ing? placental previa/undiagnosed vaginal bleeding
4. What qualifies an 15 beat per minute increase for 15 or more seconds
acceleration in
FHR?
5. What qualifies a 15 beat per minute decrease for 15 seconds or more
deceleration in
FHR?
, NUR 335 Exam 2
6. What are the re- Baseline: 110-160 bpm
quirements of a Variability: moderate (6-25 beat change within 1 box)
category 1 fetal Decelerations: can be absent or early
heart strip? Accelerations: absent or present
7. What are the re- Variability: absent variability (no change in heart rate) accompanied by any of the
quirements for a following findings
category 3 fetal
heart strip? Baseline: less than 110 beats per minute (bradycardia) OR sinusoidal pattern
Decelerations: recurrent late decelterations (nadir of deceleration occurs at end
of 50% or more of contractions seen) OR recurrent variable decelerations (nadir
occurs within 15 seconds of start of deceleration)
8. What are the re- Baseline: tachycardia, bradycardia without absent variability
quirements of a Variability: minimal (1-5 bpm change in one 10 second box), marked (>25 bpm
category 2 fetal change in one 10 second box), or absent (no bpm change) not accompanied by
heart strip? recurrent decelerations
Decelerations: Recurrent variable decels with minimal or moderate variability,
prolonged decels (2-10 minutes), recurrent late decles with moderate variability,
variable decels with slow return to baseline, overshoots, or shoulders
Accelerations: absent after fetal stimulation
9. How is uterine ac- frequency
tivity interpreted duration
in FHR monitor- intensity
ing? resting tone
relaxation between contractions
10. What is indicat- - indication: umbilical cord compression
ed when a fe- - causes: cord prolapse, nuchal cord, baby laying on cord
tal heart strip has - treatment: assess for cord prolapse (if found elevate presenting part and rush for
recurrent vari- c/s), reposition mom, administer amnioinfusion (cushion the cord), stop oxytocin,
, NUR 335 Exam 2
able decelera- administer oxygen (10L/min face mask), have mom push every other contraction,
tions? causes? every third compression, or temporarily stop pushing
treatment?
11. What is indicat- - indication: increased fetal intracranial pressure
ed when a fe- - causes: normal finding as fetus descends into the birth canal
tal heart strip has - treatment: prepare for delivery!
recurrent ear-
ly decelerations?
treatment?
12. What is in- - indication: placental insufficiency
dicated when - causes: DM, pre-e, HTN, hypotension, placental abruption, post-due baby
a fetal heart - treatment: position change (get off vena cava), stop oxytocin (or cervical ripening
strip has recur- agents), start oxygen (10L/min face mask), administer IV fluids to correct hypoten-
rent late decel- sion
erations? causes?
treatment?
13. What is indicat- - indication: cord compression or placental insufficiency
ed when a fe- - causes: tachysystole, hypotension, placental abruption, cord prolapse, severe
tal heart strip has cord compression, vagal stimulation, rapid fetal descent
recurrent pro- - treatment: POOF interventions, determine cause, if FHR becomes bradycardic it
longed deceler- is category 3 so delivery c/s may be indicated
ations? causes?
treatment?
14. What are some - maternal fever!! infection
causes of fetal - caffeine
tachycardia? - illicit drugs
- dehydration
- anemia
- early fetal hypoxemia
