NUR 252 Maternal and Newborn Review
Questions and Correct Answers
What does fetal monitoring tell us? ✅Fetal oxygenation, acid-base status of the fetus,
ability of the CNS to regulate FHR
What is the best predictor of fetal health? ✅Variability
What conditions can affect the fetal oxygen supply? ✅1. Maternal HTN/Hypotension
2. Hypovolemia
3. Anemia
4. Damaged vasculature
**Alterations in fetal circulation - 2 vessel cord or other congenital abnormalities
What are potential consequences of Uterine Hypoxia/asphyxia? ✅Cerebral palsy
Epilepsy
RDS (Resp distress syndrome)
Renal damage
NEC (Necrotizing Enterocolitis)
Chronic brain impairment
What does the TOCO transducer measure and where is it placed? ✅Measure
Contraction or uterine activity. It cannot measure strength of contraction.
Top near the fundus
What does the ultra sound transducer do? ✅It detects the fetal heartrate and is placed
near the pubic bone on the lower portion of the pregnant belly.
*note: it requires ultrasound jelly
What is a IUPC? ✅Intrauterine pressure catheter
This can detect the strength or effectiveness of the contractions
How can a nurse measure the strength of a contraction without the IUPC? ✅palpating
the fundus:
-tip of nose- mild
-chin- moderate
-forehead-strong
,What is intermittent monitoring? ✅A Doppler US used to monitor HR one min before
during and one min after contraction
What are the 3 main important components of the Fetal Heart Monitoring Strip? ✅1.
Baseline Heart Rate
2. Variability
3. Periodic Changes
What are the kinds of variability of a FHR? ✅1. Absent
2. Minimal
3. Moderate
4. Marked
What are the kinds of periodic FHR changes? ✅1. Accelerations
2. Decelerations
-Early Decels (benign)
-Late Decels (Ominous)
-Variable Decels (Ominus)
-Prolonged Decels (Can be Ominous)
What is a normal baseline fetal heart rate range? ✅110-160 bpm (for 10 min)
What are periodic accelerations? ✅Transient increases above the FHR baseline
-Fetal movement
-Contractions
These are positive and reassuring they are increases that are at least 15 beats from
baseline and last for at least 15 seconds
What are periodic early decelerations? ✅-gradual onset before peak of contraction
with a return to baseline before the end of the contraction
-uniform in shape
-Caused by: head compression via contraction
-Not associated with Hypoxia
What do early decelerations look like? ✅
What is a periodic variable decelerations? ✅-shaped U, V, W "varied in shape"
-rapid decrease and increase in rate
-Variable in duration, timing depth not uniform
-Caused by cord compression
What are interventions for variable deceleration? ✅-position change
-vaginal exam (ck for prolapsed cord)
, -stop oxytocin
-anticipate amnioinfusion
-call dr
What is an amnioinfusion? ✅a transvaginal infusion of fluid to compensate for the loss
of amniotic fluid
What are late decelerations? ✅-decline of FHR begins after the contraction and is
delayed onset and delayed return to baseline
-Caused: Utero-placental insufficiency
What are interventions for late decelerations? ✅-lateral positioning
-stop oxytocin
-oxygen
-IV fluid bolus
-notify dr
-anticipate expedient delivery
How does maternal positioning affect fetal perfusion? ✅the baby can compress the
aorta and vena cava when mom is on her back. turning on the side helps to improve
circulation of these main vein/artery
How long does a prolonged deceleration have to go before it is now a "prolonged"?
✅greater than 2 min
What is a category I Fetal Heart Rate pattern? ✅Normal and strongly predictive of a
normal acid base balance status of the fetus
What is a category II FHR pattern? ✅Indeterminate: this is not predictive of abnormal
fetal acid-based status but requires continued surveillance and re-evaluation
There is no proof of good or bad it is unknown without more info.
What is a category III FHR pattern? ✅This is predictive of abnormal fetal-acid base
status at the time of strip.
This is proof of things going wrong and you should prepare to deliver
VEAL CHOP ✅V- Variable Decels - Cord Compression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placental insufficiency
What is gravida and para? ✅Gravida is number of pregnancies
Questions and Correct Answers
What does fetal monitoring tell us? ✅Fetal oxygenation, acid-base status of the fetus,
ability of the CNS to regulate FHR
What is the best predictor of fetal health? ✅Variability
What conditions can affect the fetal oxygen supply? ✅1. Maternal HTN/Hypotension
2. Hypovolemia
3. Anemia
4. Damaged vasculature
**Alterations in fetal circulation - 2 vessel cord or other congenital abnormalities
What are potential consequences of Uterine Hypoxia/asphyxia? ✅Cerebral palsy
Epilepsy
RDS (Resp distress syndrome)
Renal damage
NEC (Necrotizing Enterocolitis)
Chronic brain impairment
What does the TOCO transducer measure and where is it placed? ✅Measure
Contraction or uterine activity. It cannot measure strength of contraction.
Top near the fundus
What does the ultra sound transducer do? ✅It detects the fetal heartrate and is placed
near the pubic bone on the lower portion of the pregnant belly.
*note: it requires ultrasound jelly
What is a IUPC? ✅Intrauterine pressure catheter
This can detect the strength or effectiveness of the contractions
How can a nurse measure the strength of a contraction without the IUPC? ✅palpating
the fundus:
-tip of nose- mild
-chin- moderate
-forehead-strong
,What is intermittent monitoring? ✅A Doppler US used to monitor HR one min before
during and one min after contraction
What are the 3 main important components of the Fetal Heart Monitoring Strip? ✅1.
Baseline Heart Rate
2. Variability
3. Periodic Changes
What are the kinds of variability of a FHR? ✅1. Absent
2. Minimal
3. Moderate
4. Marked
What are the kinds of periodic FHR changes? ✅1. Accelerations
2. Decelerations
-Early Decels (benign)
-Late Decels (Ominous)
-Variable Decels (Ominus)
-Prolonged Decels (Can be Ominous)
What is a normal baseline fetal heart rate range? ✅110-160 bpm (for 10 min)
What are periodic accelerations? ✅Transient increases above the FHR baseline
-Fetal movement
-Contractions
These are positive and reassuring they are increases that are at least 15 beats from
baseline and last for at least 15 seconds
What are periodic early decelerations? ✅-gradual onset before peak of contraction
with a return to baseline before the end of the contraction
-uniform in shape
-Caused by: head compression via contraction
-Not associated with Hypoxia
What do early decelerations look like? ✅
What is a periodic variable decelerations? ✅-shaped U, V, W "varied in shape"
-rapid decrease and increase in rate
-Variable in duration, timing depth not uniform
-Caused by cord compression
What are interventions for variable deceleration? ✅-position change
-vaginal exam (ck for prolapsed cord)
, -stop oxytocin
-anticipate amnioinfusion
-call dr
What is an amnioinfusion? ✅a transvaginal infusion of fluid to compensate for the loss
of amniotic fluid
What are late decelerations? ✅-decline of FHR begins after the contraction and is
delayed onset and delayed return to baseline
-Caused: Utero-placental insufficiency
What are interventions for late decelerations? ✅-lateral positioning
-stop oxytocin
-oxygen
-IV fluid bolus
-notify dr
-anticipate expedient delivery
How does maternal positioning affect fetal perfusion? ✅the baby can compress the
aorta and vena cava when mom is on her back. turning on the side helps to improve
circulation of these main vein/artery
How long does a prolonged deceleration have to go before it is now a "prolonged"?
✅greater than 2 min
What is a category I Fetal Heart Rate pattern? ✅Normal and strongly predictive of a
normal acid base balance status of the fetus
What is a category II FHR pattern? ✅Indeterminate: this is not predictive of abnormal
fetal acid-based status but requires continued surveillance and re-evaluation
There is no proof of good or bad it is unknown without more info.
What is a category III FHR pattern? ✅This is predictive of abnormal fetal-acid base
status at the time of strip.
This is proof of things going wrong and you should prepare to deliver
VEAL CHOP ✅V- Variable Decels - Cord Compression
E- Early Decels H- Head Compression
A- Accelerations O - OK
L-Late Decels P - Placental insufficiency
What is gravida and para? ✅Gravida is number of pregnancies
