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Exam (elaborations)

NURS 450 Exam 3 Practice Questions and Correct Answers

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Why measure fetal heart rate? fetal heart rate changes may indicate lack of oxygen to fetus or excessive bleeding affecting the fetus -Goals: reduce neonatal death, and avoid neurologic/brain injury When is measuring fetal heart rate necessary? 1. Signs of fetal distress 2. Epidural analgesia 3. Labor induction What is electronic fetal monitoring? measures the fetal heart rate and uterine contractions 2 options: - External vs internal -Intermittent vs continuous Ultrasound transducer/Doppler -external monitoring -records the fetal heart rate -gives printed record of heart rate and contractions, and makes heart sounds audible Tocodynamometer -external monitoring -records the frequency and duration of the contractions -gives printed record of heart rate and contractions, and makes heart sounds audible Fetal scalp electrode (FSE) -internal monitoring -attached to the baby's scalp to record the electrical conduction of the fetal heart -requires rupture of membranes Intrauterine pressure catheter (IUPC) -internal monitoring -requires rupture of membranes -thin tube inserted inside the uterine cavity to measure duration, frequency, and strength of uterine contractions Internal vs external methods -may be used interchangeably Advantages of fetal monitoring for the mother -constant feedback on fetal heart rate may be reassuring -visible evidence of uterine contractions when the woman has an epidural and cant feel them -permanent record of fetal heart rate and uterine contractions Disadvantages of fetal monitoring for the mother -restricts position and movement

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NURS 450 Exam 3 Practice Questions
and Correct Answers
Why measure fetal heart rate? ✅fetal heart rate changes may indicate lack of oxygen
to fetus or excessive bleeding affecting the fetus
-Goals: reduce neonatal death, and avoid neurologic/brain injury

When is measuring fetal heart rate necessary? ✅1. Signs of fetal distress
2. Epidural analgesia
3. Labor induction

What is electronic fetal monitoring? ✅measures the fetal heart rate and uterine
contractions
2 options:
- External vs internal
-Intermittent vs continuous

Ultrasound transducer/Doppler ✅-external monitoring
-records the fetal heart rate
-gives printed record of heart rate and contractions, and makes heart sounds audible

Tocodynamometer ✅-external monitoring
-records the frequency and duration of the contractions
-gives printed record of heart rate and contractions, and makes heart sounds audible

Fetal scalp electrode (FSE) ✅-internal monitoring
-attached to the baby's scalp to record the electrical conduction of the fetal heart
-requires rupture of membranes

Intrauterine pressure catheter (IUPC) ✅-internal monitoring
-requires rupture of membranes
-thin tube inserted inside the uterine cavity to measure duration, frequency, and strength
of uterine contractions

Internal vs external methods ✅-may be used interchangeably

Advantages of fetal monitoring for the mother ✅-constant feedback on fetal heart rate
may be reassuring
-visible evidence of uterine contractions when the woman has an epidural and cant feel
them
-permanent record of fetal heart rate and uterine contractions

Disadvantages of fetal monitoring for the mother ✅-restricts position and movement

, -may cause unnecessary interventions
-machine becomes focus of attention
-possible need for early rupture of membrane
-possible infection

Advantages of fetal monitoring for the baby ✅-may detect risk to baby's health during
labor

Disadvantages of fetal monitoring for the baby ✅-possible infection from internal
monitoring
-possible fetal distress from artificial rupture of membranes of FSE insertion
-possible unnecessary interventions such as assisted or surgical delivery

Intermittent auscultation ✅-listening to the fetal heart at regular intervals using a
handheld Doppler
-alternative to continuous electronic FHR monitoring
-determined over one to two minutes at intervals of 5-30 minutes depending on the
stage of labor
-leads to fewer interventions

Continuous electronic fetal monitoring ✅-monitoring both the fetal heart rate and
contractions continuously
-mother must stay in bed
-no evidence of improved outcomes
-significantly increases chances for a c-section or forceps delivery
-not recommended for low risk women in labor
-beneficial for high risk patients (preeclampsia, growth restriction, type 1 diabetes,etc)

continuous vs intermittent ✅-neither achieve the goals (reduced neonatal death, brain
injury)
-one doesn't perform better than the other
-continuous electronic fetal monitoring led to higher surgical rates without any neonatal
benefit

Normal fetal heart range ✅110-160 BPM

Leopold's maneuver ✅A way to determine the position of the fetus inside the woman's
uterus

External version ✅A procedure used to turn a fetus from a breech position into a head
down position before labor begins

Fetal kick counts ✅-Fetal movement decreased with low oxygen intake
-Counting fetal movement helps to determine if the fetus is getting enough oxygen
-Indicator of fetal well-being

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