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NURS352 Exam Study Guide

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NURS352 Exam Study Guide Antepartum Fetal Surveillance - answerfetal movement assessment, nonstress test, contraction stress test, biophsycial profile, umbilical artery doppler velocimetry, ultrasound, amniocentesis, chorionic villi sampling maternal conditions that warrant additional fetal surveillance - answerantiphospholipid syndrome, hyperthyroidism, hemoglobinopahties, cyanotic heart disease, lupus, chronic renal disease, type 1 diabetes, hypertensive disorders, pregnancy conditions that warrant additional fetal surveillance - answerpregnancy induced hypertension, decreased fetal movement, oligohydramnios, polyhydramnios, intrauterine growth restriction, postterm pregnancy, isoimmunixation, fetal anomalies, previous fetal demise, multiple gestation fetal movement assessment - answerkick counts, done after dinner with mother resting on side with 10 movements in 2 hours and no smoking for 2 hours before counting advatages of fetal movement assessment - answerlow tech, can be done daily, done on all pregnancies, reassuring for mother intrapartum fetal assessment - answerelectronic fetal monioring- external or internal monitoring, intrauterine pressure catheter components of EFM interpretation - answerbaseline, variability, periodic changes 3 tier fetal heart rate interpreteation - answer3 categories variability in EFM - answervariation of FHR around baseline of 5-10 which indivates parasympathetic system, chemoreceptors, baroreceptors and cardiac responsiveness health acceleration in EFM - answerup 10-25 of baseline which indiates sympathetic system what decreases variability - answerprematurity-specifically before 28 weeks, hypoxia, congenital heart anomalies, fetal tachycardia, fetal metabolic acidosis, CNS depressants, , fetal sleep cycles,betamethasone, neurological abnormality when should variability be present - answerafter 32 weeks Absent variability - answeramplitude range undetectable ©THEBRIGHT EXAM SOLUTIONS 11/8/2024 12:08 PM minimal variability - answer5 bpm moderate variability - answer6-25 bpm Marked variability - answer25 bpm most significant sign of fetal compromise - answerVariability in FHR that is persistently absent or minimal normal range hr fetal - answer120-160 fetal bradcardia - answerless than 120 causes of bradycardia in fetus - answerheart block, occiput posterior, transverse position, serious fetal compromise tachycardia in fetus - answerover 160 mild tachycardia in fetus - answer160-180 severe tachycardia in fetus - answerover 180 tachycardia over 200 bpm in fetus - answerusually due to congenital anomaies or fetal tachyarrhythmia persisent tachycardia w fetal hypoxia, fetal anemia, maternal fever suggests - answerchorioamnionitis category 1 - answerBaseline 110-160, variability is moderate, accelerates present or absent, early decelerations present or absent, and variable or late decelerations absent what does category 1 mean - answerNot a risk to a fetus - normal acid-base status at time, routine care category 2 - answertachy or brady cardia w/o absent variability, minimial variability, absent variability w/o recurrent decelerations, marked variability, absence of accelerations after stim, recurrent variable decelerations with miniminal or mod varaibility, prolonged decelation from 2-10 min, reccurent late decelerations w mod variability, variable decelerations w slow return to baseline or overshoot what does category 2 mean - answerindeterminate, not predictive of abnormal fetal acid base status but requires continued monitoring category 3 - answersinusoidal pattern or absent variabiilty w recurrent late decelerations, recurrent variable decelerations, or bradycardia what does category 3 mean - answerabnormal fetal acid base status, efforts to expedite can resolve underlying cause deceleration classifications - answerearly, variable, late, prolonged

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©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM


NURS352 Exam Study Guide


Antepartum Fetal Surveillance - answer✔fetal movement assessment, nonstress test, contraction stress
test, biophsycial profile, umbilical artery doppler velocimetry, ultrasound, amniocentesis, chorionic villi
sampling

maternal conditions that warrant additional fetal surveillance - answer✔antiphospholipid syndrome,
hyperthyroidism, hemoglobinopahties, cyanotic heart disease, lupus, chronic renal disease, type 1
diabetes, hypertensive disorders,

pregnancy conditions that warrant additional fetal surveillance - answer✔pregnancy induced
hypertension, decreased fetal movement, oligohydramnios, polyhydramnios, intrauterine growth
restriction, postterm pregnancy, isoimmunixation, fetal anomalies, previous fetal demise, multiple
gestation

fetal movement assessment - answer✔kick counts, done after dinner with mother resting on side with
10 movements in 2 hours and no smoking for 2 hours before counting

advatages of fetal movement assessment - answer✔low tech, can be done daily, done on all
pregnancies, reassuring for mother

intrapartum fetal assessment - answer✔electronic fetal monioring- external or internal monitoring,
intrauterine pressure catheter

components of EFM interpretation - answer✔baseline, variability, periodic changes

3 tier fetal heart rate interpreteation - answer✔3 categories

variability in EFM - answer✔variation of FHR around baseline of 5-10 which indivates parasympathetic
system, chemoreceptors, baroreceptors and cardiac responsiveness health

acceleration in EFM - answer✔up 10-25 of baseline which indiates sympathetic system

what decreases variability - answer✔prematurity-specifically before 28 weeks, hypoxia, congenital heart
anomalies, fetal tachycardia, fetal metabolic acidosis, CNS depressants, , fetal sleep
cycles,betamethasone, neurological abnormality

when should variability be present - answer✔after 32 weeks

Absent variability - answer✔amplitude range undetectable

, ©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM

minimal variability - answer✔<5 bpm

moderate variability - answer✔6-25 bpm

Marked variability - answer✔>25 bpm

most significant sign of fetal compromise - answer✔Variability in FHR that is persistently absent or
minimal

normal range hr fetal - answer✔120-160

fetal bradcardia - answer✔less than 120

causes of bradycardia in fetus - answer✔heart block, occiput posterior, transverse position, serious fetal
compromise

tachycardia in fetus - answer✔over 160

mild tachycardia in fetus - answer✔160-180

severe tachycardia in fetus - answer✔over 180

tachycardia over 200 bpm in fetus - answer✔usually due to congenital anomaies or fetal
tachyarrhythmia

persisent tachycardia w fetal hypoxia, fetal anemia, maternal fever suggests - answer✔chorioamnionitis

category 1 - answer✔Baseline 110-160, variability is moderate, accelerates present or absent, early
decelerations present or absent, and variable or late decelerations absent

what does category 1 mean - answer✔Not a risk to a fetus - normal acid-base status at time, routine
care

category 2 - answer✔tachy or brady cardia w/o absent variability, minimial variability, absent variability
w/o recurrent decelerations, marked variability, absence of accelerations after stim, recurrent variable
decelerations with miniminal or mod varaibility, prolonged decelation from 2-10 min, reccurent late
decelerations w mod variability, variable decelerations w slow return to baseline or overshoot

what does category 2 mean - answer✔indeterminate, not predictive of abnormal fetal acid base status
but requires continued monitoring

category 3 - answer✔sinusoidal pattern or absent variabiilty w recurrent late decelerations, recurrent
variable decelerations, or bradycardia

what does category 3 mean - answer✔abnormal fetal acid base status, efforts to expedite can resolve
underlying cause

deceleration classifications - answer✔early, variable, late, prolonged

, ©THEBRIGHT EXAM SOLUTIONS

11/8/2024 12:08 PM

early deceleration - answer✔FHR decrease before contraction, mirror image of contraction and EHR

late deceleration - answer✔The slowing of the fetal heart rate after the onset of a uterine contraction
and persisting after the contraction ends.

VEAL CHOP - answer✔V- Variable C- Cord Comphression

E- Early Decels H- Head Compression

A- Accelerations O - OK

L-Late Decels P - Placenta insuff

types of reduced placental exchange - answer✔excessive contractions, hypotension, maternal
hypoxemia, hypertension, diabetes IUGR, abruption

IUGR - answer✔intrauterine growth restriction

late deceleration picture - answer✔

early deceleration picture - answer✔

variable deceleration picture - answer✔

variable deceleration - answer✔Periodic change in fetal heart rate caused by umbilical cord
compression; decelerations vary in onset, occurrence, and waveform. usually V or W shaped

severe variable deceleration with overshoot - answer✔variability preserved and shows good reserve

fetal distress nursing interventions - answer✔reposition patient, turn off pitocin, increase IV rate, admin
O2, assess labor and scalp stimulation, assess for cord prolapse, notify provider, prepare for labor and
resus

non stress test - answer✔electronic monitoring w/o contractions

what happens to heart rate when fetus moves - answer✔accelerates

loss of reactivity w/o contractions indicates - answer✔sleep cycle or CNS depression or fetal acidosis

non stress test results - answer✔reactive or nonreactive

reactive in non stress test - answer✔2 or more accelerations of 15bpm for 15 seconds w/in 20 minutes-
heart is reactive to movement

nonreactive in non stress test - answer✔no FHR accelerations or accelerations less than 15 pbm for 40
min period

contraction stress test - answer✔a stress test used to evaluate the ability of the fetus to tolerate the
stress of labor and delivery, FHR changes in contractinos

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