Maternal Health Exam 2 with 100%
correct answers
How often should you auscultate the FHR in each phase of labor? - ANS Latent phase -
every hour
Active phase - every 30 minutes
Second stage - every 15 minutes
What are the external methods of monitoring fetal heart rate (2) - ANS 1) Ultrasound
transducer - looks at fetal heart tones
2) Tocotransducer - looks at contractions only and senses when the abdomen gets tense
Where do you listen to the fetal heart tone if the baby is in cephalic or breech position? - ANS
Cephalic: below maternal umbilicus
Breech: ABOVE maternal umbilicus
What are the internal methods of monitoring fetal heart rate? (2) - ANS 1) Spiral Electrode -
connects to the top of the baby's head by lodging right beneath the skin. Measures fetal heart
tones. *More accurate
2) Intrauterine Pressure Catheter (IUPC) - catheter inserted into uterus to measure the
pressure/intensity of a contraction
What has to be already done to use the internal monitoring methods of fetal heart rate? - ANS
The bag of water has to already be broken and mom has to be dilated 2-3 cm
What is the normal range for fetal heart rate? - ANS 110-160 bpm
less than 110, bradycardia
higher than 160, tachycardia
How do you get a baseline average rate of a fetal HR? - ANS Monitor fetal heart rate during
a 10 minute period to find their baseline
What is the normal frequency of contractions and their length? - ANS 2-5 contractions in 10
minutes that last 45-80 seconds. They should not last longer than 90 seconds
What is variability in a FHR? - ANS Beat to beat fluctuations in baseline fetal heart rate. This
measures the well being of the fetus
, What causes variability in FHR? - ANS Fetal hypoxemia, congenital abnormalities, neuro
injury, medications given to mom in labor, extreme prematurity, fetal sleep state (can decrease
when fetus is sleeping)
How much variability do we want to see in a FHR? - ANS We want Moderate variability =
6-25 bpm difference between top peak and lowest peak
What is acceleration and what does it mean? - ANS -An abrupt increase in FHR above
baseline (15 bpm above baseline that lasts more than 15 seconds) *Hills in the HR
-HEALTHY! This is a reassuring sign of fetal well being! It can be caused by fetal movement,
sterile vaginal exam and fundal pressure
What is early deceleration? - ANS -gradual decrease in FHR in response to head
compression which can occur during a sterile vaginal exam, contractions and fundal pressure
and second stage of labor. It's NORMAL
-Will look like a mirror image from the contraction lines
-Just occurs during labor
What is late deceleration? - ANS -BAD!!! Gradual decrease in FHR in response to
uteroplacental insufficiency (something is wrong with the blood flow/baby is holding breath for
too long).
-Deceleration begins after contraction has started and return to baseline after contraction ends
*THIS REQUIRES AN INTERVENTION
What are the nursing interventions for late deceleration? - ANS -Place woman in lateral
position
-Increase IV fluids to help blood flow
-Discontinue oxytocin (if any)
-start O2 at 8-10 L/min on a nonrebreather mask
What is variable deceleration? - ANS -BAD!!! Abrupt decrease in FHR of more than 15 bpm,
lasting at least 15 seconds caused by compression of umbilical cord
-Can occur anytime during contractions from the transition phase and second stage of labor
-*Often shaped like a V
-REQUIRES INTERVENTION
Nursing interventions for variable deceleration? - ANS -Change maternal position
-Discontinue oxytocin
-02 at 8-10 L/min
-Assess for prolapsed cord
-Assist with amnioinfusion (use IUPC to help baby float)
What is a category 1 FHR? - ANS -Baseline rate of 110-160 bpm
-Moderation variability
correct answers
How often should you auscultate the FHR in each phase of labor? - ANS Latent phase -
every hour
Active phase - every 30 minutes
Second stage - every 15 minutes
What are the external methods of monitoring fetal heart rate (2) - ANS 1) Ultrasound
transducer - looks at fetal heart tones
2) Tocotransducer - looks at contractions only and senses when the abdomen gets tense
Where do you listen to the fetal heart tone if the baby is in cephalic or breech position? - ANS
Cephalic: below maternal umbilicus
Breech: ABOVE maternal umbilicus
What are the internal methods of monitoring fetal heart rate? (2) - ANS 1) Spiral Electrode -
connects to the top of the baby's head by lodging right beneath the skin. Measures fetal heart
tones. *More accurate
2) Intrauterine Pressure Catheter (IUPC) - catheter inserted into uterus to measure the
pressure/intensity of a contraction
What has to be already done to use the internal monitoring methods of fetal heart rate? - ANS
The bag of water has to already be broken and mom has to be dilated 2-3 cm
What is the normal range for fetal heart rate? - ANS 110-160 bpm
less than 110, bradycardia
higher than 160, tachycardia
How do you get a baseline average rate of a fetal HR? - ANS Monitor fetal heart rate during
a 10 minute period to find their baseline
What is the normal frequency of contractions and their length? - ANS 2-5 contractions in 10
minutes that last 45-80 seconds. They should not last longer than 90 seconds
What is variability in a FHR? - ANS Beat to beat fluctuations in baseline fetal heart rate. This
measures the well being of the fetus
, What causes variability in FHR? - ANS Fetal hypoxemia, congenital abnormalities, neuro
injury, medications given to mom in labor, extreme prematurity, fetal sleep state (can decrease
when fetus is sleeping)
How much variability do we want to see in a FHR? - ANS We want Moderate variability =
6-25 bpm difference between top peak and lowest peak
What is acceleration and what does it mean? - ANS -An abrupt increase in FHR above
baseline (15 bpm above baseline that lasts more than 15 seconds) *Hills in the HR
-HEALTHY! This is a reassuring sign of fetal well being! It can be caused by fetal movement,
sterile vaginal exam and fundal pressure
What is early deceleration? - ANS -gradual decrease in FHR in response to head
compression which can occur during a sterile vaginal exam, contractions and fundal pressure
and second stage of labor. It's NORMAL
-Will look like a mirror image from the contraction lines
-Just occurs during labor
What is late deceleration? - ANS -BAD!!! Gradual decrease in FHR in response to
uteroplacental insufficiency (something is wrong with the blood flow/baby is holding breath for
too long).
-Deceleration begins after contraction has started and return to baseline after contraction ends
*THIS REQUIRES AN INTERVENTION
What are the nursing interventions for late deceleration? - ANS -Place woman in lateral
position
-Increase IV fluids to help blood flow
-Discontinue oxytocin (if any)
-start O2 at 8-10 L/min on a nonrebreather mask
What is variable deceleration? - ANS -BAD!!! Abrupt decrease in FHR of more than 15 bpm,
lasting at least 15 seconds caused by compression of umbilical cord
-Can occur anytime during contractions from the transition phase and second stage of labor
-*Often shaped like a V
-REQUIRES INTERVENTION
Nursing interventions for variable deceleration? - ANS -Change maternal position
-Discontinue oxytocin
-02 at 8-10 L/min
-Assess for prolapsed cord
-Assist with amnioinfusion (use IUPC to help baby float)
What is a category 1 FHR? - ANS -Baseline rate of 110-160 bpm
-Moderation variability
