MATERNAL HEALTH EXAM 2 QUESTIONS WITH
100% ACCURATE ANSWERS
How often should you auscultate the FHR in each phase of labor? - accurate answer -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) - accurate answer -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? - accurate
answer -Cephalic: below maternal umbilicus
Breech: ABOVE maternal umbilicus
What are the internal methods of monitoring fetal heart rate? (2) - accurate answer -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? - accurate
answer -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? - accurate answer -110-160 bpm
less than 110, bradycardia
higher than 160, tachycardia
How do you get a baseline average rate of a fetal HR? - accurate answer -Monitor fetal heart rate
during a 10 minute period to find their baseline
What is the normal frequency of contractions and their length? - accurate answer -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? - accurate answer -Beat to beat fluctuations in baseline fetal heart rate.
This measures the well being of the fetus
What causes variability in FHR? - accurate answer -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? - accurate answer -We want Moderate variability =
6-25 bpm difference between top peak and lowest peak
, What is acceleration and what does it mean? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --Baseline rate of 110-160 bpm
-Moderation variability
-Accelerations can be present or absent
-Early decelerations can be present or absent
-NO LATE OR VARIABLE DECELERATIONS
**We want this category
What is a category III FHR? - accurate answer -*Bad!
-absent variability and any of:
-recurrent late decelerations, recurrent variable decelerations and bradycardia.
THIS OCCURS bc the baby is under stress!
100% ACCURATE ANSWERS
How often should you auscultate the FHR in each phase of labor? - accurate answer -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) - accurate answer -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? - accurate
answer -Cephalic: below maternal umbilicus
Breech: ABOVE maternal umbilicus
What are the internal methods of monitoring fetal heart rate? (2) - accurate answer -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? - accurate
answer -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? - accurate answer -110-160 bpm
less than 110, bradycardia
higher than 160, tachycardia
How do you get a baseline average rate of a fetal HR? - accurate answer -Monitor fetal heart rate
during a 10 minute period to find their baseline
What is the normal frequency of contractions and their length? - accurate answer -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? - accurate answer -Beat to beat fluctuations in baseline fetal heart rate.
This measures the well being of the fetus
What causes variability in FHR? - accurate answer -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? - accurate answer -We want Moderate variability =
6-25 bpm difference between top peak and lowest peak
, What is acceleration and what does it mean? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --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? - accurate answer --Baseline rate of 110-160 bpm
-Moderation variability
-Accelerations can be present or absent
-Early decelerations can be present or absent
-NO LATE OR VARIABLE DECELERATIONS
**We want this category
What is a category III FHR? - accurate answer -*Bad!
-absent variability and any of:
-recurrent late decelerations, recurrent variable decelerations and bradycardia.
THIS OCCURS bc the baby is under stress!
