Exam 2 Study Guide NSG 3500 - Updated for Current Exam

Exam 2 Study Guide NSG 3500 - Updated for Current Exam Fetal Heart Rate (FHR) - answer - 110-160 Variation of fetal heart - answer - Absent (no fluctuations/flat),minimal (5 bpm variation), moderate (6-25 bpm variation), marked (25 bpm variation) you want to see moderate A sedated baby could show - answer - minimal variability marked variability in FHR - answer - 25 bpm indication of distress Accelerations in FHR - answer - Transient increase in FHR (15x15) for term and 10x 10 minimum for PT 32 weeks and lower should be about 10x10 32 weeks and higher should be about 15x15 What happens if there are no accelerations - answer - Distressed baby Decelerations in FHR - answer - Periodic decrease in FHR could be an indication of a problem VEAL CHOP - answer - V- Variable C- Cord Comphression E- Early Decels H- Head Compression A- Accelerations O - OK L-Late Decels P - Placenta Periodic decelerations - answer - Decelerations of fetal heart rate associated with uterine contractions. episodic decelerations - answer - drops in the FHR not associated with uterine contractions causes for accelerations - answer - - spontaneous fetal movement - during a vaginal exam - electrode application - fetal reaction to external sounds - fetal scalp stimulation - breech presentation - occiputposterior position - uterine contractions - fundal pressure - abdominal palpation accelerations are - answer - normal and signifies fetal well being Types of decelerations - answer - early, late, variable Early decelerations - answer - everything lines up perfectly head is being compressed on. the baby is in the canal and is ready to come out PREPARE FOR DELIVERY Late decelerations - answer - at peak of contraction, baby's heart rate start to drop. Shifted to the right of the contraction. Placental insufficiency. Not giving the baby oxygen baby's "oxygen supply" starts running out if continual late decels occur Variable decelerations - answer - Sharp decline and incline cord compression baby can press on their own cord prolapsed cord through the cervix (emergency situation) do not take hand out until baby comes out because if you let go, the cord will compress again you can add fluid to the amniotic sac Prolonged deceleration - answer - A visually apparent decrease (may be either gradual or abrupt) in FHR of at least 15 beats/min below the baseline and lasting more than 2 minutes but less than 10 minutes Sinusoidal FHR pattern - answer - A specific fetal heart rate pattern that is described as a smooth, sine-wave like undulating pattern with a cycle frequency of 3-5bpm that continues for at least 20min or more. PNS &SNS not communicating #1 cause =Fetal anemia and loosing blood *can also be meds- Butorphanol minutes to act very rare For decelerations, you can decrease - answer - oxytocin poof for late and variable decels - answer - P-position change (left lateral) O- oxytocin needs to be turned OFF O- Oxygen needs to be ON F- Fluids - LATE: IV fluid bolus to increase BP for placenta - VARIABLES: Amnioinfusion in uterus via IUPC IUPC (intrauterine pressure catheter) - answer - measures contraction frequency, duration, strength(in mm mercury). The 5 P's of maternal and fetal mechanisms - answer - -Power (pushing and contractions, urge to bear down, should not push if cervix is not fully dilated) -Passageway (Pelvis) -Passenger (Baby) -Passageway + Passenger (presentation) -Psychosocial (how they feel about the other things, support when they go home, how they feel about pregnancy) Do not push if cervix is not fully dilated because - answer - it could tear the baby's head pushes against the cervix and can cause cervical swelling, contracting the cervix fetal lie - answer - relationship of the long axis of the fetus to the long axis of the mother Longitudinal (head first) Transverse (Sideways) Oblique (butt first) fetal attitude - answer - relationship of fetal parts to one another is the head flexed or ex