Fetal assessment during labor
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| a useful tool for visualizing FHR patterns on a monitor screen or printed tracing. This is the primary mode of intrapartum fetal assessment inthe US and is the most commongly performed OB procedure | Electronic fetal monitoring
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| This must be maintained during labor to prevent fetal compromise and to promote newborn health after birth. | fetal o2 supply
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| causes of a decrease in fetal oxygen supply | Reduction of blood flow through maternal vessels Reduction of the o2 content in the maternal blood Alterations in fetal circulation, occuring with compression of the umbilical cord. Reduction in blood flow r/t uterine hyperstimulation HTN DM
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| baseline rate of 110-160 moderate variablity absent late or variable decelerations, early decels either present or absent, accelerations are either present or absent | Catergory 1
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| Recurrent late decels Recurrent variable decelerations Bradycardia sinusoidal | Catergory 3
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| ______ are associated with fetal hypoxemia | Abnormal FHR patterns
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| _______ a deficiency of oxygen in the arterial blood | hypoxiemia
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| an inadequate supply of oxygen at the cellular level. | hypoxia
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| _______ involves listening to fetal heart sounds at periodic intervals to assess the FHR | intermittent ausculation
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| this does not provide a permanent documented visual record of the FHR and cannot be used to assess visual patterns of the FHR variability or periodic changes | Intermittent ausculation
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| _______ may be difficult to perform in women who are obese. | Intermittent ausculation
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| ________ can develop into severe fetal ______ | hypoxemia;hypoxia
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| Marked Variability | greater than 25 bpm above baseline
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| During intermittent auscultation count the FHR for ___ to ___ seconds between contractions to identify the ausculatated rate, best assessed in the absence of uterine activity | 30-60
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| What is the purpose of EFM> | to continuously assess fetal oxygenation
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| converts the fetal ECG as obtained from the presenting part to the FHR via a cardiotachometer. Can be used only when membranes are ruptured and the cervix is dialated during the intrapartum period. electrode must be attached securely for accurate reading | Spiral electrode
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| monitors the frequency, duration, and intensity of contractions. Measures intauterine pressure at the cath tip and converts it to mmHg on the strip. membranes must be ruptured and cervix dialated during the intrapartum period | IUPC
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| measures uterine activity transabdominally, placed over the fundus above the umbilicus and held with an elastic belt. They can measure the frequency and approximate duration of UC, but not the intensity. | tocotransducer
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| When monitoring a woman in preterm labor remember that fundus may be located _________ the level of the umbilicus | below
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| use ____________ as an additional way to assess contraction frequency and to validate the monitor tracing. | palpation
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| This can objectively measure the frequency, duration, itensity of contractions and resting tone | IUPC
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| An increase in the __________ causes an acceleration in FHR | Sympathetic response
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| An increase in the ________ causes a decrease in FHR | Parasympathetic response
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| the average rate during a 10 minute segment that excludes periodic or episodic changes, periods of marked variability, and segments of the baseline that differ by more tha 25 bpm | baseline fetal heart rate
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| There must be more than ____ minutes of interpretable baseline data in a 10 minute segment of tracing in order to determine the baseline | 2
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| irregular waves or flucuations in the baseline FHR of two cycles per minute or greater. | variability
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| Variability is a characteristic of the baseline FHR and does not include _____ & _____ of the FHR | accels and decels
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| absent or minimal variability is classified as either _________ or _________ | abnormal;indeterminate
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| can be a result of fetal hypoxemia and metabolic acidemia. Other causes are congenital anomalies, preesisting neuro injury or CNS depressants. Also occurs with tachy, extreme prematurity, or sleeping fetus | minimal varibility
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| Sleep states do not last longer than ______ | 30 minutes
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| predictive of a normal fetal acid balance base. | moderate variability
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| ___ is unclear, and includes variability 30 beats above baseline. | Marked
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| regular, smooth, undulating wavelike pattern. This is not included in the FHR variablity definition. its an uncommon pattern and occurs with severe fetal anemia. | sinusoidal pattern
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| a baseline >160 bpm for 10 minutes or longer. can be considered an early sign of fetal hypoxemia, esp when associated with late decels and minimal or absent variability. results from infection, maternal hyperthyroidism, fetal anemia or med response | tachycardia
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| baseline FHR of <110 bpm for >10 min. occurs rarely and is not specifically associated to fetal oxygenation. | Bradycardia
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| _____ is often caused by some type of fetal cardiac problem such as structural defects involving the pacemakers or conduction system or fetal heart failure. Also, viral infection, maternal hypoglycemia and hypothermia | Bradycardia
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