Interpretation of Fetal and Uterine Monitoring Sherpath

The nurse knows that patient education has been effective when the patient makes which statement about the difference between a tocodynamometer and an intrauterine pressure catheter (IUPC)?

"The tocodynamometer is positioned outside my body, while the IUPC is positioned inside my body." Whereas the tocodynamometer is an external monitoring device, the IUPC is an internal monitoring device.

The nurse is assessing the fetal heart rate of a woman who is currently lying supine and identifies a nonreassuring pattern. Which recommendation would the nurse make to address this pattern?

"Turn on your side." The patient should not lie supine, because compression of the aorta could negatively affect the fetus. A change of position, such as lying on the side, is the first response to a nonreassuring fetal heart rate pattern in this situation.

Which response would the nurse provide the patient who asks why oxygen is being given after the nurse identifies a nonreassuring fetal heart rate?

"We need to increase your oxygen, which will increase the baby's oxygen." The nurse provides a simple and direct explanation for the intervention being provided.

A patient is concerned about the baseline variability in the heart rate of her fetus. Which responses by the nurse describe the significance of baseline variability to the patient?

- "Variability demonstrates that there is adequate oxygenation of the fetus." - "Variability suggests that the fetus is able to adapt to the labor process."

Which uterine resting tones are considered reassuring?

- 18 mm Hg with an intrauterine pressure catheter (IUPC) - 350 Montevideo units with electronic fetal monitoring (EFM)

The maternity nurse is monitoring a patient with dysfunctional labor for signs of potential fetal compromise. Which assessment findings would alert the nurse to a potential for fetal compromise?

- Absent variability - No cervical change in 4 hours - Uterine resting tone 30 mm Hg via intrauterine pressure catheter - Recurrent late decelerations

Which qualities are considered normal when assessing fetal heart rate (FHR)?

- Baseline FHRof 140 beats/min - FHR variability of 20 beats/min

A nurse is beginning to care for a patient in labor. The health care provider has prescribed an intravenous (IV) infusion of oxytocin. The nurse makes sure that which implementations occur before initiation of the infusion?

- Continuous electronic fetal monitoring - Making sure that a vial of terbutaline is immediately available - Preparing an IV infusion pump

Which nursing actions are appropriate when the fetal monitor shows a pattern of late decelerations?

- Discontinue oxytocin. - Administer oxygen by face mask. - Reposition the patient onto her side.

Which uterine activity indicators does the intrauterine pressure catheter (IUPC) measure in mm HG?

- Intensity - Resting tone

Which methods are used to assess uterine activity externally?

- Palpation - Tocodynamometer

Which characteristics describe early decelerations?

- Referred to as mirror images of contraction - Primarily periodic and often benign - Onset, nadir, and recovery correspond with beginning, peak, and end of contraction

The nurse understands that ________ Montevideo units (MVUs) or more are considered adequate for normal labor progression.

200 200 Montevideo units (MVUs) or more are considered adequate for normal labor progression.

A nurse is caring for a patient in labor who is receiving oxytocin via intravenous infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued?

A fetal heart rate of 90 beats/min A normal fetal heart rate is 110 to 160 beats/min. Bradycardia and/or late or variable decelerations indicate fetal distress and the need to discontinue the oxytocin infusion.

When is fetal heart rate (FHR) and uterine activity (UA) assessment indicated for a low-risk patient in the first stage of labor?

After rupture of membranes FHR and UA should be assessed after rupture of membranes to assess fetal response to rupture and whether UA changes.

Which fetal heart rate classification is considered nonreassuring?

Category III Category III classification refers to abnormal findings that are nonreassuring.

Which fetal condition can cause a fetal heart rate (FHR) of <60 beats/min for more than 60 seconds that does not quickly return to baseline?

Cord compression Variable decelerations that last a long time and do not quickly return to baseline can occur with cord compression, which could compromise the fetus.

Match the type of nonreassuring deceleration with the associated cause.

Disrupted oxygen transfer - Late Interrupted oxygen supply - Prolonged Umbilical cord compression - Variable

Which deceleration is considered a normal finding?

Early Early decelerations are a result of fetal head compression and are considered a normal finding that is not associated with poor fetal status or outcomes.

Which description of moderate variability of the fetal heart rate is accurate?

Fetal heart rate fluctuates between 10 and 20 beats/min. A fluctuating fetal heart rate of 6 to 25 beats/min is considered moderate variability and is normal and reassuring.

Which fetal heart rate finding may result from maternal fever?

Fetal heart rate of 180 beats/min for 12 minutes A maternal fever can directly increase the fetal temperature or infect the fetus in cases of infection. The fetus responds with an increased heart rate, which can lead to fetal tachycardia.

The nurse caring for the patient in labor understands that absent (or minimal) variability is usually considered nonreassuring. However, which condition related to decreased variability is considered benign?

Fetal sleep Fetal sleep states are benign causes of absent baseline variability. The episodes are usually 40 minutes or less and happen occasionally.

Which uterine contraction strength classification is used when labor is measured at >500 Montevideo units (MVUs)?

Hypertonic Above 400 MVUs, the uterine contraction strength is considered hypertonic, which is abnormal.

The nurse notes fetal tachycardia and suspects that the patient may be dehydrated. Which nursing action is appropriate to address this nonreassuring finding?

Increase the rate of intravenous (IV) saline administration. Tachycardia can be the result of maternal hypovolemia caused by dehydration. Increasing the rate of nonadditive intravenous fluids can improve placental perfusion by increasing maternal blood volume.

A patient arrives at a birthing center in active labor. Her membranes are still intact, and the health care provider prepares to perform an artificial rupture of membranes (AROM). What will the nurse relay to the patient as the most likely outcome of the procedure?

Increased pressure on the cervix The rupture of the amniotic membranes releases the cushion provided by the amniotic sac and causes an increase in the pressure of the fetal head on the cervix. This increased pressure will often result in an increase in contractions and a decrease in the time for dilation and effacement of the cervix.

Which uterine contraction intensity classification is defined as a firm but not rigid fundus that is difficult to indent with fingertips?

Moderate A moderate-strength contraction means a firm fundus that is difficult to indent with fingertips (feels like touching a finger to a chin).

Which nonreassuring fetal heart rate (FHR) pattern includes a reduction in FHR of ≥15 beats/min for more than 2 minutes?

Prolonged decelerations Prolonged decelerations cause a decrease in FHR of ≥15 beats/min below baseline and last longer than 2 minutes but less than 10 minutes. The return to baseline FHR usually occurs after the contraction is over.

The nurse is caring for a woman who is receiving oxytocin. The data displayed on the electronic fetal monitor shows that the contractions are approximately 10 seconds apart. Which intervention would the nurse perform next?

Stop the oxytocin. One of the side effects of oxytocin or other uterine stimulants is excessive uterine activity, which can be harmful to the patient and fetus. Therefore the first action would be to stop the medication.

The nurse is monitoring a patient in the active stage of labor with internal fetal monitoring. The patient has been experiencing contractions that last 70 to 90 seconds and occur every 1 to 2 minutes, and she has a uterine resting tone of 25 mm Hg. The nurse recognizes that the patient is experiencing which type of difficult labor?

Tachysystole Tachysystole, or hypertonic uterine dysfunction, is a potential complication of labor induction. It is defined by an increase in the uterine resting tone or more than 5 uterine contractions in a 10-minute time frame.

The nurse notes accelerations on the fetal heart rate pattern. Which information is the nurse able to determine given this assessment?

The fetus has normal acid-base balance. Accelerations are usually a reassuring sign that the fetus has a responsive central nervous system and is not in acidosis.