This is considered what kind of movement? B. B. For children with II-III degree of prematurity, respiratory failure (rhythmic surface breathing), which lasts up to 2-3 months of life, is characteristic. A. A. C. Variability may be in lower range for moderate (6-10 bpm), B. C. Damages/loss, Elements of a malpractice claim include all of the following except Sympathetic nervous system Increasing O2 consumption T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. B. Dopamine B. Breach of duty A balance between these two opposing nervous systems results in resting baseline fetal heart rate and baseline variability. B. Labetolol B. Oxygenation B. C. Premature atrial contraction (PAC). Immediately after birth with the initiation of breathing, the lung expands and oxygen availability to tissue rises by twofold, generating a physiologic oxidative stress. Normal oxygen saturation for the fetus in labor is ___% to ___%. Fetuses delivered between 3436 weeks, however, seem to respond more like term fetus, a feature that should be recognized by obstetricians. A. A. The tissue-oxygenation index and mean arterial blood pressure were continuously measured in very premature infants (n = 24) of mean (SD) gestational age of 26 (2.3) weeks at a mean postnatal age of 28 (22) hours. 7379, 1997. C. Late deceleration A. Baroreceptors Pulmonary arterial pressure is the same as systemic arterial pressure. 200 Olmos-Ramrez RL, Pea-Castillo M, Mendieta-Zern H, Reyes-Lagos JJ. C. Vagal stimulation, While caring for a 235-lb laboring woman who is HIV-seropositive, the external FHR tracing is difficult to obtain. A. A. If the pH value is <7.20, immediate delivery is recommended, whereas a pH of 7.207.25 is considered borderline and repeating FBS within 60 minutes is recommended [12]. 160-200 B. Some triggering circumstances include low maternal blood . Respiratory acidosis 105, pp. PCO2 72 This is illustrated by a deceleration on a CTG. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. C. 300 C. None of the above, A Category II tracing Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. FHR patterns that may indicate a decrease in maternal oxygenation and, consequently, a decrease in transfer of oxygen to the fetus may include any or all of the following: late decelerations, fetal tachycardia, and/or minimal or absent FHR baseline variability. Figure 2 shows CTG of a preterm fetus at 26 weeks. Crossref Medline Google Scholar; 44. If hypoxic or mechanical insults persist for a longer period, then the fetus utilizes its adrenal gland to cope with this ongoing stress, leading to a stress response This stress response that occurs through the release of catecholamines from the adrenal glands and represents a physiological mechanism for coping with mechanical or hypoxic insults of labour may not be fully operational in a preterm baby. As the neonatal outcome is largely determined by the gestational maturity and fetal weight, operative intervention is likely to increase maternal morbidity and mortality without significantly improving perinatal survival. C. Third-degree heart block, The fetus of a mother with preeclampsia is at high risk for developing Determine if pattern is related to narcotic analgesic administration Several theories have been proposed as a potential explanation for this fetal heart rate pattern, notably decreased amount of amniotic fluid, reduced the Wharton jelly component in the cord of the preterm fetus and lack of development of the fetal myocardium and, therefore, the resultant reduced force of contraction. A. Persistent supraventricular tachycardia B. B. Betamethasone and terbutaline c. Fetal position At how many weeks gestation should FHR variability be normal in manner? A. Cerebellum The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. A. Digoxin Obtain physician order for CST 2023 Jan 13;13:1056679. doi: 10.3389/fendo.2022.1056679. Consider induction of labor E. Maternal smoking or drug use, The normal FHR baseline d. Gestational age. Breach of duty C. Multiple gestations, Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system? C. Possible cord compression, A woman has 10 fetal movements in one hour. Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. B. mixed acidemia A. C. Proximate cause, *** Regarding the reliability of EFM, there is C. Mixed acidosis, pH 7.02 The transcutaneous PO2 (tcPO2) response to blood interruption (BIS test) was measured in 6 healthy adults and 28 infants, including premature infants. The progression from normal oxygenation to asphyxia is a continuum with progressive changes in vital signs and end-organ effects. O, The data show meanSEM calculated every minute for the fetal heart rate, fetal arterial blood pressure, fetal femoral blood flow and fetal femoral vascular resistance during a 1 h episode of acute hypoxia (box) in 13 fetuses between 125 and 130 days of gestation, 6 fetuses between 135 and 140 days of gestation and 6 fetuses >140 days (term is, The data show meanSEM calculated every minute for the fetal heart rate, fetal arterial blood pressure, fetal femoral blood flow and fetal femoral vascular resistance during a 1h episode of acute hypoxia (box) in 14 fetuses at 1271 days of gestation (term is. Breach of duty A. Amnioinfusion 952957, 1980. Category I A. C. More rapid deterioration from Category I to Category II or III, C. More rapid deterioration from Category I to Category II or III a. According to NICE guidelines, fetal blood sampling is recommended in the presence of pathological CTG (Table 2). A. Fetal echocardiogram 7.10 Marked variability C. Polyhydramnios, Which of the following is the most appropriate method of monitoring a patient who is a gestational diabetic? Moreover, studies have shown fetal acidosis to occur more often in pre-term fetuses delivered before 34 weeks than those delivered between 3436 weeks [5]. Practice PointsSurvival dramatically increases beyond 28 weeks as the fetal organs are relatively mature and there is significant improvement in fetal neurological development. B. The correct nursing response is to: Recent epidural placement C. Narcotic administration Continuing Education Activity. Fetal tachycardia to increase the fetal cardiac output 2. B. C. Kleinhauer-Betke lab test, Stimulation of the fetal vagus nerve will Angiotensin II and cardiovascular chemoreflex responses to acute hypoxia in late gestation fetal sheep. Premature atrial contractions (PACs) By the 24th week, the fetus weighs approximately 1.3 pounds (600 g). The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. Decreased FHR variability Late decelerations were noted in two out of the five contractions in 10 minutes. This cut off value yielded a sensitivity of 81% and specificity of 100% to predict scalp pH of <7.2 [14]. what characterizes a preterm fetal response to interruptions in oxygenation. Which of the following factors can have a negative effect on uterine blood flow? C. Sinus tachycardia, Which of the following is not commonly caused by administration of indomethacin? Increased FHR baseline 3, pp. Approximately half of those babies who survive may develop long-term neurological or developmental defects. Increase in baseline By is gamvar toxic; 0 comment; A. A. B. Tracing is a maternal tracing Increased oxygen consumption 28 weeks C. Atrioventricular node PO2 21 B. A. Bradycardia pH 7.05 C. Vagal stimulation, Clinically significant fetal metabolic academia is indicated by an arterial cord gas pH of less than or equal to 7.10 and a base deficit of It is usually established in the fetal period of development and is designed to serve prenatal nutritional needs, as well as permit the switch to a neonatal circulatory pattern at . C. Velamentous insertion, Which of the following is the primary factor in uteroplacental blood flow? By increasing fetal oxygen affinity Several additional tests of fetal well-being are used in labour, which include fetal blood sampling (FBS), fetal pulse oximetry, and fetal electrocardiograph (STAN analysis). B. Bigeminal The blood that flows through the fetus is actually more complicated than after the baby is born ( normal heart ). Fetal heart rate decelerations in the absence of uterine contractions often occur in the normal preterm fetus between 20 and 30 weeks gestation. However, caution should be exercised in fetuses prior to 28 weeks that demonstrate such features as perinatal outcome is poor in this group. C. Decrease or discontinue oxytocin infusion, C. Decrease or discontinue oxytocin infusion, The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. With results such as these, you would expect a _____ resuscitation. C. Ventricular, *** When using auscultation to determine FHR baseline, the FHR should be counted after the contractions for 93% of these preterm births occur after 28 weeks, 6% between 2227 weeks, and 1% before 22 weeks. C. Tone, The legal term that describes a failure to meet the required standard of care is 2004 Jun 15;557(Pt 3):1021-32. doi: 10.1113/jphysiol.2004.061796. B. B. Catecholamine C. Sympathetic and parasympathetic nervous systems, All of the following are components of liability except A. A. A. Insert a spiral electrode and turn off the logic D. 7.41, The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. Increase FHR Premature Baby NCLEX Review and Nursing Care Plans. It provided a means of monitoring fetal oxygen saturation of fetal haemoglobin that is measured optically (similar technology for pulse oximetry in adults) during labour. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. Baseline variability of greater than five beats per minute with signs of cycling is likely to develop, between 3032 weeks gestation. Epub 2004 Apr 8. 2023 Feb 10;10(2):354. doi: 10.3390/children10020354. Fetal circulation, unlike postnatal circulation, involves the umbilical cord and placental blood vessels which carry fetal blood between the fetus and the placenta . II. In uterofetal activity typically results in an increase in fetal heart rate recorded as accelerations on CTG. A. Acidemia B. Onset of-labour in gestational ages between 2426 week represents a high-risk group in which greater than two thirds of cases are driven by an underlying infective process. A. Idioventricular At this gestation, there is a high risk of neonatal morbidity and mortality, and survival is dependant more on fetal weight and maturity rather than mode of delivery. Characteristics of antepartum and intrapartum fetal heart rate tracings differ in the preterm fetus as compared to a term fetus. A. HCO3 Any condition that predisposes decreased uteroplacental blood flow can cause late decelerations. A. With regards to the pre-term fetus, fetal blood sampling has not been validated in this group. As the maturity of the central nervous system occurs with advancing gestational age, this cycling of the fetal heart rate is established. B. A. Cerebellum C. Contraction stress test (CST), B. Biophysical profile (BPP) score T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. A. Metabolic acidosis 1, pp. Within this cohort, the risk of neonatal morbidity and mortality secondary to prematurity is significantly reduced with good survival outcomes. B. Bigeminal C. 240-260, In a patient with oxytocin-induced tachysystole with normal fetal heart tones, which of the following should be the nurse's initial intervention? A. Idioventricular Category II-(Indeterminate) FHR patterns may indicate problems in the oxygenation pathway but no clue as to severity/effect on the fetus. C. Decreased FHR accelerations, pH 6.9, PO2 15, PCO2 55, HCO3 18, BE -22 The latter is determined by the interaction between nitric oxide and reactive oxygen species. what characterizes a preterm fetal response to interruptions in oxygenation. D. Accelerations, Place the following interventions for a sinusoidal FHR in the correct order: B. Phenobarbital Late decelerations are defined as a visually apparent, gradual decrease in the fetal . B. Premature atrial contraction (PAC) C. Increased maternal HR, Which of the following is not commonly caused by nifedipine administration? Premature ventricular contraction (PVC) Presence of late decelerations in the fetal heart rate A. Metabolic acidosis C. Use a Doppler to listen to the ventricular rate, A. Insert a spiral electrode and turn off the logic, *** The fetus responds to a significant drop of PO2 by A. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? 100 1, pp. Patients 68 (41 males) small for gestational age (SGA) (birth weight <10th percentile) and 136 (82 males) appropriate for . B. 20 min 1 Quilligan, EJ, Paul, RH. Hence, continuous monitoring of the fetus during labour, with the view to recognizing features of suspected fetal compromise on CTG and instituting an operative intervention, should be considered with caution. C. Gravidity & parity, gestational age, maternal temperature, Which medications used with preterm labor can affect the FHR characteristics? The availability of oxygen to the fetus is limited by the route taken by oxygen from the atmosphere to fetal tissues, aided or diminished by pregnancy-associated changes in maternal physiology and, ultimately, a function of atmospheric pressure and composition of the mother's inspired gas. R. M. Grivell, Z. Alfirevic, G. M. Gyte, and D. Devane, Antenatal cardiotocography for fetal assessment, Cochrane Database of Systematic Reviews, no. Continuous fetal heart rate monitoring in this group is recommended, following agreement with the patient. Base deficit 14 T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect accelerations and decelerations from the baseline, and can clarify double-counting of half-counting of baseline rate. Good intraobserver reliability C. Variable, An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is B. 200-240 A. Arterial 32, pp. C. Respiratory acidosis, As a contraction beings, partial umbilical cord compression causes occlusion of the low-pressure vein and decreased return of blood to the fetal heart, resulting in decreased CO, hypotension, and a compensatory FHR _____. Babies may be born preterm because of spontaneous preterm labour or because there is a medical indication to plan an induction of labour or caesarean . Oxygen consumption by the placenta is a significant factor and a potential limitation on availability to the fetus.

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