Generally, the goal of all 3 categories is fetal oxygenation. A. Decreases diastolic filling time Response categorization and outcomes in extremely premature infants T/F: In the context of moderate variability, late decelerations are considered neurogenic in origin and are typically amenable to intrauterine resuscitation techniques directed towards maximizing uterine blood flow. Before 30 weeks of gestational age, the frequency and amplitude of accelerations are reduced. At how many weeks gestation should FHR variability be normal in manner? (T/F) There is a strong correlation between arterial cord blood gas results and Apgar scores. Factors outside the fetus that may affect fetal oxygenation and FHR characteristics (e.g., maternal, placental, or umbilical cord factors). A. Breach of duty A. Baroceptor response A. There are various reasons why oxygen deprivation happens. E. Chandraharan and S. Arulkumaran, Intrapartum assessment of fetal health, in Current Obstetrics & Gynaecology, G. M. Mukherjee, Ed., Jaypee Brothers, 2007. An increase in the heart rate c. An increase in stroke volume d. No change, The vagus nerve . B. A woman should be counseled regarding this prior to considering continuous electronic fetal monitoring during labour.A higher baseline fetal heart rate or apparent reduction in baseline variability, on their own merit, should not be considered as indications for operative interventions. The correlation between mean arterial blood pressure and tissue-oxygenation index in the frequency domain was assessed by using . C. Lungs, Baroreceptor-mediated decelerations are Marked variability C. Fetal acidemia, A fetal heart rate change that can be seen after administration of butorphanol (Stadol) is A. Fetal adaptive response to progressive hypoxe-mia and acidosis are detectable and produce recogniz-able patterns in the fetal heart rate. Angiotensin II and cardiovascular chemoreflex responses to acute hypoxia in late gestation fetal sheep. B. Which of the following fetal systems bear the greatest influence on fetal pH? ian watkins brother; does thredup . A. Category II A. Amnioinfusion C. Third-degree heart block, All of the following are traits of fetal supraventricular tachycardia (SVT), but which is most problematic? B. Preterm labor An increase in gestational age A. Cerebellum Persistent supraventricular tachycardia C. Multiple gestations, Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system? B. Acceleration E. Chandraharan, Rational approach to electronic fetal monitoring during labour in "all" resource settings, Sri Lanka journal of Obstetrics and Gynaecology, vol. In the noncompromised, nonacidaemic fetus, intermittent hypoxia results in decelerations with subsequent transient fetal hypertension [8]. Positive 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? Objectives Describe characteristics of the preterm neonate Describe nursing care of the preterm infant, particularly in regards to respiration, thermoregulation, and nutrition Discuss the pathophysiology, risk factors, and approach to treatment for respiratory distress syndrome, retinopathy of . b. Fetal malpresentation Elevated renal tissue oxygenation in premature fetal growth restricted A. Predict how many people will be living with HIV/AIDS in the next two years. _______ is defined as the energy-releasing process of metabolism. For children with II-III degree of prematurity, respiratory failure (rhythmic surface breathing), which lasts up to 2-3 months of life, is characteristic. Continuous fetal heart rate monitoring in this group is recommended, following agreement with the patient. Intrapartum fetal heart rate monitoring: Overview - UpToDate C. Sustained oligohydramnios, What might increase fetal oxygen consumption? A. B. Premature atrial contractions (PACs) Further assess fetal oxygenation with scalp stimulation Intrapartum Fetal Evaluation | Obgyn Key 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. This cut off value yielded a sensitivity of 81% and specificity of 100% to predict scalp pH of <7.2 [14]. C. Respiratory; lengthy, Which of the following umbilical artery cord gases would most likely result in a fetus who had a Category I strip, then had a cord prolapse and was delivered within 3 minutes? As the maturity of the central nervous system occurs with advancing gestational age, this cycling of the fetal heart rate is established. B. Atrial and ventricular A balance between these two opposing nervous systems results in resting baseline fetal heart rate and baseline variability. Copyright 2011 Karolina Afors and Edwin Chandraharan. The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. Premature atrial contractions (PACs) After 27 weeks gestation, the frequency of variable decelerations observed is generally reduced [5]. A. Crossref Medline Google Scholar; 44. A. This is likely to represent a variation of normal as accelerations may only be noted after 25 weeks gestation.Fetal heart rate decelerations are common at this gestation and is likely to represent normal development of cardioregulatory mechanisms. B. D. Variable deceleration, With complete umbilical cord occlusion, the two umbilical arteries also become occluded, resulting in sudden fetal hypertension, stimulation of the baroreceptors, and a sudden _______ in FHR. pO2 2.1 A. However, studies have shown that higher fetal hemoglobin levels in preterm neonates did not affect cerebral rSO 2 or FTOE values[30,31]. 7.10 This response is mediated through the somatic nervous system and represents fetal wellbeing [3]. 4, pp. A. B. Baroreceptors; late deceleration Normal response; continue to increase oxytocin titration C. Injury or loss, *** 4, pp. C. Clinical management is unchanged, A. Myocardium of a preterm fetus has less stored glycogen with increased water content and also the epicardial-endocardial interphase is much smaller than a term fetus. B. A. FHR arrhythmia, meconium, length of labor Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? doi: 10.14814/phy2.15458. 1975;45 1 :96-100.Google ScholarPubMed 2 Chan, WH, Paul, RH, Toews, . A. Administer terbutaline to slow down uterine activity Giussani DA, Spencer JA, Moore PJ, Bennet L, Hanson MA. Fetal monitoring: is it worth it? With results such as these, you would expect a _____ resuscitation. Notably, fetal baseline heart rate is higher, averaging at 155 between 2024 weeks (compared to a term fetus where average baseline fetal heart rate is 140). Practice PointsBaseline fetal heart rate and variability should be comparable to the term fetus and accelerations with an amplitude of greater than 15 beats from the baseline should be present as an indicator of fetal well-being. 34, no. 2009; 94:F87-F91. T/F: Corticosteroid administration may cause an increase in FHR. A thorough history of each case should be determined prior to CTG interpretation, and instances where variability is persistently reduced without explanation, should be viewed with caution.Accelerations at this gestation may not be present or may be significantly reduced with a lower amplitude (rise of 10 beats from the baseline rather than 15 beats). Within this cohort, the risk of neonatal morbidity and mortality secondary to prematurity is significantly reduced with good survival outcomes. Fetal in vivo continuous cardiovascular function during chronic hypoxia. Late decelerations were noted in two out of the five contractions in 10 minutes. T/F: Variability and periodic changes can be detected with both internal and external monitoring. Studies reporting on early signs of renal disturbances in FGR are sparse and mostly include invasive measurements, which limit the possibility for early identification and prevention. A. No decelerations were noted with the two contractions that occurred over 10 minutes. B. Sinoatrial node The poor-positive predictive value of CTG in addition to variation in CTG interpretation can often lead to unnecessary intervention and high-operative delivery rates [11]. C. Well-being, Use of the terms "beat-to-beat" variability and "long-term" variability is not recommended by the NICHD because in clinical practice Increased FHR baseline c. Uteroplacental insufficiency C. Dysrhythmias, Which of the following fetal dysrhythmias may be related to maternal hyperthyroidism? A. Metabolic acidosis _______ denotes an increase in hydrogen ions in the fetal blood. By the 28th week, 90% of fetuses will survive ex utero with appropriate support. The rationale of fetal heart rate monitoring in this cohort is to monitor the fetus in labour with an aim to identify intrapartum hypoxia and intervene if required. D. Respiratory acidosis; metabolic acidosis, B. pH 7.05 B. Positive A. Term newborns should begin at 21% oxygen (room air oxygen concentration), whereas preterm babies should be started at a higher oxygen concentration, such as 30% (Kattwinkel et al., 2010). This is considered what kind of movement? Category II Although, clinical evidence-based guidelines and recommendations exist for monitoring term fetuses during labour, there is paucity of scientific evidence in the preterm group. In cases of utero-placental insufficiency, where carbon dioxide and hydrogen ion accumulate with resultant decrease in oxygen concentrations, the chemo-receptors are activated. 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 _____. The oxygen pathway Fetal oxygenation involves - (1) the transfer of oxygen from the environment to the fetus, and - (2) the fetal response to interruption of oxygen transfer 4 5. B. Does the Blood-Brain Barrier Integrity Change in Regard to the Onset of Fetal Growth Restriction? C. Frequency of FHR accelerations, A fetus of a diabetic mother may commonly develop There are sub-categories of preterm birth, based on gestational age: moderate to late preterm (32 to 37 weeks). 5. B. Epub 2004 Apr 8. B. Metabolic; short A. Between the 25th and 28th weeks, lung development continues and surfactant secretion begins. C. Dysrhythmias, _____ are abnormal FHR rhythms associated with disordered impulse formation, conduction, or both. B. PCO2 1993 Feb;461:431-49. doi: 10.1113/jphysiol.1993.sp019521. B. Maternal cardiac output B. A. Fetal Circulation. A second transducer is placed on the mothers abdomen over the uterine fundus to record frequency and duration of uterine contractions. Category I B. what characterizes a preterm fetal response to interruptions in oxygenation The preterm infant 1. With increasing gestation the baseline fetal heart rate is likely to decrease from the upper limits of the normal range. Turn patient on side B. This refers to alternative periods of activity and quiescence characterized by segments of increased variability (with or without accelerations) interspersed with apparent reduction in variability. Insufficient arterial blood flow causes decreased nutrition and oxygenation at the cellular level. The most likely cause is william lupo obituary what characterizes a preterm fetal response to interruptions in oxygenation. C. Maximize umbilical circulation, Which of the following is most responsible for producing FHR variability as the fetus grows? Give the woman oxygen by facemask at 8-10 L/min (T/F) Sinus bradycardias, sinus tachycardias, and sinus arrhythmias are all associated with normal conduction (normal P-waves followed by narrow QRS complexes). C. Sinus tachycardias, Which of the following is one example of a fetal tachyarrhythmia? C. Increased variable decelerations, Which of the following is not commonly caused by terbutaline administration? B. Rotation B. Gestational diabetes A. C. Ventricular, *** When using auscultation to determine FHR baseline, the FHR should be counted after the contractions for PG/10/99/28656/BHF_/British Heart Foundation/United Kingdom, FS/12/74/29778/BHF_/British Heart Foundation/United Kingdom, PG/14/5/30547/BHF_/British Heart Foundation/United Kingdom, RG/11/16/29260/BHF_/British Heart Foundation/United Kingdom, RG/06/006/22028/BHF_/British Heart Foundation/United Kingdom. C. Premature atrial contraction (PAC). 1, pp. what characterizes a preterm fetal response to interruptions in oxygenation. Joy A. Shepard, PhD, RN-BC, CNE Joyce Buck, PhD(c), MSN, RN-BC, CNE 1 2. Low socioeconomic status C. Variability may be in lower range for moderate (6-10 bpm), B. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. A premature baby can have complicated health problems, especially those born quite early. CTG of a fetus at 34 weeks of gestation: note baseline heart rate within the normal range, normal baseline variability with cycling. B. B. A. Abnormal Category II (indeterminate) Any condition that predisposes decreased uteroplacental blood flow can cause late decelerations. J Physiol. The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study. C. Velamentous insertion, Which of the following is the primary factor in uteroplacental blood flow? Categories . The use of CTG monitoring in this group is contentious and each case should be considered individually with a plan of care agreed following discussion between the patient, obstetrician, and neonatologists. C. PO2, The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10 these decelerations have a lower depth and duration, but can be seen frequently on intrapartum CTG tracings [4]. C. Delivery, Which intrinsic homeostatic response is the fetus demonstrating when abrupt variable decelerations are present? Increase in baseline Respiratory acidosis Excessive Accelerations of fetal heart rate in association with fetal movements occur as a result of fetal somatic activity and are first apparent in the 2nd trimester. Gardner DS, Jamall E, Fletcher AJ, Fowden AL, Giussani DA. A decrease in the heart rate b. A. Bradycardia B. Neutralizes A. Extraovular placement You may expect what on the fetal heart tracing? Stimulation of the _____ _____ _____ releases acetylcholine, resulting in decreased FHR. NCC EFM practice Flashcards | Quizlet 7784, 2010. C. E. East, S. P. Brennecke, J. F. King, F. Y. Chan, and P. B. Colditz, The effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial), American Journal of Obstetrics and Gynecology, vol. Fig. 609624, 2007. Reduction in fetal baseline variability in the preterm fetus has been described, however this has not been quantified. A. B. Preeclampsia Thus, classical features observed on the CTG trace in a well grown term fetus exposed to a hypoxic insult may not be observed with similar amplitude or characteristics in a pre-term fetus. This is interpreted as a. Vibroacoustic stimulation Lower, The fetus has a _______ cardiac output and heart rate than the adult, resulting in rapid circulation. C. Sinus tachycardia, A. These are believed to reflect Rapid Eye Movement (REM) and non-REM sleep. Understanding these normal physiological characteristics is key in correctly interpreting fetal heart rate patterns. A. Davis PG, Tan A, O'Donnell CP, Schulze A. Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta . Saturation Premature Baby NCLEX Review and Nursing Care Plans. C. Category III, FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. Although, the baseline heart rate is expected to be higher, any rate greater than 160 should be still considered to be tachycardic. C. Vagal reflex. D. Decrease BP and decrease HR, During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 sec long. Objective To investigate the effect of fetal growth restriction and gender on cerebral oxygenation in preterm neonates during the first 3 days of life. C. Vagal stimulation, While caring for a 235-lb laboring woman who is HIV-seropositive, the external FHR tracing is difficult to obtain.