Week 2 FHR Interpretation (everything)- not presented Flashcards by Amanda D

Q

Fetal HR Monitoring =

A

Fetal brain monitoring

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Q

Brain monitors and responds to what :

A

extrinsic Influences
Intrinsic influences
Homeostatic interactions b/w the fetus and the environment

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Q

The Goal of FHR Monitoring is to

A

maintain optimal blood flow (oxygenation) of the brain w/o compromising other organs

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Q

Strip Review / Essential characteristics for tracing interpretation:

Clinical Setting -

A

provides the background risk

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Q

Strip Review / Essential characteristics for tracing interpretation:

Baseline -

A

Important to determine all other freatures

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Q

Strip Review / Essential characteristics for tracing interpretation:

Variability-

A

a marker of normal pH

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Q

Strip Review / Essential characteristics for tracing interpretation:

Decelerations -

A

A marker of ongoing O2 deprivation

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Q

Strip Review / Essential characteristics for tracing interpretation:

Contractions -

A

potential cause of O2 deprivation

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Q

Strip Review / Essential characteristics for tracing interpretation:

Accelerations -

A

a marker of normal pH

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Q

Strip Review / Essential characteristics for tracing interpretation:

Change over time -

A

evidence of an evolving process and marker of time course

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Q

Order of Oxygen transfer from Environment to fetus:

A

Environment
Lungs
Heart
vasculature
Placenta
Cord
Fetus

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Q

The subsequent fetal response if oxygen transfer is disrupted (fetal response); in order:

A

Hypoxemia
Hypoxia
Metabolic Acidosis
Hypotension
Potential Injury

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Q

Types of decelerations

A

Early, Late, Variable (videos)

PPT:
variable
late
prolonged

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Q

Significant FHR decelerations (variable, late, prolonged) represent

A

interruptions in fetal oxygen transfer

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Q

Interruptions in fetal oxygen transfer are represented by

A

decelerations

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Q

Disrupted oxygen transfer does not cause injury unless

A

there is progression to metabolic acidemia

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Q

Metabolic acidemia + disrupted oxygen transfer =

A

injury potential

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Q

the presence of FHR variability and/or accelerations predict

A

the ABSENCE of metabolic acidosis

* the converse is not always true*

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Q

The absence of metabolic acidosis is seen by

A

the presence of FHR variability and/or accelerations

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Q

Three Tier System:

Describe Category 1 -

Study These Flashcards

A

“Go to” definition of normal.

Baseline: 110-160 bpm
Variability: moderate (6-25 bpm)
Accelerations: present or absent
Decelerations: No late/variable/prolonged

Q

Baseline: 110-160 bpm

Study These Flashcards

A

Category 1

Q

Variability: moderate (6-25 bpm)

Study These Flashcards

A

Category 1

Q

Decelerations: No late/variable/prolonged

Study These Flashcards

A

Category 1

Q

Accelerations: present or absent

Study These Flashcards

A

Category 1

Three Tier System: Describe Category 3

Absent variability WITH any one of the following: - recurrent late decelerations - recurrent variable decelerations - bradycardia Sinusoidal Pattern - cycle frequency 3-5/min last at least 20" * If persists, likely evidence that you are "in deep doo doo"

Absent variability WITH any one of the following: - bradycardia Category?

Category 3

Absent variability WITH any one of the following: - recurrent late decelerations Category?

Category 3

Sinusoidal Pattern -cycle frequency 3-5/min last at least 20" Category?

Category 3

Three Tier System: Describe Category 2

Baseline: -Bradycardia (<110bpm) with preserved variability -Tachycardia (>160bpm) Variability -Minimal (< or = to 5bpm but detectable) -Absent (undetectable) *But NOT accompanied by recurrent decelerations -Marked (>25bpm) Accelerations -Absence of acceleration with scalp stimulation Decelerations: -Late/Variable/recurrent/Prolonged

Three Tier System: Describe Category 2 BASE LINE (brady and tachy)

- Bradycardia (<110bpm) with preserved variability | - Tachycardia (>160bpm)

Three Tier System: Describe Category 2 Variability:

- Minimal (< or = to 5bpm but detectable) - Absent (undetectable) *But NOT accompanied by recurrent decelerations - Marked (>25bpm)

Three Tier System: Describe Category 2 Accelerations/Decelerations:

Accelerations -Absence of acceleration with scalp stimulation Decelerations: -Late/Variable/recurrent/Prolonged

Bradycardia <110bpm with preserved variability Category?

Category 2

Absence of acceleration with scalp stimulation Category?

Category 2

Tachycardia > 160bpm Category?

Category 2

Describe Category 1:

"Strongly predictive of normal fetal acid-base status"

"Strongly predictive of normal fetal acid-base status" Describes what category?

Category 1

Describe Category 2:

"Indeterminate.... [they] require evaluation and continued surveillance and reevaluation, taking into account the entire associated clinical circumstances"

"Indeterminate.... [they] require evaluation and continued surveillance and reevaluation, taking into account the entire associated clinical circumstances" describes what category?

category 2

Describe category 3:

"Predictive of abnormal fetal acid-base status"

"Predictive of abnormal fetal acid-base status" describes category?

Category 3

Moderate variability predicts pH

> 7.15 | -Negative predictive value 98%

Minimal/absent variability AND decels are associated with a pH

<7.15 | - though predictive value still poor (23%)

Increases with depth of recurrent decelerations increases the

likelihood of acidemia | *especially late and w/minimal or absent variability

pH > 7.15

moderate variability

pH < 7.15

absent or minimal variability and decels

Name, in order the evolving fetal compromise process:

1. Recurrent variable/late decels 2. Progressively deeper decelerations 3. Reflexive fetal tachycardia (+/-) 4. Progressive reduction in variability moderate to minimal to absent 5. Terminal Bradycardia

Reverse order of fetal compromise process (5 steps):

5. terminal bradycardia 4. progressive reduction in variability moderate to minimal to absent 3. reflexive fetal tachycardia (+/-) 2. Progressively deeper decelerations 1. Recurrent variable/ late decelerations