Electronic Fetal Monitoring Practice Flashcards

A set of 100 question-and-answer flashcards covering Electronic Fetal Monitoring (EFM) patterns, interpretations, causes, and nursing interventions as presented in the lecture notes.

What is the primary purpose of Electronic Fetal Monitoring (EFM)?

To allow the healthcare team to assess how the baby is tolerating labor.

Which fetal heart rate patterns indicate a baby is tolerating labor 'Well'?

Accelerations or early decelerations.

Which fetal heart rate pattern indicates a baby is tolerating labor 'Poorly'?

Late decelerations.

Which fetal heart rate pattern is considered a 'Cause for concern'?

Variable decelerations.

What does EFM assess in relation to uterine contractions?

Fetal Heart Rate (FHR) patterns.

Is Electronic Fetal Monitoring (EFM) considered an invasive or non-invasive procedure?

Non-invasive.

Who is specifically mentioned as being able to perform EFM?

A nurse.

What is the normal range for a resting Fetal Heart Rate (FHR)?

$110-160\text{ bpm}$.

How is tachycardia defined in a fetus during monitoring?

FHR $> 160\text{ bpm}$ if lasting over $10\text{ mins}$.

How is bradycardia defined in a fetus during monitoring?

FHR $< 110\text{ bpm}$ if lasting over $10\text{ mins}$.

How many minutes of a $10\text{-minute}$ window are needed to establish a baseline FHR reading?

$2\text{ minutes}$.

How is 'absent' variability clinically characterized?

Nonreassuring.

What is the numerical definition of 'minimal' variability?

Detectable but less than or equal to $5/\text{minute}$.

What is the numerical definition of 'moderate' variability?

$6-25/\text{minute}$.

What is the numerical definition of 'marked' variability?

Greater than $25/\text{min}$.

What are Electronic Fetal Monitoring accelerations?

Increases in fetal heart rate.

Name four causes of fetal heart rate accelerations.

Fetal movement, contractions, stimulation, and umbilical vein compression.

Why are accelerations considered a reassuring sign of well-being?

Because they require no intervention from nursing staff.

What nursing intervention is required when accelerations are observed?

NO intervention.

How is the timing of an early deceleration described in relation to a contraction?

Slowing of the FHR with the start of the contraction with return of FHR to baseline at the end of compression.

What is the primary physiological cause of early decelerations?

Compression of fetal HEAD.

List four causes of early decelerations.

Compression of fetal head from contraction, uterine contractions, vaginal exam, and fundal pressure.

What are the documented interventions for early decelerations?

Continue supportive care and identify as normal progression of labor.

What should early decelerations be identified as?

Normal progression of labor.

How are variable decelerations numerically defined?

Transient slowing of FHR to $< 110\text{ bpm}$.

In what three ways are variable decelerations described as being 'variable'?

Variable in duration, intensity, and timing with contractions.

What is the primary physiological cause of variable decelerations?

Umbilical CORD compression.

Name four specific cord-related causes for variable decelerations.

Umbilical cord compression, short cord, prolapsed cord, and nuchal cord.

What is the first intervention for a patient exhibiting variable decelerations?

Reposition patient to facilitate improved blood flow to fetus.

List three additional interventions for variable decelerations besides repositioning.

Oxygen administration, discontinue oxytocin, and vaginal examination.

What is the visual drop characterization of a variable deceleration?

Sudden drop.

What is the visual return characterization of a variable deceleration?

Rapid return.

When do late decelerations begin in relation to contractions?

After the contraction begins.

When do late decelerations return to baseline FHR?

After the contraction ends.

What is the physiological cause of late decelerations?

PLACENTAL insufficiency causing inadequate perfusion (aka oxygenation to the fetus).

How is the priority of late decelerations categorized?

EMERGENCY!!!

List the five immediate bedside interventions for late decelerations.

Reposition (side-lying), place IV, discontinue (D/C) oxytocin, administer oxygen, and elevate legs.

What two administrative or preparation tasks must a nurse perform during late decelerations?

Notify provider and prepare for delivery.

What is the recommended position for a patient during late decelerations?

Side-lying.

Name six possible causes for a sinusoidal FHR pattern.

Fetal anemia, Rh isoimmunization, fetomaternal transfusion, vasa previa, placental chorioangioma, or traumatic amniocentesis.

What does a Category I (Normal) tracing predict?

Strongly predictive of normal acid-base status at the time of observation.

What is the baseline FHR range for a Category I tracing?

$110-160\text{ bpm}$.

What type of variability is required for a Category I tracing?

Moderate variability.

Are early decelerations allowed in Category I?

They may be present or absent.

Are late or variable decelerations allowed in Category I?

Absent.

How is the Category II (Indeterminant) interpretation described?

Not strongly predictive of normal acid-base status.

How is Category II defined in relation to Category I and III?

Anything that cannot be categorized as category I or category III.

What does a Category III (Abnormal) tracing predict?

Abnormal acid-base status at the time of observation.

What is the required variability state for a Category III tracing?

ABSENT variability.

Category III requires absent variability and any ONE of which four features?

Recurrent late decelerations, recurrent variable decelerations, bradycardia, or sinusoidal pattern.

What does the 'V' stand for in the VEAL CHOP MINE tool?

Variable Decelerations.

What does the 'C' stand for in the VEAL CHOP MINE tool?

Cord Compression.

What does the 'M' stand for in the VEAL CHOP MINE tool?

Move Client.

What does the 'E' stand for in the VEAL CHOP MINE tool?

Early Decelerations.

What does the 'H' stand for in the VEAL CHOP MINE tool?

Head Compression.

What does the 'I' stand for in the VEAL CHOP MINE tool?

Identify as progression.

What does the 'A' stand for in the VEAL CHOP MINE tool?

Accelerations.

What does the 'O' stand for in the VEAL CHOP MINE tool?

Other (reassuring).

What does the 'N' stand for in the VEAL CHOP MINE tool?

No interventions.

What does the 'L' stand for in the VEAL CHOP MINE tool?

Late Decelerations.

What does the 'P' stand for in the VEAL CHOP MINE tool?

Placental Insufficiency.

What does the 'E' stand for in the MINE intervention for Late Decelerations?

Emergent Actions.

What is the cause for decelerations that begin and end with contractions according to the tool?

Head Compression.

What is the intervention for cord compression identified in the acronym?

Move Client.

What intervention is required for Accelerations according to VEAL CHOP MINE?

No interventions.

What is the shorthand used for 'discontinue' in the interventions?

D/C.

What is the shorthand used for bits per minute in the notes?

$bpm$.

If an FHR baseline is $150\text{ bpm}$ with moderate variability and late decelerations are absent, what category is it?

Category I.

If a tracing shows ABSENT variability and bradycardia, what category is it?

Category III.

What condition involving red blood cells can cause a sinusoidal pattern?

Fetal anemia.

What type of transfusion is associated with the sinusoidal pattern?

Fetomaternal transfusion.

What is 'vasa previa' identified as a cause for?

Sinusoidal pattern.

What is 'placental chorioangioma' identified as a cause for?

Sinusoidal pattern.

What is 'traumatic amniocentesis' identified as a cause for?

Sinusoidal pattern.

Is fundal pressure a cause of early or late decelerations?

Early decelerations.

Is nuchal cord specified as a cause for early or variable decelerations?

Variable decelerations.

Is umbilical vein compression associated with accelerations or late decelerations?

Accelerations.

What does placental insufficiency cause to happen to the fetus?

Inadequate perfusion (oxygenation).

What immediate action involves an IV for late decelerations?

Place IV.

What immediate action involves legs for late decelerations?

Elevate legs.

What is the timing relationship to contractions for variable decelerations?

Variable time relationship to contractions.

Is EFM capable of providing a permanent record?

Yes.

What interpretation category applies when there is 'insufficient data'?

Category II (Indeterminant).

Is moderate variability reassuring?

Yes.

How is 'minimal' variability defined numerically?

$\le 5/\text{minute}$ but detectable.

What is the threshold for 'marked' variability?

$> 25/\text{min}$.

Does a nurse need to intervene for FHR accelerations?

No, it requires NO intervention.

What is the first intervention for cord compression?

Move Client (Reposition patient).

When should the provider be notified according to page 10?

When late decelerations (Emergency) occur.

What is the status of acid-base in Category III?

Abnormal.

What is the status of acid-base in Category I?

Normal.

Are late decelerations 'normal' or 'poor' indicators of labor?

Poor indicators.

What does the 'O' in VEAL CHOP represent regarding fetal status?

Other (reassuring).

Is tachycardia defined as exactly $160\text{ bpm}$ or greater than $160\text{ bpm}$?

$> 160\text{ bpm}$.

Is bradycardia defined as exactly $110\text{ bpm}$ or less than $110\text{ bpm}$?

$< 110\text{ bpm}$.

What does the acronym VEAL stand for?

Variable, Early, Acceleration, Late.

What does the acronym CHOP stand for?

Cord, Head, Other, Placental.

What does the acronym MINE stand for?

Move, Identify, No, Emergent.

What is the result of head compression according to the tool?

Early Decelerations.

What intervention is described as 'Emergent Actions' for placental insufficiency?

Reposition (side-lying), place IV, D/C oxytocin, admin oxygen, elevate legs, prepare for delivery, notify provider!