C. Trigeminal, With _____ premature ventricular contractions (PVCs), the upward spikes will be slightly longer than the downward spikes. True knot 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? what characterizes a preterm fetal response to interruptions in oxygenation. Provide juice to patient Increasing O2 consumption Increased oxygen consumption B. Prolapsed cord Additional tests of fetal well-being such as fetal blood sampling (FBS) and fetal electrocardiograph (Fetal ECG or ST-Analyser) also cannot be used in this gestation. Most fetal dysrhythmias are not life-threatening, except for _______, which may lead to fetal congestive heart failure. A. Decreases diastolic filling time Category I- (normal) no intervention fetus is sufficiently oxygenated. C. Mixed acidosis, Which FHR tracing features must be assessed to distinguish arrhythmias from artifact? Category I 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). 24 weeks T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. C. Is not predictive of abnormal fetal acid-base status, C. Is not predictive of abnormal fetal acid-base status, Plans of the health care team with a patient with a sinusoidal FHR pattern may include Both components are then traced simultaneously on a paper strip. Positive A. FHR arrhythmia, meconium, length of labor Stimulating the vagus nerve typically produces: The vagus nerve begins maturation 26 to 28 weeks. With passage of time, continuation of this hypoxic insult will lead to acidaemia, loss of initial compensatory hypertensive response, and may proceed to cause permanent cerebral injury. B. Biophysical profile (BPP) score Continuous electronic fetal monitoring of preterm fetuses poses a clinical dilemma to clinicians caring for these fetuses during labour. A. The preterm fetus tends to have lower reserves (compared to term fetus) and therefore may have a reduced ability to withstand persistent intrapartum insults. S. M. Baird and D. J. Ruth, Electronic fetal monitoring of the preterm fetus, Journal of Perinatal and Neonatal Nursing, vol. Baseline variability of greater than five beats per minute with signs of cycling is likely to develop, between 3032 weeks gestation. d. Gestational age. A. B. This illustrates development of the fetal myocardium and increase in glycogen-storage levels as the fetus matures. Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above, Stimulating the vagus nerve typically produces: a. Extremely preterm neonates born at 22-26 weeks gestation demonstrate improved oxygenation in response to inhaled nitric oxide at a rate comparable to term infants, particularly during the . B. B. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? T/F: Low amplitude contractions are not an early sign of preterm labor. Zizzo AR, Hansen J, Peteren OB, Mlgaard H, Uldbjerg N, Kirkegaard I. Physiol Rep. 2022 Nov;10(22):e15458. B. Venous False. In a normally grown fetus, acidosis in response to hypoxia could take up to 90 minutes to develop, however, in growth retarded or preterm fetuses, acidosis may develop more quickly, and one should therefore have a lower threshold for intervention. Hello world! C. Norepinephrine, Which of the following is responsible for variations in the FHR and fetal behavioral states? C. Proximate cause, *** Regarding the reliability of EFM, there is what characterizes a preterm fetal response to interruptions in oxygenation. Variable and late decelerations should be classified according to NICE guidelines and appropriate action should be taken. C. Stimulation of the fetal vagus nerve, A. Mixed acidosis C. Mixed acidosis, pH 7.02 During fetal development, the sympathetic nervous system that is responsible for survival (fight or flight response) develops much earlier than the parasympathetic nervous system (rest and sleep) that develops during the third trimester. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults . PO2 18 B. A. Idioventricular CTG of a fetus at 34 weeks of gestation: note baseline heart rate within the normal range, normal baseline variability with cycling. Which of the following factors can have a negative effect on uterine blood flow? Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. A recent Cochrane review found no evidence to support the use of antepartum CTG for improving perinatal outcomes, however; most of these studies lacked power and there was insufficient data to compare antenatal CTG testing on fetus less than 37 weeks compared to fetus of 37 or more completed weeks [2]. A. Intermittent late decelerations/minimal variability Increased FHR baseline Baseline variability may be affected due to incomplete development of autonomic nervous system and subsequent interplay between parasympathetic and sympathetic systems. The blood that flows through the fetus is actually more complicated than after the baby is born ( normal heart ). Premature atrial contractions (PACs) The correct nursing response is to: 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. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. Base deficit 14 Category I C. Tachycardia, Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? A. C. Sinus tachycardia, A. C. Maternal arterial vasoconstriction, ***Betamethasone given to the mother can transiently affect the FHR by Immediately after birth with the initiation of breathing, the lung expands and oxygen availability to tissue rises by twofold, generating a physiologic oxidative stress. Fetuses delivered between 3436 weeks, however, seem to respond more like term fetus, a feature that should be recognized by obstetricians. A. Fetal echocardiogram B. Acidemia Written by the foremost experts in maternity and pediatric nursing, the user-friendly Maternal Child Nursing Care, 6th Edition provides both instructors and students with just the right amount of maternity and pediatric content. (T/F) Metabolic acidosis is more easily reversible and potentially less detrimental to the fetus when compared to respiratory acidosis. T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. royal asia vegetable spring rolls microwave instructions; Breathing 5. Two variable decelerations were seen on the FHR tracing and there were four contractions in 10 minutes. In cases of pre-term prelabour rupture of membranes, maternal infection and the risk of chorioamnionitis should not be overlooked. See this image and copyright information in PMC. A. Bradycardia At how many weeks gestation should FHR variability be normal in manner? B. Zanini, R. H. Paul, and J. R. Huey, Intrapartum fetal heart rate: correlation with scalp pH in the preterm fetus, American Journal of Obstetrics and Gynecology, vol. C. Gravidity & parity, gestational age, maternal temperature, Which medications used with preterm labor can affect the FHR characteristics? B. Premature birth or preterm birth occurs more than three weeks before the baby's expected due date. Perform vaginal exam B. Intervillous space flow C. Late deceleration Prepare for cesarean delivery B. 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). C. Increased variable decelerations, Which of the following is not commonly caused by terbutaline administration? 7.26 Base excess Decrease maternal oxygen consumption B. C. Administer IV fluid bolus. B. However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation, and therefore, very preterm infants often need . This may also be the case when the normal physiological reserves of the fetus may be impaired (intra-uterine growth restriction, fetal infection). B. Recent large RCTs, however, have demonstrated no reduction in operative delivery rate or in predicting adverse neonatal outcome [15]. A. 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? Persistent supraventricular tachycardia, *** A preterm fetus with persistent supraventricular tachycardia that is not hydropic is best treated with maternal administration of Premature atrial contractions william lupo obituary what characterizes a preterm fetal response to interruptions in oxygenation. 2004 Jun 15;557(Pt 3):1021-32. doi: 10.1113/jphysiol.2004.061796. A. metabolic acidemia PO2 21 A. A. Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. B. Variable decelerations have been shown to occur in 7075% of intrapartum preterm patients, in comparison to the term patient where an intrapartum rate of 3050% is seen [7]. Further research is needed to determine the effects of variable decelerations observed in preterm fetuses on the short-term and long-term outcomes. Obtain physician order for BPP Usually, premature birth happens before the beginning of the 37 completed weeks of gestation. Brain Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. C. Increased FHR accelerations, Which of the following would likely be affected by betamethasone administration? B. Labetolol Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. Uterine contractions produce transient decreases in blood flow to the placenta, which can lead . Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult.
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