Ch.26

• Assessment of Risk Factors:

  • B_
  • P_
  • S_
  • E_?

  biophysical, psychosocial, sociodemographic, environmental
• Biophysical Assessment:

  • D_ F_ M_ C_
  • Used to monitor fetus C_ by C_ that may affect O_
  • K_ C_ should be _ movements in a _hr period
  • Fewer than _ kicks in _ hr warrants further evaluation by N_
  • Alarm Signal
  • N_ M_ in a _ hr period
  • See if M_ decreases movement?

  daily fetal movement count, complicated, conditions, oxygenation, kick counts, 10, 2, 3, 1, nst, no movement, 12, meds
• Ultrasound:

  • Fetal Well-being scan - _wks
  • Fetal surveillance - T_ most common during _ trimester
  • Standard - B_
  • L_ - _ A_
  • S_ - Really looks at S_ items?

  20, transvaginal, first, basic, limited, 1 aspect, specialized, specific
• Indications for Ultrasound:

  • Fetal H_ A_, G_, and A_
  • G_ A_
  • P_ P_ and F_
  • Fetal G_ D_ and P_ A_
  • N_ screening?
  • heart activity, growth, anatomy, gestation age, placenta position, function, genetic disorders, physical anomalies, nt
• Fetal Well-Being

  • D_ B_ F_ A_
  • A_ F_ V_ - AFI
  • Less than _ cm - O_
  • _ cm or greater - P_
  • B_ F_ in W_ F_ and P_
  • Severe restriction is indicated by A_ of R_ F_ during D_ and associated with I_

  doppler blood flow analysis, amniotic fluid volume, 5, oligo, 25, poly, blood flow, women, fetus, placenta, artery, reversed flow, diastole, IUGR
• Five Parameters of BPP:

  • B_ - Needs to be then _ sec or more per _ mins
  • M_ - Fewer than _ movements not good
  • T_ - Need at least _ movement
  • A_ - > _ cm or < _ cm in _ pocket
  • N_ - Reactive and non-reactive?

  breathing, 30, 30, movement, 3, tone, 1, afi, 5, 2, 1, nst
• Scoring of BPP:

  • _ - _ = N_
  • _ - _ = S_ C_ A_
  • _ - _ = C_ A_?

  8, 10, normal, 4, 6, suspect chronic asphyxia, 0, 2, chronic asphyxia
• Biophysical Profile (BPP)

  • P_ A_ of the F_
  • N_ U_ A_
  • Assesses A_ F_ V_, F_ B_ M_, T_
  • Can include N_?

  physical assessment, fetus, noninvasive ultrasound assessment, amino fluid volume, fetal breath movements, tone, nst
• Amniocentesis:

  • _ wks or later
  • Used for
  • G_ C_
  • F_ M_ - _:_ M_
  • Potential Complications
  • L_
  • H_
  • R_ isoimmunization
  • I_ and L_
  • P_ A_ and I_?
  • 15, genetic concerns, fetal maturity, 2, 1, mature, lof, hemorrhage, rh, infection, labor, placental abruption, injury
• Amniocentesis:

  • R_ should be administered to Rh _ mothers (covers A_ chance of B_ M_)
  • If infections hurts the baby who is Rh_ give R_?

  rhogam, negative, any, blood mixing, negative, rhogam
• Chorionic Villus Sampling:

  • Needle inserted transc_ and transa_ to obtain a tissue sample from the fetus
  • For G_ S_
  • E_ dx is R_ R_
  • Performed _ to _ wks
  • Give R_ if mother is Rh _?

  cervical, abdominal, genetic studies, earlier, rapid results, 10, 13, rhogam, negative
• Maternal Serum Alpha-Fetoprotein (MSAFP)

  • Used to screen for N_ T_ D_ in pregnancy
  • Performed between _ to _ wks with _ to _ wks being ideal
  • Triple-and quad-screening to detect A_ T_
  • High - N_ T_ D_
  • Low - D_ S_?
  • neural tube defects, 15, 20, 16, 18, autosomal trisomies, neural tube defects, down syndrome
• Coombs' Test:

  • Screening for R_ I_
  • Detects O_ A_ that may place fetus at risk for I_ with material A_?

  rh incompatibility, other antibodies, incompatibility, antigens
• Cell-free DNA screening in maternal blood:

  • N_ P_ G_ testing
  • Provides D_ Dx N_ for fetal R_ S_, G_, and certain P_ transmitted S_ G_ disorders
  • Performed early as _ wks
  • Results in about _ business days?

  noninvasive prenatal genetic, definitive, noninvasively, rh staus, gender, paternally, single gene, 10, 10
• Electronic Fetal Monitoring for Antepartums:

  • Does the I_ E_ continue to support the F_
  • N_ Test (NST)
  • Reactive - N_, _ A_ in _ min period
  • Nonreactive - R_ F_ E_, N_ A_ at A_?
  • intrauterine environment, fetus, non-stress, normal, 2 accelerations, 20, requires further evaluation, no accelerations, all
• Contraction Stress Test:

  • If B_ can T_ without D_
  • Tested N_ T_ close to D_ D_
  • O_ stimulation
  • N_ is G_
  • P_ is B_ (late FHR D_ with _% or more C_)?

  baby, tolerate, decelerations, not too, due date, oxytocin, negative, good, positive, bad, decelerations, 50, contractions
• Nursing Role in Antepartal:

  • Assessment for R_
  • P_ E_
  • Anticipatory P_
  • C_ for family A_
  • S_ P_
  • May P_ some A_

  risk, provide education, planning, counseling, adaptation, support person, perform, assessments
• Vibroacoustic Stimulation:

  • Performed in conjunction with N_
  • Used to stimulate F_ M_ and H_ R_ accelerations using S_ and V_
  • Fetus monitoring _ mins before stimulation to obtain heart rate
  • Stimulator applied for _ seconds on the maternal abdomen over fetal H_
  • Can be repeated at _ min intervals up to _ times when no R_ occurs?

  nst, fetal movement, heart rate, sound, vibration, 5, 3, 1, 3, response