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HESI®-RN Comprehensive Review
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Electronic Fetal Monitoring

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Electronic Fetal Monitoring
22 Picmonics to Learn | 43 mins
Fetal Circulation
Placenta
Umbilical Vein
Ductus Venosus
Right Atrium
Foramen Ovale
Left Atrium
Aorta
Right Ventricle
Ductus Arteriosus
Umbilical Arteries
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2 mins
Decelerations (and Accelerations) Overview
VEAL CHOP
Variable Deceleration
Cord Compression
Early Deceleration
Head Compression
Acceleration
Okay
Late Deceleration
Placental Insufficiency
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2 mins
Early Decelerations
Cause
Fetal Head Compression
Occurs During
Uterine Contractions
Placement of Internal Mode of Monitoring
Vaginal Examination
Fundal Pressure
Considerations
Normal Pattern
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1 min
Late Decelerations
Cause
Uteroplacental Insufficiency
Occurs During
Disruption of Oxygen Transfer to Fetus
Considerations
Abnormal Pattern
Interventions
Discontinue Oxytocin
Oxygen with Non-Rebreather (8-10 L/min)
Side-lying Position
Elevate Legs
Increase Rate of IV Solution
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2 mins
Variable Decelerations
Mechanism
Umbilical Cord Compression
Occurs During
Abnormal Cord Position
Considerations
Transition Phase
Interventions
Oxygen with Non-Rebreather (8-10 L/min)
Change Maternal Position
Discontinue Oxytocin
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2 mins
Parts of an ECG
PQRST
P Wave
Atrial Depolarization
QRS Complex
Ventricular Depolarization
T Wave
Ventricular Repolarization
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2 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
Atropine
Mechanism of Action
Muscarinic Antagonist
Indications
Bradycardia
Increased Exocrine Secretions
Smooth Muscle Spasms
Side Effects
Tachycardia
Dry Mouth
Urinary Retention
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2 mins
Terbutaline (Brethine)
Mechanism of Action
Beta-2 Agonists
Indications
Asthma
Tocolytic
Side Effects
Hypotension
Tremor
Tachycardia
Pulmonary Edema
Hyperglycemia
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2 mins
Placental Implantation Abnormalities
Mechanism
Placenta Adheres Directly to Myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by Scar Tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section Delivery
Artery Ligation or Embolization
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2 mins
Oxytocin (Pitocin)
Mechanism of Action
Increase Uterine Contractions
Indications
Labor Induction
Control Postpartum Hemorrhage
Side Effects
Uterine Rupture
Water Intoxication
Contraindications
Fetal Lung Immaturity
Cervix Not Ripened
Active Genital Herpes Infection
Considerations
Use Lowest Dose
IV Pump
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3 mins
Prolapsed Umbilical Cord
Mechanism
Cord Prolapses
Signs and Symptoms
Visualization of Cord
Prolonged or Variable Decelerations
Considerations
Hips Elevated
Insert 2 fingers in Vagina
Saline Towel on Cord
Oxygen
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2 mins
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
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2 mins
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
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2 mins
Fentanyl
Mechanism of Action
Opioid Receptor Agonist
High Potency
Indications
Anesthesia Induction
Chronic Pain
Breakthrough Pain
Side Effects
CNS Depression
Respiratory Depression
Constipation
Miosis
Considerations
Addiction
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3 mins
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
Local Anesthetic Overview
Indications
Minor Procedures
Epidurals
Mechanism of Action
Blocks Na+ Channels
State Dependent
Combined with Vasoconstrictors
Infected Tissue Requires Higher Dose
Drugs
Esters
Amides
Side Effects
Arrhythmias
Cardiotoxicity
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1 min
Postpartum Hemorrhage
Mechanism
Uterine Atony
Lacerations
Retained Placenta
Signs and Symptoms
Bleeding
Hypotension
Boggy Uterus
Considerations
Oxytocin
Bimanual Compression of Uterus
Surgery
Blood Transfusion
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2 mins
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Postnatal Circulation
Infant Breathes
Decreased Pressure in Pulmonary Vasculature
Decreased Right Heart Pressure
Increased Left Atrial Pressure
Closes Foramen Ovale
Increased O2
Decreased Prostaglandins
Closed Ductus Arteriosus
Pharmacologic Intervention of Ductus Arteriosus
Open with Prostaglandins
Closed with Indomethacin
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3 mins

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