Labor is very stressful for the fetus. It is important for the intrapartum nurse to be knowledgeable regarding the mechanisms that regulate the fetal heart rate and keep the brain well oxygenated
When evaluating the patient's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart rate are the a. Uterine activity
b. Autonomic nervous system
c. Baroreceptors
d. Chemoreceptors
e. Adrenal glands
B, C, D, E
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Correct The sympathetic and parasympathetic branches of the autonomic nervous
system are balanced forces that regulate FHR. Sympathetic stimulation
increases the heart rate, while parasympathetic responses, through
stimulation of the vagus nerve, reduce the FHR and maintain variability.
The baroreceptors stimulate the vagus nerve to slow the FHR and decrease
the blood pressure. These are located in the carotid arch and major arteries.
The chemoreceptors are cells that respond to changes in oxygen, carbon
dioxide, and pH. They are found in the medulla oblongata and the aortic
and carotid bodies. The adrenal medulla secretes epinephrine and
norepinephrine in response to stress, causing an acceleration in FHR.
Incorrect Hypertonic uterine activity can reduce the time available for exchange of
oxygen and waste products; however, this is a maternal factor. The fifth
fetal factor is the central nervous system. The fetal cerebral cortex causes
the heart rate to increase during fetal movement and decrease when the
fetus sleeps.
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