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Fetal assessment and nursing care during labor

What is true? There is a decrease in fetal circulation and O2 during contractions.
What is a normal, reassuring FHR? - 110-160 BPM - moderate variability - acceleration: at least 15 BMP/15 sec - no deceleration
What are advantages of internal fetal monitoring? early detection of abnormal heart patterns, better accuracy of contraction intensity and FHR variability
What are disadvantages of internal fetal monitoring? ROM must occur, risk of infection, cervix need to be dilated >2 cm, presenting part must descend far enough for electrode
What is nonreassuring FHR patterns associated with? fetal hypoxia
What is early deceleration associated with? - head compression from contraction - fundal pressure
What is late deceleration associated with? - uteroplacental insufficiency - maternal HTN
What are nursing intervention to late decelerations? Change pt to side-lying position, D/C oxytocin, give 8-10L O2, notify MD, increase IV fluid
What is variable deceleration associated with? - cord compression - oligohydramnios
What is point of maximal impulse (PMI)? location where fetal heart tones are best heard on a woman's abdomen; best head over fetal back.
What are the steps to performing Leopold's maneuvers? 1. ID fetal part occupying fundus. 2. Locate smooth contour of fetal back. 3. ID fetal presenting part over pelvis 4. Outline fetal head 4.
What does ultrasound imaging provide? noninvasive visualization of fetus and placenta.
What does doppler ultrasound provide? info about blood flow in maternal-fetal circulation
What does fetal scalp blood sampling assess? assesses for fetal blood gases: pH, PO2, PCO2
What is normal uterine activity during labor? Contractions q 2-5 min, <90 sec. duration, mod-strong intensity
With vaginal bleeding, vaginal exam should be avoided until what are ruled out? placenta previa and placenta abrutptio
What is the most important indicator of labor progress? cervical dilation
What are 2 tests to confirm ROM? - Ferning test - Nitrazine paper (+ is blue)
What are characteristics of normal amniotic fluid? clear, straw color, and odorless
The RN should prepare for what when pt feels an urge to have a bowel movement during the transition phase? Prepare for impending delivery.
How does a full bladder affect labor? Distended bladder reduces pelvic space needed for birth.
Created by: odbal24
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