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Intrapartum:
Fetal assessment and nursing care during labor
| Question | Answer |
|---|---|
| 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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