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Exam 2.5

QuestionAnswer
Absent variability Completely flat, never varies from baseline
Minimal variability Goes away from baseline 1-5 beats
Moderate variability Away from baseline 6-25 beats, normal and good.
Marked variability Varying from baseline greater than 26 beats from baseline
What levels of variability are most concerning? Absent variability and marked variability require immediate intervention. Minimal variability is okay but not for extended periods of time.
A term fetus should have what rate of accelerations? What about a preterm? A term fetus should have 15:15 accelerations, a preterm should have 10:10
What separates a prolonged acceleration from a new baseline fhr? If the baby moves, its an acceleration, if the baby isn't moving and the heart rate is up, its a new baseline.
VEAL CHOP acronyms VEAL - Variable decel, Early decel, Acceleration, and Late decel CHOP - Cord compression, Head compression, Okay, Placental insufficiency
What are characteristics of a variable deceleration? Happens randomly, sometimes baby may hang themselves with the cord, or the mother could be lying on the cord.
What are the characteristics of an early deceleration? What could they require if too early in labor? Mirrors the contraction, caused by vasovagal response due to the head being compressed. Check cervix for dilation. If too early in labor, may require amnioinfusion
When does a late decel occur? After the peak of a contraction
What are the interventions for a late decel? Turn pt sidelying, administer 10L O2 v mask, start fluid bolus 1L/hr, turn off oxytocin. Then call physician.
FHR category 1-3 Category 1 - Normal Category 2 - Not good or bad Category 3 - Abnormal, watch at bedside
What does nubain do Does not take away the pain but relaxes them so they don't care about it. This drug builds tolerance quickly.
Demerol common side effect vomiting
How much fluid is required for an epidural? When is the patient turned off of epidural? Give 1L fluid before epidural. No turn off point pt must be able to sit still.
When is it time for the mother to push? Completely dilated, and mother feels rectal pressure.
What is the most common pregnancy position? Lithotomy
What is the most common position for OP babies? Knee chest
How often should you change positions during delivery? Every 30 minutes.
When do u call for back up during delivery? Once baby starts crowning
 

 



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