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NRN 102 (CH 17)

CCAC NRN 102 Fetal Assessment During Labor

What must be maintained during labor to prevent fetal compromise and promote newborn health after birth? Fetal oxygen supply
What does reassuring FHR include? Normal baseline rate of 110 - 160 beats/min, moderate variability, presence of accelerations, absence of decelerations
What does a nonreassuring FHR pattern include? Baseline FHR rate of less than 110 or more than 160 beats/min, absent or persistently minimal variability, recurrent late or variable decelerations, bradycardia
What is the purpose of electronic FHR monitoring? The ongoing assessment of fetal oxygenation.
What is the goal of electronic monitoring? To detect fetal hypoxia and metabolic acidosis during labor so that interventions to resolve the problem can be implemented in a timely manner before permanent damage or death occurs.
What does the tocotransducer measure? Uterine activity transabdominally
What is baseline FHR? the average rate during a 10 minute segment that excludes accelerations, decelerations, and periods of marked variability
Waht is baseline variability? The fluctuations in the baseline FHR that are irregular in amplitude and frequency.
What are the classifications of variability? Absent or undetectable, minimal (<5 beats/min), Moderate (6 to 25 beats/min), Marked (>25 beats/min)
What are accelerations reliable in predicting? Absence of fetal metabolic acidemia
What must occur before an intrauterine pressure catheter can be used? Rupture of membranes
What is the rule for determining an acceleration? 15 beats/min above the baseline for 15 sec
Early deceleration gradual decrease and return to baseline associated with contractions.
Caused by fetal head compression Early decelerations
Late decelerations gradual decrease and return to baseline associated with contractions with the lowest point after the peak of the contraction
usually indicate uteroplacental insufficency Late decelerations
Prolonged deceleration deceleration of FHr from the baseline of at least 15 beats/min lasting more than 2 min but less than 10 min.
Recurrent decelerations occur with more than 50% of contractions
abrupt decleration and return to baseline of 15 beats/min or more lasting more than 15 sec but less than 2 minutes. Variable decelerations
caused by compression of the umbilical cord variable deceleration
List some causes of variable decelerations maternal position with cord between fetus and maternal pelvis, cord around the fetal neck, arm, or body, short cord, knot in cord, prolapsed cord
What is your priority intervention with variable or late decelerations? Change maternal position
What are the three priority interventions in order in intrauterine resusitation? 1) open the maternal and fetal vasculature system (position change) 2) increase blood volume (open IV) 3) optimize oxygenation to the circulating blood volume (administer O2)
What is amnioinfusion? Infusion of room temperature isotonic fluid into the uterine cavity through a double lumen IUPC when the amniotic fluid volume is low.
Created by: JayneAnn