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107 Ch, 17

Fetal Assessment During Labor

QuestionAnswer
What is a normal uterine contraciton q2-5min, last <90sec, intensity ,100mmHg, 30sec bn, ,5 in 10 min Tachysystole: >5 in 10 min
where does the fetus get it's oxygen uteroplacental exchange, fetal circulation
what can decr fetal O2 mom hypertension, hypotension, hypovolemia from hemorrhage, compression of cord
how is well being of fetus monitored FHR in comparison to contraction
Nonreassuring FHR patterns are associated with fetal hypoxemia: low O2 in aa blood...can deteriorate to fetal hypoxia: low O2 at cellular level
what are signs of nonreassuring FHR <110bpm/>160bpm, decels
What are two methods for EFM electronic fetal monitoring external and internal
what are external methods of EFM FHR: ultrasound transducer(below umbilicus) UC: tocotransducer (on fundus)
what is internal method of EFM spiral electrode or (FSE) fetal scalp electrode must be 2cm dilated and (ROM) rupture of membrane
What is an (IUPC) intrauterine pressure catheter measure pressure of uterus
What is best FHR pattern accels and moderate variability
what are causes of tachycardia >160 from baseline FHR fetal hypoxia, infection in amnio, fetal anemia, mom fever, drugs, dehydration
what is causes of bradycardia <110 from baseline FHR late fetal hypoxia, umbilical cord compression, mom hypotension
If water breaks what should nurse do check temp q2h, birth w/in 24hrs
what are two types of changes in FHR periodic: occur with UCs episodic: Not with UCs
what defines an accelerated contraction 15 beats high, 15 long and return to baseline
what are 4 types of decels early: response to fetal head compromise late: uteroplacental insufficiency...FIX..occurs after UC variable: umblilical cord compression prolonged: below baseline of 15bm last more than 2 min.
what are nursing interventions for decels change mom position, incr IV fluids, discontinue pitocin, O2(8-10L)
what are 5 components to evaluate of an FHR tracing baseline rate, variability, accels, decels, change or trends in FHR pattern
What are interventions for hypotension incr IV, change to later/Trendelenburg, give ephedrine or phenylephedrine
what are interventions of uterine tachysystole reduce pitocin, give Brethine(relax UC)
what are interventions for nonreassuring FHR 2nd stage use open glottis pushing, not Valsalva fewer pushing shorter pushing efforts push only Q 2nd/3rd contraction push only with urge to push
2 factors that effect fetal status positioning and pushing
Interventions for vag bleeding notify MD anticipate C-section do NOT do vag exam
Interventions for infection cooling measures IV collect urine/amnio sample to lab
Interventions for Prolapse Cord upward pressure on presenting part, relieve compression Trendelenburg/modified Sims' sterile wrap cord w/ NS O2 IV do NOT replace cord prepare for birth
what do you monitor for in fetal well being FHR assessment meconium stained amnio fluid mom vitals and UC activity
Interventions for nonreassuring FHR patterns ID cause fetal O2 mom O2 reduce cord compression
Causes of decr variability fetal sleep cycle, drugs, hypoxia, <32wks gestation
Causes of incr variability early mild hypoxia, fetal stimulation
Created by: palmerag