N113 - Monitoring during labor
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| What is the traditional method of fetal monitoring? | show 🗑
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| show | Information was intermittent. Fetal heart rate changes during contraction and is difficult to hear.
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| What is direct electronic monitoring? | show 🗑
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| show | Transducer applied to maternal abdomen. Not accurate due to fetal & maternal movement. Tocodynamometer records uterine contractions - measures tension of abdominal wall.
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| At what rate is a FHR tachycardic? | show 🗑
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| show | Maternal fever, maternal hyperthyroidism, amnionitis, fetal hypoxia (will have other symptoms), illicit drug use
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| show | FHR below 110 for 10 minutes or more - is it true bradycardia or deceleration?
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| show | beta-adrenergic blockers, anesthetics, maternal hypotension, prolonged umbilical cord compression, maternal hypothermia
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| show | It indicates that the sympathetic & parasympathetic nervous systems are intact.
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| How is minimal variability rated? | show 🗑
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| show | 6-25 bpm - what we like to see
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| show | > 25 bpm
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| show | Transient elevations in FHR of 5-15 bpm from baseline for several seconds to minutes then return to baseline. Indicates functioning of the cardiac control center of the medulla.
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| show | Always relate a deceleration to the contraction
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| What is an early deceleration? | show 🗑
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| What is a late deceleration? | show 🗑
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| What can be the cause of a late deceleration? | show 🗑
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| show | Change maternal position, increase mainline IV solution, observe character of contractions, SHUT OFF pitocin if being used, administer O2 by face mask, notify physician if interventions do not help.
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| What is a variable deceleration? | show 🗑
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| What is a prolonged deceleration? | show 🗑
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| show | Try putting women in knee chest position (on hands and knees with head lower than chest). If cord is visible in vagina, put on sterile glove an manually push the presenting part off the cord - do not remove hand! - C-section must be done.
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