Fetal assessment and nursing care during labor
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| What is true? | There is a decrease in fetal circulation and O2 during contractions.
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| What is a normal, reassuring FHR? | - 110-160 BPM
- moderate variability
- acceleration: at least 15 BMP/15 sec
- no deceleration
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| What are advantages of internal fetal monitoring? | early detection of abnormal heart patterns, better accuracy of contraction intensity and FHR variability
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| 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
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| What is nonreassuring FHR patterns associated with? | fetal hypoxia
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| What is early deceleration associated with? | - head compression from contraction
- fundal pressure
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| What is late deceleration associated with? | - uteroplacental insufficiency
- maternal HTN
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| 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
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| What is variable deceleration associated with? | - cord compression
- oligohydramnios
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| 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.
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| 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.
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| What does ultrasound imaging provide? | noninvasive visualization of fetus and placenta.
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| What does doppler ultrasound provide? | info about blood flow in maternal-fetal circulation
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| What does fetal scalp blood sampling assess? | assesses for fetal blood gases: pH, PO2, PCO2
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| What is normal uterine activity during labor? | Contractions q 2-5 min, <90 sec. duration, mod-strong intensity
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| With vaginal bleeding, vaginal exam should be avoided until what are ruled out? | placenta previa and placenta abrutptio
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| What is the most important indicator of labor progress? | cervical dilation
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| What are 2 tests to confirm ROM? | - Ferning test
- Nitrazine paper (+ is blue)
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| What are characteristics of normal amniotic fluid? | clear, straw color, and odorless
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| The RN should prepare for what when pt feels an urge to have a bowel movement during the transition phase? | Prepare for impending delivery.
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| How does a full bladder affect labor? | Distended bladder reduces pelvic space needed for birth.
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Created by:
odbal24
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