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