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25 Cards in this Set
- Front
- Back
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Hand-held fetal monitoring devices
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Fetoscope
Doppler-ultrasound |
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Internal Electronic Fetal monitoring devices
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Scalp electrodes
Intrauterine pressure catheter (IUPC)-measures pressure inside uterus |
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External Electronic Fetal monitoring devices
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Ultrasound transducer-high freq sound waves, fetal heart rate
Tocometer-uterine ctx |
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Characteristics of FHR
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Baseline
Periodic Variability |
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Baseline
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Fetal heart rate between contractions
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Periodic changes
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Heart rate assessed, before, during, and after contraction
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Variability
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Variation from baseline
Only measurable with electronic fetal monitoring |
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Duration
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beginning of one contraction to the next
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External fetal monitoring
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measures long term variability
Heart rate over long period of time can be consistently or intermittently |
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Internal fetal monitoring
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Must be
-dilated -occiput/vertex present part -ruptured membranes Measures short term variability beat to beat variability intensity of ctx VERY ACCURATE |
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Fetal tachycardia
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Above 160 for 10 min or longer
-early sign of issue |
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Maternal Causes of fetal tachycardia
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Fever, chorioamnionitis
hyperthyroidism drugs dehydration anxiety |
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Fetal causes of fetal tachycardia
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Early hypoxia
asphyxia fetal anemia infection prematurity |
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Fetal Bradycardia
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below 110 for 10 minutes or longer
late sign of issue, immediately prior to death |
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Causes of bradycardia
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Placental transfer of anaesthetics
Prolonged cord compression maternal hypothermia or hypotension Maternal supine hypotension syndrome (pressure on vena cava) |
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Variabiity
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absent= ominous sign
minimal=less than 5bpm= bad average/moderate=HR fluctuates between 6-25bpm=normal average Marked-varies over 25bpm=bad |
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Acceleration
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increase in baseline of 15bpm for 15 sec or more
-sign of wellbeing |
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Deceleration
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decrease in baseline of 15bpm for 15 sec or more
-may be benign or nonreassuring |
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Early decelerations
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Benign
Caused by head compression Mirror contractions (begin and end with ctx) uniform in shape gradual decline |
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Variable decelerations
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Cord compression
Variable shape Abrupt deceleration, with "shoulders" not coordinated with ctx |
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Late decelerations
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Placental insufficiency, hypotension
Late onset |
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Documenting FHR in latent, active, and 2nd stage of labor
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Latent- q hour
Active- q 15-30min Pushing- q5 min or between ctx |
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Reassuring FHR patterns
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Baseline 110-160
No decelerations or changes in baseline Accelerations with fetal mvmnt Moderate (6-25) variability |
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Non-reassuring FHR patterns
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Tachy or Brady
Decreased or absent variability Late decelerations severe variable decelerations |
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Nursing interventions
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TURN OFF PIT
change positioning--> lateral Increase iv fluids O2 NOTIFY PROVIDER Fetal stimulation amniofusion Discourage valsalva |
