Variety is the Spice of Life
Fluctuations in the baseline FHR that is a strong indicator of fetal well being and central nervous system function.
What is variability?
A gradual decrease and return of the fetal heart rate associated with a uterine contraction that is associated with head compression and labor progress. The nadir occurs at the same time as the peak of the contraction (mirrors). (gradual = > 30 sec from baseline to nadir)
What is an early deceleration?
External monitor used to assess uterine activity.
What is a Tocodynamometer or "Toco"?
A fetal heart rate of 110-160 beats per minute.
What is normal fetal heart rate baseline?
This is known as a "fetal alarm system"
What are "no fetal movements in 12 hours"?
Proiority nursing intervention after rupture of membranes.
What is "assess fetal heart rate"?
An abrupt decrease in the fetal heart rate > 15 seconds - lasting > 15 seconds that is U, V, W shaped and not related to contractions, caused by cord compression. Abrupt = (< 30 sec from baseline to nadir)
What is a variable deceleration?
Internal monitor used to monitor uterine activity and is invasive but more accurate than a tocodynamometer.
What is an internal pressure catheter?
Fetal heart rate of less than 110 beats per minute.
What is fetal bradycardia?
A noninvasive test to evaluate fetal well being.
Results:
•Two or more accelerations of 15 beats/min lasting 15 seconds over a 20 minute period.
•Normal baseline heart rate.
•Moderate variability.
What is a reactive nonstress test?
Medical emergency that requires the nurse to digitally hold the presenting part off the cord until baby is delivered by cesarean.
What is a "Prolapsed Cord"?
A deceleration that lasts > 2 minutes (but less than 10 min)
What is a prolonged deceleration?
More than 5 uterine contractions in 10 minutes averaged over a 30 minute window.
What is tachysystole?
Fetal heart rate baseline of > 160 beats per minute.
What is fetal tachycardia?
A test to evaluate placenta function.
Results:
Three contractions in ten minutes with one or more late deceleration present
What is a positive contraction stress test?
Turn off oxytocin, oxygen 8-10 liters per face mask, open main IV line, position left side.
"What are nursing interventions when uterine tachysystole (hyperstimulation) occurs during an induction or augmentation of labor with oxytocin?
A gradual decrease in fetal heart rate that occurs after peak of the contraction and returns to baseline after the contraction is over. (Gradual = > 30 sec from baseline to nadir)
What is a late deceleration?
Contractions that palpate like a forehead.
What are "firm" or "strong" contractions?
The fetus is positioned ROA per your Leopold's maneuver and to assess the fetal heart rate this is where you position the external fetal monitor.
What is the right lower quadrant?
Noninvasive test to evaluate fetal well being, with a ideal score 8-10, that evaluates:
•Fetal breathing movements
•Gross body movement
•Fetal tone
•Reactive Non stress test
•Amniotic fluid volume
What is a "Biophysical Profile" or "BPP"?
Length of time membranes are ruptured has a direct correlation to this risk that nurses should monitor for.
What is risk of sepsis?
Variability that is predictive of the absence of fetal metabolic acidemia.
What is moderate variability?
The nurse recognizes this type of fetal heart rate deceleration as a sign of uteroplacental insufficiency and the first intervention is to reposition mom on her left side.
What are late decelerations?
Term that describes how often contractions occur.
What is frequency?
The fetal heart rate rounded to increments of 5 beats per minute during a 10 minute window, excluding accelerations, decelerations and periods of marked variability.
What is FHR baseline?
Late decelerations appear, accelerations disappear, fetal breathing stops, fetal movement ceases, fetal tone absent.
What are signs of fetal hypoxia?
Most common drug used to stop contractions with a black box warning due to the potential side effects.
"What is Terbutaline?
Variability that is undetectable
What is absent variability?
The nurse repositions mom on her left side, provides 8-10 L of oxygen per face mask, and increases the main line IV fluids.
What is intrauterine resuscitation?
Time period between contractions which palpates as "soft" and allows fetus to resoxygenate.
What is "resting tone"?
Fetal heart rate increases of at least 15 beats per minute over baseline and lasts at least 15 seconds and are a reassuring indication of an intact CNS and healthy fetus.
What are accelerations?
Determinant of fetal lung maturity.
What is a Lung Surfactant (L:S) ratio of 2:1 or greater?
Uterine incision in which a vaginal delivery is contraindicated due to risk of rupture.
"What is a "classical" or "high vertical" uterine incision?