VEAL CHOP
True or false- Early decelerations are seen before the contraction
False, they mirror each other. it is not actually "early"
What is routine information we need to obtain from mom at every prenatal visit?
Weight, BP, Pulse, Fundal Height, Urinalysis, Mental health, fetal movement, any concerns
What are things to watch for in a patient after she has had an amniocentesis?
Chills, fever, leakage, decreased FM, contractions
Which type of Deceleration is the most alarming?!!
Late decelerations
What does nadir mean?
Which deceleration is characterized by an abrupt drop in heart beat for at least 15min
Variable deceleration
Glucose tolerance test
Which test screens for PTL by assessing the pH of possible amniotic fluid. Will be blue/green if pos
Nitrazine test
Intervention for early decelerations
No interventions needed, but may want to do a cervical check as this may indicate progression.
What is the purpose of an Ultrasound for pregnancy?
Verify pregnancy, confirms EDD, rule out ectopic/abnormalities with fetus
What category tracing is characterized by moderate variability, A couple accelerations, a couple late decelerations, and normal HR
Category 2- intervention is needed due to the late decelerations
Would a patient diagnosed with T1 or T2 DM need to do the glucose testing?
No, they already need to manage a DM pregnancy
Which test is characterized by the goal of at least 2 FHR accelerations in a 20min interval. Will use a TOCO and US to monitor
NST
The EFM is on for 10minutes: Minimal variability, FHR 110, no accelerations
What might be going on?
Could be a sleep cycle
Could be high due to mom on pain meds
Could be in fetal distress
How do you find baseline FHR on electronic fetal monitoring?
Assess where the FHR keeps coming back to, draw a line through the strip. Do not take into account the accelerations or decelerations.
Also, need to monitor for 10min before confirming baseline
Babies head is moving down birth canal as mom dilates to 9cm!
What might you see on the fetal monitoring strip that would reflect this?
Early decelerations due to head compression
What testing could potentially lead to mom needing penicillin in labor?
Pos GBS swab at 35-36wks
4 blood draws, 2 or more elevated will be dx for GDM
The nurse is watching a strip and notices minimal variability, FHR 70BPM for 5min, and recurrent prolonged decelerations. What is the intervention?
Baby is coming out the sun roof immediately!!
Nope!
When might you see variables? Do you need to have contractions to have variables?
Cord compression, Nuchal chord, cord prolapse, ROM
No, you do not need to have ctx to have variables
What is the RPR test for? it is screened at prenatal visits as well as at the hospital
Syphilis
A patient who is 30wks is feeling 2 kick counts every couple of hours. Is this normal or is there intervention needed? If so, what intervention?
Yes, intervention is needed. A pt 28wks or more should never feel less than 3 kicks per hour. She needs to go to triage for further monitoring as the baby may be in distress.
What are the interventions for Late decelerations?!
Flip, Drip, Scratch, Sniff
Reposition (Side laying), Fluid bolus, stop pitocin, 10L non rebreather mask,
I have a question- Pierre didnt say anything about "Scratch" to stimulate baby?
What may happen to the fetus when the mom refuses the Rhogam vaccine?
Fetal demise caused by severe anemia or Hydrops Fetalis (swelling in the cavities)