Chapter 14: FHR etc etc
A client presents to the birthing center in labor. The clients membranes have just ruptured. Which assessment is the nurse's priority?
-FETAL HEART RATE.
Category 1 tracing interventions:
- Normal -requires no intervention -baseline FHR 110-160 -moderate variability
The nurse encourages a women in labor to ambulate based on the understanding that ambulating:
-Enlists the aid of gravity to move the fetus -enhances the effectiveness of contractions -increases the urge to push during the second stage -encourages rotation of the fetus -helps the fetus line up with the angle of the pelvis
Signs indicating abnormal fetal acid-base status
-Fetal bradycardia -sinusoidal pattern -recurrent late decelerations rationale: fetal tachycardia and minimal variability, needs evaluation and continued monitoring, are NOT predicative of abnormal fetal acid-base status
A nurse is reviewing the FHR and notes it to be in the range of 100 to 106 bpm over the past 10 minutes.. Which conditions might the nurse suspect as the cause?
-Fetal hypoxia -Effect of maternal analgesia -prolonged umbilical cord compression
What would the nurse cite as being able to be detected when using continuous monitoring but not intermittent monitoring?
-TYPES OF DECELERATIONS, -VARIABILITY RATIONALE: Intermittent FHR auscultation can be used to detect FHR baseline and rhythm and changes from baseline. It cannot detect variability and types of deceleration as electronic fetal monitoring can.
A women received morphine during labor to help with pain control. Which finding would the nurse need to monitor the newborn for after delivery:
Decrease alertness: -Morphine is a commonly used opioid for the management of pain during labor.
category 2 tracing:
Not predictive of abnormal fetal acid-base status - but require evaluations and continued monitoring -fetal tachycardia -bradycardia (<110) -minimal or marked variability -prolonged deceleration more than 2 mins but less than 10 mins
Category 3 tracing : ABNORMAL
PREDICTIVE OF ABNORMAL FETUS -FETAL BRADYCARDIA (<110 - RECCURENT LATE DECELERATIONS
A women is in the fourth stage of labor. During the first hour of this stage, the nurse would assess the woman's fundus at which frequency?
every 15 minutes and then every 30 minutes
what would you mostly suspect Ruptured based on which result?
pH: 6.5 amniotic fluid is alkaline, so and increase in pH may indicate rupture.
