University:
West Coast University
Course:
NURS 103 | Fundamentals of Nursing
Academic year:

2021
Views:

1

Pages:

3
Author:

Alma Hester

Breaking Down Fetal Monitoring V-variable decelerations C- Cord Compression I’m being squeezed (umbilical cord).. Change mom’s position E- early decelerations H- Head Compression Ouch! It’s tight on my head (uterine ctx).. Assess fetal decent by sterile vaginal exam I’m good. Leave my mommy alone! (accelerations in absence of any decelerations!) Oh No! I’m not getting enough blood flow! (Placenta is having some trouble. Nurse cannot fix this problem. Delivery will resolve problem) Contact the healthcare provider 1st! THEN perform other interventions. If you perform interventions first (position change, oxygen, etc.) it will not resolve the problem. It will help but you still need to call the doctor. Just get the doctor to bedside and then go from there. A-acceleration L- Late deceleration O- okay! P- Placental insufficiency Category Category I Category II Intervention Nothing. Continue to monitor, provide caring labor support, monitor for further descent. If the client is complete (full dilation and effacement) we have to wait to see if the baby has descended down further into the pelvis and birth canal. If the baby is still high in station (0 to -4), just continue to monitor and delay pushing until increased rectal pressure is felt. Depends on the type of fetal heart rate pattern and/or uterine activity. See if VEAL CHOP applies (FHR) and intervene from there. If it is uterine activity, fix the cause (tachysystole- stop med). Administration of oxygen is only performed if there is a change in the variability in relation to the non-reassuring FHR pattern. You MUST know the gestational age prior to administration. Very preterm (earlier than 28 weeks gestation) will have minimal variability d/t immature CNS. Applying oxygen during this time will not resolve the problem. Later in gestation (>29 weeks) will aid in resolution and improve variability. Most importantly, figure out what the cause of the pattern change is and intervene. If it is from hypotension, what caused it? Blood loss (administer fluid bolus) or epidural (contact Anesthesia for possible ephedrine administration) and then perform remaining interventions. Category III ABNORMAL- FIRST CONTACT PROVIDER! Don’t do anything else. This category the only route will be delivery. There are only a few strips that meet this requirement: Sinusoidal Absent variability WITH recurrent variable and/or late decelerations Fetal bradycardia <110bpm