L&D/Maternal-Fetal Monitoring/Quick Notes Flashcards Preview

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Flashcards in L&D/Maternal-Fetal Monitoring/Quick Notes Deck (21):
1

Baseline FHR

110-160 beats/min

(Saunders 348)

2

Fetal Bradycardia

FHR less than 110 beats/min for 10 minutes

3

Fetal Tachycardia

FHR greater that 160 beats/min for 10 minutes

4

If fetal brady or tachycardia occur...
Nursing actions (4)

1) Reposition mother
2) Admin oxygen (non rebreather 15 l)
3) Assess mothers VS
4) Notify Provider

5

Variability

Fluctuations in baseline FHR

6

Reassuring FHR pattern

Reassuring FHR patterns are those that are associated with fetal well-being and lack of acute distress. Reassuring FHR readings include periodic accelerations, mild variable decelerations lasting less than 30 seconds, or early decelerations that mirror contractions in duration and timing

7

Nonassuring FHR pattern

Nonreassuring FHR patterns are those that suggest fetal compromise or a declining ability to cope with the stress of labor.
Nonreassuring patterns include a significant decrease in baseline variability or baseline heart rate, progressive fetal tachycardia or bradycardia, persistent late decelerations, or recurrent late return to baseline after decelerations.

8

Accelerations

Brief FHR increase 15 beats/min for 15 secs

9

Brief FHR increase 15 beats/min for 15 secs
Assuring or nonassuring?

Assuring
Reactive test if at least 2 in 20 minutes

10

Non reactive result

Acceleration not present or does not meet Assuring criteria
indicates fetus at risk or asleep

11

Late decelerations are (2) caused by

1) impaired placental exchange
2) Uteroplacental insufficiency

12

Nonreassuring Fetal Heart Rate Patterns (8)
(Saunders 350)

1) Brady
2) Tachy
3) Late decele
4) Prolonged decel
5) Hypertonic uterine activity
6) Decrease or Absent variability
7) Variable decelerations falling less than 70 beats/min for longer than 60 minutes
8) Undetected variability

13

Nonreassuring Fetal Heart Rate Patterns
Priority Nursing Actions

(Saunders 350)

1) Identify cause
2) dc oxytocin (pitocin) infusion
3) Change mother's position
4) Oxygen 8-10 l non rebreather
5) Infuse IV fluids
6) FHR assess, continue monitoring
7) C-section in needed
8) Document: Event, actions taken, mother's response
9) Notify provider

14

Nonreassuring Fetal Heart Rate Patterns
Priority Nursing Actions
Identify cause

1) Prolapsed cord
2) Hypo or hypertension
3) Fever
4) Oxytocin stop infustion, tocolytic may be prescribed

15

Variable decelerations indicate

Variable decelerations falling less than 70 beats/min for longer than 60 minutes before returning to baseline

restricted flow to umbilical cord

16

Variable decelerations
Priority Nursing Action

Change position
Adm oxygen
dc Pitocin
VS
Notify provider
prepare for amniofusion if prescribed

17

Fetal Reactivity via NST

Two accelerations of 15 beats per min lasting 15 seconds

18

An increasing baseline FHR indicates?
An above average baseline FHR us acceptable up to 160

Maternal Infection

19

NST are contractions expected ?

NO

20

What types of heart rates (decelerations) are associated with contractions? (3)

Early
Late
Variable

21

FHR repeatedly drops abruptly to 90 beats per minute unrelated to contractions …indicates?

Umbilical cord compression
Waveform V or U

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