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25 Cards in this Set
- Front
- Back
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Late Dcells are ? They are the ? kind. They are caused by ? that can be from maternal hypotension, excessive uterine activity, abruptio/previa placenta, chronic hypertension, maternal DM, severe maternal enemia, maternal cardiac disease, etc... Late Dcells can cause fetal ?
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bad, worst
uteroplacental insufficiency, hypoxia |
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Late Dcells are visually apparent usually symmetrical gradual decreases and return of the ? associated with the ?
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FHR,
UC |
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A Dcell is a ? in timing with the nadir of the Dcell occuring after the peak of the ?
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delay,
Uterine contraction, |
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What do we do if we see a late Dcell, in order to get them back to normal ?
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P-position pt on her side,
O-oxygenate with 8-12L face mask, I-Increase plain IV fluid, S-Sterile vag exam, O-Oxytocin off, N-notify MD, Evaluate/Assess pt, Document actions taken |
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Variable Dcells are caused by ? They show up on the tracing as an abrupt decrease in FHR with an onset to nadir of < ? sec. To be a Dcell there has to be a decrease
≥ ? bpm lasting ≥ ? sec and it must be < mins in duration |
umbilical cord compression,
30sec, 15bpm, 15sec, 2min |
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How does the umbilical cord become compressed ?,?,?,?,? or oligohydramnios is an AFI < ? AFI=
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nuchal cord, cord around body, cord pressed against a bone, knot in cord, prolapsed cord,
5, amniotic fluid index |
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Nursing interventions for Dcells include - have the mom change her ? like lying on her ? or getting her on ?'s and ?'s, we might give mom ? of try possible IV changes like turning off the ? and call the ?
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position,
side, hands and knees, O2, pitocin, notify doctor |
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Shoulders are Acells that may ? or ? a varible Dcell. Usually moderate variability is present so this is ? Shoulders and Overshoots may ? occur with variable Dcells
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precede,
follow, reassuring, ONLY! |
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Usually the overshoot lasts a significant time period(longer than a shoulder) so this is a ? sign in a postterm fetus(≥41weeks) associated with ?/?
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NON-reassuring,
hypoxia/acidosis |
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We can also see overshoots if the fetus is ? and/or mom has a dose of ?
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pre-term,
Atropine |
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Evaluation of Uterine contractions includes finding out the ?
A ? is required to evaluate intensity accurately. The goal for a resting tone is < ?mmhg/cmH20 IUPC or a ? uterus if on a Toco transducer. |
DIF,
IUPC(cmH20), 20, relaxed |
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When palpating uterine contractions with pads of fingers avoid ? movement so we don't stimulate contractions. Uterine contractions are documentes as ?,?,?
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constant,
mild, moderate, strong |
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? always qualifys as to presence or absence of associated FHR decels. This is measured as > ? UC in ? min over
? min time period. |
tachysystole,
5 UC, 10 min, 30 min |
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Normal UC are ≤ ? UC in ? min over ? min ttl.
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5 UC,
10 min, 30min |
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If the fetal HR is 110-160bpm, with moderate variability, no late or variable decels, with early Dcells and no Acells would be considered a category ? these measurements are ?
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one, WNL
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Category III is associated with an abnormal ?-? balance and requires prompt ? and ?
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acid-base,
evaluation, action |
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If there is a sinusoidal pattern or absent variability plus any of the following-recurrent late Dcells, recurrent variable Dcells, or bradycardia then the pt is in a category ?
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III
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sinusoidal pattern is a visually apparent ? sine wave with a cycle frequency of ?-? min that persists for ≥ ? min
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smooth,
3-5min, 20min |
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Category III interventions include -POISONED-
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Position mom on her side,
Oxygen 8-12 L on mask, Increase plain IV fluid, Sterile vag exam Oxytocin off Notify MD Evaluate/Assess pt Document actions taken |
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"VEAL CHOP" = ?
V → C E → H A → O L → P |
Variable Dcell → Cord compression,
Early Dcell → Head compresion, Accells → Adequate O2 Late Dcells → Placental/Uterus insufficiency |
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Category II includes all ?'s that are not in category I or III
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FHR's
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recurrent late Dcell with absent variability is a category ?
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III
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In a category II, if we see prolonged Dcells > 2mis but < 10min we should get ready for the doctor to perform a ?
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C-section
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Name the 5 FHR signs that fit into category 1 ?,?,?,?,?
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HR 110-160bpm,
Moderate variability, Acells +/- (absent or present), Early Dcell +/-(absent or present), NO late Dcells or Variable Dcells |
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What does a category III mean ?
Name the 5 FHR signs that fit into category III ? |
Category III = TAKE ACTION!!! use POISONED!!!
Sinusoidal pattern, or Absent variability plus one of the following, recurrent late Dcells, recurrent variable Dcells, bradycardia. |
