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16 Cards in this Set
- Front
- Back
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Maternal Assessment:
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1) Contractions
-frequency, duration, intensity -palpate the stomach during a contraction to see how firm it is -only rely on INTERNAL monitor for the picture on the graph (the external monitor is not very accurate) 2) Cervical assess -dilation/effacement/staging -ex. 1-10cm/0-100%/-3-+3 |
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Fetal Assessment:
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1) HR
2) Position Can use Leopolds maneuver to help find FHT. Feel on the mom's abdomen for baby's spine, easiest to hear FHT on the baby's back |
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If the baby is in cephalic position, where do u listen for the FHT?
Breech? Transverse? |
cephalic - lower quadrants
breech - upper quadrants transverse - umbillicus |
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How do we monitor the baby's HR?
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External: Ultrasound
Internal: Fetal scalp electrode |
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What's the normal fetal heart rate?
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120-160
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What's fetal tachycardia?
What causes it most of the time? |
>160
Early hypoxia |
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What's fetal bradycardia?
What are the two main causes? |
<120
1) Late fetal hypoxia 2) Umbilical cord compression. -If prolapsed need to keep head off of cord until emergency c/s. Mom needs to get in knees-to-chest position |
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What is variability?
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Normal HR fluctuations - this is a GOOD sign because it means the CNS is being perfused
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What decreases variability?
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hypoxia, CNS drugs, baby sleeping
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What increases variability?
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EARLY hypoxia, fetal stimulation (ex. fetal scalp electrode), increase placental blood flow (mom on L side)
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When does EARLY deceleration occur?
What is it caused by? Is this normal? |
BEFORE the peak of contraction
Caused by head compression Yes, normal vagal response - no intervention needed |
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When does LATE deceleration occur?
What causes it? |
AFTER a contraction
Caused by placental insufficiency |
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What's the nurses job for late deceleration?
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Get the baby's HR up
-Put O2 on mom -d/c pitocin -give tocolytics -turn to L side -hydrate -notify physician AFTER interventions, priority is to get the HR UP |
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What is VARIABLE deceleration?
What causes it? |
HR drops VERY low (lower than other deceleration)
Cord compression or prolapse |
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Nursing interventions for variable deceleration:
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Same as late deceleration except the mom needs to be position knees-to-chest (butt higher than head - sorry, no other way to explain)
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What's the normal pH range for the baby?
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7.20 - 7.25
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