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L&D2 FHR

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juniperk's version from 2017-11-17 19:13

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Question Answer
What can cause increased variability in FHR?acute hypoxia, mechanical compression of cord
What is the normal standard for accelerations?2 accelerations every 20 minutes is a normal response
How long should accelerations last?>32 weeks gest: >15 bpm for 15 seconds
What does an early deceleration look like?a mirror image of the contraction. subtle U shaped
4 causes of nonreassuring variabilitya. Hypoxia (asphyxia) b. Acidosis c. Maternal drug ingestion (narcotics, CNS depressants such as magnesium sulfate) d. Fetal sleep
5 causes of FHR bradycardiaa. Late manifestation of fetal hypoxia b. Medication-induced (narcotics, MgSO4) c. Maternal hypotension d. Fetal heart block e. Prolonged umbilical cord compression
6 causes of FHR tachycardiaa. Early sign of fetal hypoxia b. Fetal anemia c. Dehydration d. Maternal infection, maternal fever e. Maternal hyperthyroid disease f. Medication-induced (atropine, terbutaline, hydroxyzine)
6 Nursing considerations for variable deceleration1. Change maternal position. 2. Stimulate fetus if indicated. 3. Discontinue oxytocin (Pitocin) if infusing. 4. Administer oxygen at 10 L by tight face mask. 5. Perform a vaginal examination to check for cord prolapse. 6. Report findings to physician and document.
What causes early decelerations?Fetal head compression
What do late decelerations look like?the onset begins at the peak of contraction. The peak and nadir do no line up. Ends after contraction ends. More than 2 or 3 in a row
What causes late decelerations?uteroplacental insufficiency which can cause fetal acidosis or fetal hypoxia
5 Nursing actions for persistent late decelerations1. Discontinue oxytocin (Pitocin) if infusing. 2. Immediately turn client onto left side. 3. Administer oxygen at 7-10 L by tight non rebreather face mask. Hyperoxygenate mom. 4. IV fluid bolus 5. Do a vag exam to see how far along mom is.
What is variable deceleration?When the onset to nadir is <30 seconds ( abruptly falls). FHR has no association with uterine contractions. Very drastic sharp line down. <15 bpm for 15 seconds. look like W or U.
What causes variable deceleration and what are the nursing interventions?umbilical cord compression. Reposition mom
what does sinusoidal indicate?fetal hypoxia, fetal anemia, or fetal/maternal hemorrhage... Needs a csection
How long do you observe the baseline to determine the HR?10 minutes or more, average between contractions, increments of 5
Variability- Sympathetic vs ParasympatheticSympathetic nervous system is speedy so the heart rate increases; Parasympathetic is pokey so they lower the heart rate
What is 0-2 bpm variability?Ominous
What is 3-5 bpm variability?minimal
What is 6-25 bpm variability?moderate
What is a prolonged deceleration?When the decel lasts longer than 2 minutes but less than 10 minutes.
How do is contraction frequency monitored (from what to what)?Start of one contraction to the start of the next.
How do is contraction duration monitored (from what to what)?from the beginning of the contraction to the end of the same contraction
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