ch. 9 notes

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ch. 9 notes
2013-02-17 17:11:40


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  1. normal fetal HR
    110-160 beats/min
  2. palpation of contractions
    • frequency, duration, tone, intensity
    • -mild (1+), moderate (2+), strong (3+)
  3. 3 methods of monitoring HR
    • -manually (doptone, fetoscope)
    • -externally (ultrasound toco)
    • -internally (fetal electrode)
  4. electronic monitoring
    external: flexible disc on mothers abdomen, recorded on graph paper

    -when used with tocodynamometer, provides info from FHR in relation to the duration and frequency of contractions

    • internal: need to be dilated and have water broken
    • -cervix must be dilated at lease 2 cm
    • -wires extend from vagina to leg plate and connected to monitor
    • -stays on until delivery
  5. AWHONN Standards for frequency for FHR assessment
    • tells how often we need to chart, ever 1 hr.
    • active phase: every 15-30 mins
    • latent phase: 5-15 mins
  6. nichd & 3 tier fhr interpretation system
  7. intrapartum fetal monitoring
    • accelerations: 15x15 for 32 weeks and above, 10x10 under 32 weeks
    • -may be due to fetal activity or mild cord compression
    • -indicate adequate fetal oxygenation
  8. early decelerations
    may be due to head compression, mirror contractions, usually does not require intervention
  9. variable decelerations
    -due to cord compression, variable in shape and timing,  (v,w,u), change maternal position, iv bolus, o2, amnioinfusion
  10. late decelerations
    • (worst kind)
    • -caused by placental insufficiency
    • -late in onset, rounded shape
    • -change maternal position, iv bolus, o2, d/c pitocin
  11. intrauterine resuscitation
    interventions for nonreassuring FHR patterns are referred to as intrauterine resuscitation. these interventions maximize intravascular volume, uterine perfusion, placental exchange, and oxygen delivery to the fetus