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normal fetal HR
110-160 beats/min
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palpation of contractions
- frequency, duration, tone, intensity
- -mild (1+), moderate (2+), strong (3+)
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3 methods of monitoring HR
- -manually (doptone, fetoscope)
- -externally (ultrasound toco)
- -internally (fetal electrode)
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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
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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
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nichd & 3 tier fhr interpretation system
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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
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early decelerations
may be due to head compression, mirror contractions, usually does not require intervention
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variable decelerations
-due to cord compression, variable in shape and timing, (v,w,u), change maternal position, iv bolus, o2, amnioinfusion
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late decelerations
- (worst kind)
- -caused by placental insufficiency
- -late in onset, rounded shape
- -change maternal position, iv bolus, o2, d/c pitocin
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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
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