Fetal Heart Rate Monitor Flashcards
3 types of fetal heart rate monitoring
Auscultation
intermittent auscultation
electronic fetal heart rate monitoring (EFM) (continuous/intermittent)
◦ noninvasive: ultrasound transducer, external
◦ invasive: electrode on fetal scalp
noninvasive vs invasive electronic fetal heart rate monitoring:
◦ noninvasive: ultrasound transducer, external
◦ invasive: electrode on fetal scalp
over what amount of time do we assess fetal HR to determine baseline?
10 friggin minutes yo
You know this- normal fetal heart rate?
110-160
Tachycardia in fetus = > ____ for _____ minutes
causes- preggo and fetus
> 160 for 10 min
◦ preggo: **infection, fever, dehydration, anemia, anxiety, meds, elicit drugs
◦ baby: infection, septic, anemia, compensate after hypoxic event
interventions for fetal tachycardia
check preggo’s temp (reduce), antibiotics, position changes, oxygenation, assess for dehydration/fluids
bracycardia in fetus + < ____ for _____
fetus and preggo causes?
<110 for 10 min
◦ hypoxia in fetus ◦ preggo: supine/compressing vena cava, hypotension, abruption, bleeding, dehydration
interventions for fetal bradycardia
◦ stop oxytocin, sidelying, oxygen, iv fluids, topolytic, notify provider
do we consider delivering with fetal tachy or brady cardia?
bradycardia
lil nugget needs some air!
what is most important predictor of adequate fetal oxygenation?
baseline fetal HR
what does an absent baseline fetal heart rate variablity mean?
poor perfusion/acid base imbalanced, no detectable change in amplitude
what does a minimal fetal heart rate baseline variability mean? (amplitude change is < _____)
related to pain meds for preggo, sleep state for fetus, <5 change in amplitude
◦ fetus could be asleep, analgesics, supine hypotension, cord compression
what does a moderate baseline variability in fetal heart rate mean? what is the amplitude range?
Predicts a well-oxygenated fetus with normal acid-base balance (at that time)
◦ this is normal! this is what we want!
◦ 6-25 beats/min amplitude range
what is a marked baseline fetal HR variability? (amplitude >____)
more up and down variation, typical to see during pushing
◦ amplitude range >25 beats/min
what kind of baseline fetal HR do we see during pushing?
marked
Ah gee, what’s an acceleration in the fetal heart rate? is it good or bad?
< ___beats for ___ seconds
increase in fetal heart rate above baseline by 15 beats for 15 seconds
- <2 min and returns to normal
its chill! we want to see this, means good oxygen, no fetal acidosis
3 types of decerlations
Early, Late, Variable
This type of deceleration is a gradual decrease is fetus HR that mirrors the contraction
early deceleration
its chill! no intervention needed
During which stage of labor do we see early decelerations? why?
2nd stage– fetus head being smashed against the vagina wall
(despite all my rage I am still just a babe in a vag…smashing pumpkins is out, smashing heads against vaginal walls is in)
early decelerations begin when the contraction _____ and return to baseline by the time the contraction _____
Deceleration begins when the contraction BEGINS and returns to baseline by the time the contraction ENDS
this kind of deceleration is an abrupt decrease in fetal HR that has no pattern with uterine contractions
variable decerlations
1 cause of variable decelerations- regular name and fancy name
cord compression (nuchal cord)
what do variable decelerations look like on the monitor
a V
nursing interventions for variable decelerations
1 =Reposition the client (side to side; knee-chest (on all fours) (start here for interventions)
• Discontinue oxytocin (oxytocin make contractions stronger and more frequent)
• Administer O2 via face mask 8-10L/min to increase placental perfusion
• Vaginal exam
• Amnioinfusion (if prescribed) place fluid back into cavity to give for room for cord to prevent compression
this type of deceleration is a gradual decrease in fetal rate at the that occurs AFTER the beginning of a contraction
late decelerations
◦ when fetus should be recovering from contraction and coming back to normal the fetus is unable to recover
late decelerations- chill or not chill
NOT chill. This is the bad one.
cause of later decelerations?
Uteroplacental Insufficiency (partial abruption)
nursing interventions for late decels?
- Change maternal position (side lying) (start here!- will allow all the other things we are doing to have benefit)
- Discontinue oxytocin
- IV bolus of lactated ringers to promote fetal oxygenation
- Administer O2 via face mask 8-10L/min
- Notify provider
- Fetal spiral electrode for more invasive monitoring (provider places)
- Plan for delivery and care of the neonate
WTF is VEAL CHOP
V – Variable Decelerations > C – Cord Compression
E – Early Decelerations > H – Head Compression
A – Accelerations > O - OK
L – Late Decelerations > P – Placental insufficiency
