intrapartum Flashcards
Advantages on FEM ultrasound
continuous graphic recording
Baseline, variability, changes in FHR
Noninvasive
Doesn’t require ROM
Nurse can place
disadvantages to FEM ultrasound
Susceptible to interference with movement
Weak signal
Tracing may be difficult to interpret
where should the ultrasound be placed to obtain the best reading?
Fetal shoulder area
advantages of FEM with toco monitor
Noninvasive, easy to place
Intermittent use
Permanent continuous recording
Nurse can place and palpate contractions
disadvantages of FEM with toco monitor
Nurse must compare to subjective data
belt may be uncomfortable
Mom may feel limited to move
Doesn’t measure intensity
where should the Toco monitor be placed to get the best reading?
On the fundus
Advantages of internal fetal scalp monitor
Clear tracings
Better information about variability
Nurse can place
Useful for overweight moms, due to increased Adipose tissue
Disadvantages of fetal scalp monitor
infection, injury
Requires ROM, cervical dilation, invasive
Cannot be used in HIV positive moms
advantages of IUPC
Pressure measurements for intensity/resting tone
Accurate timing of contractions
Permanent record of uterine activity
Disadvantages of IUPC
ROM required with adequate dilation
Invasive
Risk for infection, uterine/personal injury
Provider places
ways to test rupture of membranes
Nitrazine paper
Ferning test
Amnisure
early decelerations
Caused by head compression
Mirrors inversely; contraction increases, HR decreases
Last 30 seconds
Occurs at zero station
Late decelerations
due to uteroplacental insufficiency,
Hypo/hypertension, bleeding
Onset at peak of contraction
variable decelerations
Due to cord compression
With or without contractions
Abrupt onset to Nadir
Are intermittent variable decelerations normal?
Yes, physiologic labor response
