Intrapartum/Labor Flashcards
Heart Rate
WHat is he baseline of the fetal heart rate
normal 110-160
tachycardia>160
Bradycardia<110
Fetal Heart Monitor
What is baseline variability
irregular fluctuation in the baseline of FHT
Fetal Heart Monitor
What does varibility indicate
indication of para/sympathetic nervous system function in push and pull of oxygen to the fetus
Fetal Heart Monitor
What are the types of baseline varaibility
Absent
Minimal
Moderate
Markerd
Fetal Heart Monitor
What is the **absent variability **
no detactible amplitude
hypoxia
Fetal Heart Monitor
What is the Mininal Variability
1-5 BPM
insufficent blood flow
fetal sleeping
Fetal Heart Monitor
What is the **Moderate Varaibility **
6 to 25 BPM
oxygenated fetus, neuorlogically intact
Fetal Heart Monitor
What is the **Marked Variability **
>25 BPM
cord compression, tachysystole
Fetal Heart Monitor
what is Acceleration
**15 BPM above baseline x 15 seconds **
indicate good oxygenation and indicate baby CNS intact
Fetal Heart Monitor
What are Variable Deceleration
Aburpt descent <30 sec
from baseline, lowest point, V/U shaped
cord compression
Fetal Heart Monitor
What are interventions of Variable decelerations
Repsoition
don’t lay them flat
can do semi-flower
need to find spot where cord is in not be compressed
Fetal Heart Monitor
What are prolonged deceleration
longer than 2 min
less then 10 min
Fetal Heart Monitor
Prolonged Interventions
- monitor BP
- Intrauterine resuscitation
Fetal Heart Monitor
what are early deceleration
Head compression cause
mirror of contraction
begin at start, reach lowest at the same time of contraction
Fetal Heart Monitor
What are late decelerations
start after contraction
Pitocin should be turned off
intervention intrauterine resuscitations
Fetal Heart Monitor
What is Intrauterine Resuscitation
Fluid bolus to enhance oxygen delivery
Fluid bolus Lateral position Inform provider Pitocin off
Contractions
How to assess contractions
Feel fundus size
Contractions
What does it mean if fundus is a shape of the tip of the nose
mild intensity
Contractions
What does it mean if fundus is a shape of the chin
moderate intensity
Contractions
What does it mean if fundus is a shape of the forehead
strong intensity
Stages of Labor
How many stages
4
Stages of Labor
What is the first stage
Latent
Stages of Labor
What is the Latent Phase
All about Cervix
need dilation for baby to get out
long time
0 to 5 cm of cervix
Stages of Labor
What occurs in Latent phase
mom is talabative excited
help mom ambulate
help with distraction
eating/drinking normally
moving around
Stages of Labor
what is the active phase
dynamic process
contractions
slightly quicker
6 to 10 cm
Stages of Labor
What can be done/expected in active phase
lean into coping stragtegies
tub, penut ballow, lunging, walking, slow dancing
fetal monitor check more often
Stages of Labor
What is the second stage
pushing baby out
Stages of Labor
What occurs in the second phase
normal pushing: telling mom to push
3 good pushes
end of stage when baby is delivered
Stages of Labor
What is the third stage
Placenta
Stages of Labor
What occurs in the third stage
start when baby born/end when placenta out
want short 3rd stage: prevent hemorrhage
Stages of Labor
3rd stage management
- passive: wait for things to happen
- active: start potocin/bolus stimulate contractions to expel placenta; little push from mom
Stages of Labor
What is delayed cord clamping in 3rd stage
clamp cord, cut, baby in warmer
last transfusion for baby, gives extra blood
45sec to 1 min attached to baby
Stages of Labor
What is the 4th stage of labor
body to go nonpregnancy
Stages of Labor
What occurs in 4th stage
start at placenta delivery/end 4hr after or mom clinically stable
* frequent assessment of bleeding
* encourage breastfeeding
* encourage skin to skin
Maneuvar
what does the Leopold Maneuver indicate
fetal position and presentation
Maneuvar
What occurs in the first Leopold Maneuvar
palpate upper abdomen both hand
1. shape
2. consistency
3. mobility
fetal head firm hard round, moves independly of trunk, breach feel soft
Maneuvar
What occurs in the second Leopold Maneuvar
hands moved mid of abdomn/pelvis and palpate
fetal back feels smooth, fetal limbs knobby and bumpy
Maneuvar
What occurs in the third Leopold Maneuvar
place one hand above symphysis (pelvic) and other at top of abdomen
1. determine posiion of baby (head or breach
fetal head top means breach
Maneuvar
What occurs in the first Leopold Maneuvar
place both hand lower abdomen and move fingers down towads pelvic
1.note cephalic promiene/brow on oposite side of fetal back
SBAR
What does I-SBAR stand for
I=Identify self & pt
S: Situation
B: Backgroun
A: Asssesment
R: recommendation
R: Read Back orders
