Intrapartum Nursing Care and Fetal Monitoring Flashcards
What are the 8 labs to be done for L&D admission?
Blood type/Rh factor CBC G/C status GBS status Hepatitis status HIV status Rubella status VDRL/RPR status
What type of IV fluid is typical for L&D?
lactated ringers
Which arm is the IV access placed?
non-dominant
What is our nursing care for newly admitted L&D patients?
Monitor VS Establish IV access Monitor contractions; maternal/fetal tolerance Monitor ROM Monitor perineum, activity and pt position Monitor fluid intake Pain management Pt comfort/support
What is important to keep in mind regarding angiocatheter size and blood products.
Need a larger Cath size due to blood viscosity
What is the purpose of fetal monitoring?
Determine fetal status Identify the fetal hypoxic stress
The umbilical vein carries what to where?
Oxygenated blood to the fetus
Umbilical arteries carry what to where?
Deoxygenated blood to placenta
True or False The CNS has no affect on the FHR.
False. It plays a significant role in the regulation of the FHR
How does a contraction effect blood flow to the mother and fetus?
Increases blood volume to mother, decrease flow to fetus
Fetal bradycardia/tachycardia diminish
Oxygenation
How do we assess the intensity of contractions when we compare them to our own bodies?
Mild = Nose Moderate = Chin Strong = Forehead
Why are Leopold’s maneuvers performed regarding fetal monitoring.
To establish position of fetus to know where to position monitoring equipment
What devices are used for monitoring the FHR? Indicate if they are internal or external.
Ultrasound transducer: external Spiral electrode: internal
What devices are used for monitoring uterine activity? Indicate if they are internal or external.
Tocotransducer: external Intrauterine pressure catheter (IUPC): internal
Name the advantages of both internal and external fetal monitoring
External: non-invasive, low risk Internal: more detailed data
On a FHR strip, each box indicates…
10sec of time
Each section between bold vertical lines indicates…
1min of time
What do the upper and lower sections of the strip represent?
Upper = FHR Lower = Contractions/uterine activity
Define the baseline FHR on the strip
FHR average over 10mins
What do accelerations indicate and is it bad?
Normal HR increases with fetal movement. It is ok.
What are decelerations?
Drops in heart rate.
What are the three types of decelerations and what do they indicate?
Early = drop in heart rate is due to head compression Late = drop in rate is due to uteroplacental exchange issues Variable = drop in rate is due to cord compression
What are the nursing interventions for early decels?
These are typical. Monitor and document
What are the nursing interventions for late decels?
Reposition mother, monitor and document
What are the nursing interventions for variable decels?
Reposition, O2 administration @ 8-10L/min w/ non-rebreather mask
A FHR reading is either _____ or _____.
Reassuring or non-reassuring
During the second stage of labor, fetal heart tones are documented…
every 5 to 15 minutes.
During the early phase of labor, fetal heart tones only need to be documented every
30 minutes
During the latent phase of labor, fetal heart tones only need to be documented every
30 minutes
Regarding Cesareans, The guidelines for decision to incision are
30 minutes.
