Podcast
Questions and Answers
Which pattern is considered an ominous sign of fetal distress and requires immediate intervention?
Which pattern is considered an ominous sign of fetal distress and requires immediate intervention?
What is a common cause of fetal distress related to cord compression?
What is a common cause of fetal distress related to cord compression?
What does a late deceleration pattern in fetal heart rate indicate?
What does a late deceleration pattern in fetal heart rate indicate?
Which nursing diagnosis is a priority related to fetal distress?
Which nursing diagnosis is a priority related to fetal distress?
Signup and view all the answers
What is a common sign of fetal distress related to impaired gas exchange?
What is a common sign of fetal distress related to impaired gas exchange?
Signup and view all the answers
In the context of fetal distress, what should be done during a late deceleration pattern?
In the context of fetal distress, what should be done during a late deceleration pattern?
Signup and view all the answers
What is the goal in relieving severe variable decelerations or prolonged bradycardia in fetal distress?
What is the goal in relieving severe variable decelerations or prolonged bradycardia in fetal distress?
Signup and view all the answers
What medical management intervention can be used when signs of cord compression are present during labor?
What medical management intervention can be used when signs of cord compression are present during labor?
Signup and view all the answers
Which action is NOT recommended during late decelerations related to uteroplacental insufficiency?
Which action is NOT recommended during late decelerations related to uteroplacental insufficiency?
Signup and view all the answers
What is the significance of a flattened appearance of the fetal heart rate?
What is the significance of a flattened appearance of the fetal heart rate?
Signup and view all the answers
Study Notes
Fetal Distress
- Fetal distress is a condition where the fetus does not receive sufficient oxygen supply to meet its demands.
- Causes of fetal distress include:
- Compression of the umbilical cord
- Uteroplacental insufficiency caused by placental abnormalities or maternal condition
- Decreased or absence of variability of heart rate
Fetal Heart Rate (FHR) Patterns
- Late deceleration pattern:
- FHR slows following the peak of a contraction and slowly returns to baseline rate during the resting phase
- Indicates fetal response to hypoxia from uteroplacental insufficiency
- Considered an ominous pattern regardless of the depth of the deceleration of the FHR and requires immediate intervention
- Severe variable deceleration pattern:
- FHR repeatedly decelerates below 90 beats/min for over 60 seconds before returning to baseline
- Indicates interference of fetal blood flow from cord compression
- Leads to fetal hypoxia and low APGAR scores unless steps are taken to correct it
- Tachycardia (above 160) is an early sign of distress, while bradycardia (below 110) is a late sign of distress.
Signs and Symptoms
- Meconium-stained amniotic fluid (excluding breech presentation)
- Changes in FHR baseline
- Decreased or absence of variability of heart rate
- HR varies less than 2-5 beats/min, causing a flattened appearance to the heart rate
- Indicates depression of the autonomic nervous system that controls heart rate
Assessment and Diagnoses
- Assess FHR baseline, variability, and pattern of periodic changes
- Assess contraction pattern and maternal response to labor
- Priority nursing diagnoses: Decreased cardiac output (fetal), Impaired gas exchange (fetal), Anxiety (maternal)
Planning and Implementation
- Institute emergency measures to correct fetal hypoxia based on FHR pattern
- For late deceleration, take steps to improve uteroplacental blood flow
- For severe variable deceleration, initiate actions to relieve cord compression
Late Deceleration (Uteroplacental Insufficiency)
- Goal is to improve maternal blood flow to the placenta
- Reposition the mother on her left side
- Administer oxygen by face mask at 8-10 L/min
- Increase IV fluids
- Discontinue oxytocin infusion, if labor is being induced
- Notify the health care provider immediately
Severe Variable Decelerations or Prolonged Bradycardia (Cord Compression)
- Goal is to relieve pressure on the umbilical cord
- Reposition the mother on either side
- If not corrected, reposition to opposite side
- Administer oxygen by face mask at 8-10 L/min
- Trendelenburg or knee-chest position, if not corrected
- Perform vaginal examination and apply upward digital pressure on the presenting part to relieve pressure on the umbilical cord
Medical Management
- Amnioinfusion: amniotic fluid may be replaced with warmed sterile saline through an intrauterine catheter when signs of cord compression are present during labor
- FHR monitoring is continued
- Intrauterine catheter is inserted
- Warmed sterile saline is delivered via the catheter using an infusion pump
- Infusion
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Learn about the causes of fetal distress, including compression of the umbilical cord and uteroplacental insufficiency. Understand the indicators such as decreased heart rate variability and its implications on the fetus.
