Fetal Assessment During Labor Chapter 13 PDF

Leopold Maneuvers - PRESENTING PART - FETAL LIE - FETAL ATTITUDE - DEGREE OF DESCENT - Vertex presentation - Fetal heart tones should be assessed below the client's umbilicus in R or L lower Quadrant - Breech Presentation...

Leopold Maneuvers - PRESENTING PART - FETAL LIE - FETAL ATTITUDE - DEGREE OF DESCENT - Vertex presentation - Fetal heart tones should be assessed below the client's umbilicus in R or L lower Quadrant - Breech Presentation - Fetal heart tones should be assessed above the umbilicus in R or L upper quadrant. - Considerations - EMPTY BLADDER - POSITIONING - Supine with a pillow under head and have both knees slightly flexed - Place rolled towel under the clients right or left hip to displace the uterus off major blood vessels - PALPATION - FETAL HEART RATE - DOCUMENTATION: MATERNAL AND FETAL RESPONSE FHR Auscultation and Uterine contraction palpation - INDICATIONS - CONSIDERATIONS - PREPARATION - ONGOING CARE - INTERVENTIONS - FINDINGS - FHR 110 -- 160 Continuous Electronic Fetal Monitoring - ADVANTAGES - DISADVANTAGES - Can't do it on pt with HIV - INDICATIONS - CONSIDERATIONS (PREP, ONGOING CARE) - PREP -- Preparation of the client - Ongoing Care - FINDINGS Accelerations - Normal A graph of a heart rate Description automatically generated - Variability - Good - Strong  - Bad - Could be baby sleeping. A graph of a heart rate Description automatically generated - Early Decelerations (Same) - Compression of the fetal head from - Uterine contractions - Vaginal exam - Fundal pressure - Placement of internal monitoring - Variable Deceleration - Causes - Umbilical cord compression - Short cord - Prolapsed cord - Knot in cord - Nuchal cord - Interventions - Reposition client - Discontinue oxytocin - Admin oxygen NRB 10 -- 15 LPM - Preform vaginal exam - Amnioinfusion if prescribed  - Late Decelerations - Slowing of FHR after contractions - Causes - Uteroplacental insufficiency causing low oxygen to baby. - Maternal hypotension, placenta previa, abruptio placentae, uterine tachysystole with oxytocin. - Preeclampsia - Late -- or post -- term pregnancy - Maternal diabetes. - Interventions - Put client on side laying position - IVF - Discontinue oxytocin - Elevate client legs - Notify provider - Prepare for vaginal birth or cesarean birth. A graph of a graph showing a normal pulse Description automatically generated with medium confidence Acronym VEAL CHOP -------------------------- ----------------------------- V: Variable Deceleration C: Cord Compression E: Early Deceleration H: Head Compression A: Acceleration O: OK; Now Worries L: Late Deceleration P: Placental Issue/Distress - Continuous Internal Monitoring - INDICATIONS - ADVANTAGES - Early detection of abnormal FHR patterns. - Accurate assessment of FHR - Accurate assessment of uterine contractions - Allows greater maternal freedom of movement - DISADVANTAGES - Membranes must be ruptured - Cervix dilated to a minimum 2 -- 3 cm - Potential risk of injury - Risk of infection - CONSIDERATIONS - Make sure it works correctly - Use aseptic techniques - COMPLICATIONS - Misinterpretation of FHR patterns - Maternal or fetal infection - Fetal trauma - Supine hypotension.