Fetal Monitoring Exam II 2.
when do you assess FHR ANSW - during labor
Prior to labor stimulants, periods of ambulation, administration of medications, initiation of anesthesia
following ROM, vaginal exams, periods of ambulation, and procedures such as enemas and caths
why do you assess F...
when do you assess FHR ANSW - during labor
Prior to labor stimulants, periods of ambulation, administration of medications,
initiation of anesthesia
following ROM, vaginal exams, periods of ambulation, and procedures such as
enemas and caths
why do you assess FHR? ANSW - to recognize abnormal uterine patterns,
evaluate effects of Pitocin and other meds
what are the two methods of fetal monitoring? ANSW - intermittent (auscultation
with fetoscope or doppler)
electronic/continuous (External toco transducer with ultrasound, internal scalp
electrode with IUPC)
intermittent fetal monitoring ANSW - low risk, one-to-one nurse-to-pt ratio, non
invasive, mom can be ambulatory
disadvantages of intermittent fetal monitoring ANSW - Is a learned skill
May miss detection of information with a weak signal or movement of mom and
baby
Difficult to identify periodic changes
Difficult to detect variability
No printed record other than nursing documentation
, AWHONN and ACOG Standards for Intermittent fetal monitoring ANSW - for
high risk mom: stage I - Q30min, stage II - Q15min
for low risk mom: stage I - Q15min, stage II - Q5 min
advantages of EFM ANSW - Continuous information
Variability can be determined
Printed record as long as mom is on the monitor
disadvantages of EFM ANSW - Requires advanced assessment and clinical
judgment skills
Has a history of controversy for interpretation and interventions Restriction of
mom's activity
Expensive
May increase C/S rate, infections
Use should be based on risk assessment but also is based on obstetric staff
preference and hosp policy
AWHONN standards for EFM ANSW - Initiation of monitoring and ongoing
evaluation only by licensed healthcare providers
Fetal heart rate monitoring includes:
Application of monitoring components
Initial assessment of mother and fetus
Intermittent auscultation
Ongoing monitoring and interpretation
Clinical interventions
RISK FACTORS to consider for EFM ANSW - Maternal Risk Factors
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