Uterine activity a Frequency b Duration c Intensity d Resting tone e Relaxation

Uterine activity a frequency b duration c intensity d

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2.Uterine activity a.Frequencyb.Durationc.Intensityd.Resting tonee.Relaxation time between UC iii. Baseline Variability 1. Causes: FHR influenced by autonomic and sympathetic system a. ANS increase FHR b. PNS decreases FHR c. Push and pull effect produces the moment-to-moment fluctuations in the FHR called variability 2. Medical Management a. Evaluate FHR for abnormal pattern and consider delivery 3. Nursing Actions a. Assess, classify and document FHR variability b. Report decreased variability to care provider iv. Fetal Tachycardia 1. Causes: a. Maternal related: i. fever infection chorioamnionitis
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ii. Dehydration iii. Anxiety iv. Anemia v. Medications (Terbutaline) vi. Illicit drugs b. Fetal related: i. Infection or sepsis ii. Activity/stimulation iii. Compensatory effort following acute hypoxemia iv. Chronic hypoxemia v. Fetal tachyarrhythmia vi. Cardiac abnormalities vii. anemia 2. Medical Management a. Treat underlying cause: antibiotics or fluids b. Consider delivery 3. Nursing Actions a. Assess maternal VS b. Give medications as ordered c. Assess hydration d. Reduce anxiety e. Assess FHR variability, position change, O2 f. Notify primary care provider v. Fetal Bradycardia 1. Causes: a. Maternal: i. Supine position ii. Dehydration iii. Hypotension iv. Acute maternal cardiopulmonary compromise v. Rupture of uterus vi. Placenta abruption vii. Medications such as anesthetics and adrenergic receptors b. Fetal: i. Fetal response to hypoxia ii. Umbilical cord occlusion iii. Acute hypoxemia iv. Late hypoxemia
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v. Hypothermia vi. Chronic fetal head compression vii. Fetal bradyarrhythmias 2. Medical Management a. Intervene related to the cause of bradycardia b. Consider delivery 3. Nursing Actions a. Confirm if EFM is monitoring FHR vs maternal heart rate b. Perform vaginal exam and assess for prolapsed cord c. Assess maternal VS d. Hydration e. Position, O2, stop Pitocin, notify PCP vi. Minimal or Absent Variability 1. Decreased variability can occur in sleep cycle 2. Can be significant for the presence of fetal hypoxia or acidosis 3. Associated with low Apgar scores and acidosis 4. Less than 0 – 5 bpm 5. Causes: a. Maternal: i. Supine hypotension ii. Cord compression iii. Uterine tachysystole iv. Drugs 1. Illicit drugs 2. alcohol b. Fetal: i. Fetal sleep ii. prematurity 6. Medical Management: a. Consider AROM to place FSE b. Manage cause c. Consider delivery
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  • Spring '10
  • samuels
  • Obstetrics, Fetal Growth, fetal movement, fetal heart, fetal lung maturity

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