51amnioinfusion refers to the addition of sterile

51.Amnioinfusion refers to the addition of sterile fuid to the amniotic fuid. Mrs. Cruz is scheduled for amnioinfusion after evaluation
through external fetal monitor. Her baby is having variable deceleration of FHR which shows cord compression. As the nurse
assigned to her, Nurse Lester correctly assisted the physician with the procedure when she does the following except:
A.helps prevent infecting the site by following the aseptic technique protocols of the institution
B.obtains the vital signs routinely, especially the temperature of the Mrs. Lauren
C. monitors the fetal heart rate and uterine contraction just once
D.none of the above
lOMoARcPSD|19566383
Downloaded by Christina Lyca Gaitero ([email protected])

MTTG. 2022
SEMINAR IN NURSING (REVIEWER)
ANSWER: C
RATIONALE: The nurse should help maintain strict aseptic technique during insertion and while caring for the catheter. The fetal heart
rate and uterine contraction should be continuously monitored. Monitor the temperature hourly to help ascertain if there already is an
infection. (Pilliteri Vol. 1, pp. 526-527)
Decelerations are temporary drops in the fetal heart rate. There are three basic types of decelerations: early decelerations,
late decelerations, and variable decelerations.
Early Decelerations: are seen when the baby's head is compressed. This often happens during the later stages of labor as the baby is
descending through the birth canal. They may also occur during early labor if the baby is premature or in a breech position, causing its
head to be squeezed by the uterus during contractions. Early decelerations have absolutely no clinical signifcance and are not harmful.
The nadir occurs with the peak of a contraction.
Late decelerations do not begin until the peak of a contraction or thereafter. They are smooth, shallow dips in heart rate that mirror the
shape of the contraction that is causing them. Onset of the deceleration occurs after the beginning of the contraction, and the nadir of
the contraction occurs after the peak of the contraction. Late decelerations are among the most worrisome form of heart rate patterns
because they usually signify a reduced oxygen supply to the baby.
 Management of Late Decelerations : These maneuvers are primarily intended to alleviate "reflex" lates.
 Place patient on side [23,24]
 Discontinue oxytocin.
 Correct any hypotension
 IV hydration.
 If decelerations are associated with tachysystole consider terbutaline 0.25 mg SC [26,27]
 Administer O2 by tight face mask [25, 40]
 If late decelerations persist for more than 30 minutes despite the above maneuvers, fetal scalp pH is indicated.
 Scalp pH > 7.25 is reassuring, pH 7.2-7.25 may be repeated in 30 minutes.
 Deliver for pH < 7.2 or minimal baseline variability with late or prolonged decelerations and inability to obtain fetal scalp pH
[28,29]
Variable Decelerations do not look like late or early decelerations. They are generally irregular, often jagged dips in the fetal heart rate
that look more dramatic than late decelerations. Variable decelerations are caused when the umbilical cord of the baby is temporarily
compressed. As a rule, variable decelerations are not worrisome. However, the baby does depend upon steady blood fow through the
umbilical cord to receive oxygen and other important nutrients. If variable decelerations are prolonged or repetitive, they can signify a
reduction of blood fow, which is harmful to the baby.
 Management of Variables
 Change position to where FHR pattern is most improved. Trendelenburg may be helpful.
 Discontinue oxytocin.
 Check for cord prolapse or imminent delivery by vaginal exam.
 Consider amnioinfusion[35-37]
 Administer 100% O2 by tight face mask [4].
Reference: