In most cases the onset nadir and recovery of the deceleration usually occurs

In most cases the onset nadir and recovery of the

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deceleration occurs after the peak of the contraction. In most cases the onset, nadir, and recovery of the deceleration usually occurs after the respective onset peak, and end of UC. o prolonged deceleration " visually apparent abrupt decrease in FHR below baseline that is 15 bpm lasting 2 minutes but 10 minutes o sinusoidal pattern " having a visually apparent smooth sine-like wave like undulating pattern in FHR baseline with a cycle frequency of 3-5/min that persists for to 20 minutes ! tachycardia " baseline FHR of > 160 bpm lasting 10 minutes or longer ! bradycardia " baseline FHR of <110 bpm lasting for 10 minutes or longer ! normal FHR " FHR pattern that reflects a favorable physiological response to the maternal fetal environment ! abnormal FHR " FHR pattern that reflects an unfavorable physiological response to the maternal fetal environment Modes or types of fetal and uterine monitoring
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7 ! auscultation o use of fetoscope/Doppler to hear the FHR by externally listening without the use of a paper recorder o fetoscope " allows practitioner to hear sounds associated with opening/closing of ventricular valves via bone conduction o Doppler " uses ultrasound technology, using sound waves deflected from fetal heart movements # Converts information into a sound that represents cardiac events ! palpation of contractions o assesses for frequency, tone, duration, intensity o nurse places fingertips on the fundus of uterus and assess for degree of tension as contractions occur o intensity of contractions is measured at peak of the contraction # mild or 1+ feels like tip of nose (easily indented) # moderate or 2+ feels like chin (can slightly indent) # strong or 3+ feels like forehead (cannot indent uterus) o resting tone is measured between contractions and listed as either soft or firm uterine tone ! external electronic fetal and uterine monitoring o uses ultrasound device to detect FHR and a pressure device to assess uterine activity o external EFM detects FHR baseline, variability, accelerations, decelerations o erratic FHR recordings or gaps on paper recorder may be due to inadequate conduction of US signal displacement of transducer, fetal/maternal movement, inadequate US gel, fetal arrhythmia o contractions are measured via tocodynamometer; cannot measure pressure/intensity o uses fetal scalp electrode/internal scalp electrode that is applied to presenting part of fetus to detect FHR o involves using intrauterine pressure catheter (IUPC) placed in the uterine cavity to directly measure uterine contractions o Contraindications " chorioamnionitis, active maternal genital herpes, HIV, conditions that preclude vaginal exams o May be used due to maternal obesity or lack of progress in labor when quantitative analysis of uterine activity is needed for clinical decision making; treat worsening category II tracing o Contractions are measured via an intrauterine pressure catheter " contractions measured in mm Hg o Peak pressure " maximum uterine pressure during a contraction measured with IUPC o Resting tone/baseline pressure "
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