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Electronic Fetal Monitoring

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What is the normal FHR
120-160 BPM
How is the Baseline FHR determined
By reading a minimum of a 10 min. strip and analyzing the FHR between contractions
What is considered fetal bradycardia
A fetal heart rate below 120 BPM for at least 10 min.
What are some causes of fetal bradycardia
maternal hypotension, umbilical cord compression, drugs, fetal congenital heart block, fetal hypoxia
What is considered fetal tachycardia
FHR above 160 BPM for at least 10 min.
What are some causes of fetal tachycardia
maternal fever, drugs, fetal arrhythmia, fetal hypoxia
Variability
The differing rhythmicity in FHR over time. Shows up as a slight jitter in the wave.
Does variability indicate a reassuring or non-reassurung FHR pattern.
Reassuring
Variability is considered to be one of the most reliable indicators of fetal-well being.
TRUE
Periodic changes are
Fluctuations in response to contractions or fetal activity.
Accelerations
Temporary NORMAL increases in FHR usually due to fetal movement.
Variable DECELS
Shaped like U, V, or W, but often not consistent in shape. Caused by cord compression. FHR drops suddenly from baseline and often returns abruptly to baseline. MOST COMMON.
What are the Nursing Interventions for variable DECELS?
Position change, Oxygen, bolus of IV fluids, and close monitoring
Early decelerations
Look uniform in shape, resembling inverted uterine contractions. They are caused by head compression., are of short duration and considered benign.
Late Decels
FHR still down after contractionis over, slow return to baseline. Caused by uteroplacental insufficiency. Pattern is OMINOUS and requires IMMEDIATE INTERVENTION.
Interventions for late DECELS
Position change (left side usually best), oxygen, bolus of IV fluids, DC pitocin if running, notify MD, prepare for possible C-section, continue to monitor closely.

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