Nursing care of child Bearing Families Session 4:

Accelerations are always good

  • at least 15 bpm increase and at least 15 second duration

Decelerations

  • early
    • gradual onset
      • time it takes to go from baseline to nadir (bottom) is at least 30 seconds
    • Gradual return to baseline
    • can be OK
    • on time with contractions, and head compression (not and issue)
  • Late
    • Gradual onset
    • after a contraction (timing is late) resolves after contraction has ended.
    • associated with lack of blood flow to the baby from the placenta.
      • placental insufficiency
  • Variable
    • Abrupt onset
      • less than 30 seconds from baseline to the nadir
    • From cord compression
  • Prolonged deceleration
    • longer than 2 minutes and less than 10
    • decrease of at least 15 bpm

Category 1

  • Baseline rate: 110-160 bpm.
  • Baseline FHR variability: moderate
  • Late or variable decelerations: absent
  • Early decelerations: present or absent
  • Accelerations: present or absent

Category 2

  • Not 1 or 3

Category 3

  • Absent baseline FHR variability and any of the following: –
    • Recurrent late decelerations
    • Recurrent variable decelerations
    • Bradycardia
  • OR just
  • Sinusoidal pattern

Labor and delivery

Secondary powers

  • physiologic pushing
    • grunting
    • more O2 throughout mom and baby
    • may take more time
    • cannot feel this Ferguson’s reflex when on an epidural
  • Closed glottis pushing
    • Take a deep breath and push
    • less O2 throught

effacement is the thinning of the cervix

dilation is the opening of the cervix

                         

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