Excessive intrauterine pressure is a likely cause of increased fluid absorption. From: Hysteroscopy, 2009 A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused bywhat?NarcoticsBarbiturates→ MethamphetaminesTranquilizersThe use of illicit drugs such as cocaine or methamphetamines might cause increased variability. Maternal ingestion ofnarcotics may be the cause of decreased variability. The use of barbiturates may also result in a significant decreasein variability, because these are known to cross the placental barrier. Tranquilizer use is a possible cause ofdecreased variability in the fetal heart rate. Which of the following FHR tracing characteristics are considered reassuring or normal (category I)? Get answer to your question and much more pp. 423-424Which device should the nurse use for monitoring the intensity of uterine contractions (UCs) in a pregnant client? Get answer to your question and much more p. 414The nurse notes variable fetal heart rate (FHR) decelerations while monitoring the fetal heart rate of a patient. Whatcauses variable decelerations? Get answer to your question and much more Cardiotocography (CTG) is a technical means of recording (-graphy) the fetal heartbeat (cardio-) and the uterine contractions (-toco-) during pregnancy, typically in the third trimester. The machine used to perform the monitoring is called a cardiotocograph, more commonly known as an electronic fetal monitor. CTG can be used to identify signs of fetal distress. MethodSimultaneous recordings are performed by two separate transducers, one for the measurement of the fetal heart rate and a second one for the uterine contractions. Transducers may be either external or internal. External measurement means strapping the two transducers to the abdominal wall
Internal monitoring differs from external monitoring.
A fetal scalp electrode is a small, circular, corkscrew-shaped needle attached to a coated wire. The clip is covered with a long, protective, flexible, plastic covering and guided up through the mother’s vagina by the caregiver doing an internal examination. The needle is gently rotated into the SKIN on the baby’s scalp. Once the clip is attached, the plastic cover is removed, leaving just the wire. The fetal scalp clip has 2 coloured wires attached. The wires are connected to the lead with a small conducting device (about the size of a match-box), strapped to the woman’s thigh. The lead is then plugged into the monitor and a typical CTG reading is printed on paper and/or stored on a computer for later reference. Use of CTG and a computer network allows continual remote surveillance: a single nurse, midwife, or physician can watch the CTG traces of multiple patients simultaneously, via a computer station. This procedure should not be any more uncomfortable than a normal vaginal examination. The internal electrode monitors the baby’s heart rate more accurately than an external Doppler. Internal measurement requires a certain degree of cervical dilatation and the waters need to be broken to attach an FSE to the baby’s head. If they are not already broken, this will need to be done to allow the electrode to be attached. Women who carry the Herpes, Hepatitis B or C or HIV viruses are recommended not to have internal monitoring, because it can increase the baby’s chances of becoming infected with these viruses. InterpretationCardiotocography is used to monitor several different measures:
A typical CTG output for a woman not in labour. A: Fetal heartbeat; B: Indicator showing movements felt by mother (caused by pressing a button); C: Fetal movement; D: Uterine contractions Uterine contractions – They are quantified as the number of contractions present in a 10 min period and averaged over 30 min.
Baseline heart rate – average baseline fetal heart rate
Variability – Fluctuations in the fetal heart rate
Decreased variability may occur in the following situations:
AccelerationsIncreases in fetal heart rate from the baseline by at least 15 beats per minute, lasting for at least 15 seconds and should be 2 accelerations every 20 minutes lasting no longer than 2 minutes.
DecelerationsDecreases in fetal heart rate from the baseline by at least 15 beats per minute, lasting for at least 15 seconds There are three types of decelerations, depending on their relationship with uterine contraction:
Significance
Reasons to monitor the baby’s heart rate can include:
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