External Fetal Monitoring (Nursing)

00:01 So when we think about monitoring, the first thing we have to do is sort of gather our equipment, We have got to have all the elements that we need in order to make that work.

00:09 So what equipment is it that we need? Let's look at the graphic and talk it through.

00:14 The first thing you're going to grab is the transducer, so this is a device that's very similar to the handheld Dopplers you might have used in cardiovascular nursing.

00:24 So you're going to grab the transducer, you're going to do Leopold to figure out where the baby's back is located.

00:31 You're going to apply gel and you're going to place the transducer on the abdomen.

00:36 The transducer is going to pick up the fetal heart tones, so the rate, the heartbeat.

00:42 The next thing you want to grab is the tocodynamometer.

00:46 That's actually going to go on the fundus of the uterus, so you want to palpate the uterus through a contraction, and the area where it feels the hardest is where you're going to place that device and as you'll see, if you turn the tocodynamometer over, you're going to see a button, and that button is actually pressed when the uterus contacts which is going to give us a read on the graph paper.

01:09 The next thing we're going to grab are monitor belts, because you're going to need those to actually hold the transducer and the toco in place.

01:17 So depending on the unit, the belt's actually going to look a little bit different, so you're going to have to ask the other nurses how it's set up, but we're going to need the belt in order to hold the devices in place.

01:28 You're going to have some sort of machine that you're going to plug the toco and the transducer into in order to receive the electrical stimulation and make a graph, so the fetal monitor itself may actually be very large and sit in the cabinet, or it may be small as this one is depicted in the graphic.

01:47 The output is going to come in two forms.

01:49 One, might be on the computer screen where you'll both be able to see both the contractions and the fetal heart rate; and you'll also possibly have paper that comes out of the machine, that you can actually take with you in order to record the information or to save for the chart.

02:05 Now most of the time we use electronic medical records so most of this information is transmitted directly into the computer and we don't really use graph paper.

02:15 But sometimes in certain clinics or outpatient setting, you may find the paper is still used and kept as a part of the permanent patient record.