Fetal Monitoring: In a Nutshell (Nursing)

00:01 Alright, so now we're going to review. So hopefully you're still with me.

00:05 Here we go.

00:06 The NICHD Guidelines determine what we use in our nomenclature in our categories for all of our fetal heart rate monitoring.

00:15 The normal fetal heart rate is 110 to 160.

00:18 Moderate variability includes the fluctuation of the heart rate 5 to 25 beats from the baseline.

00:25 Accelerations for a fetus that's greater than 32-weeks must be 15 beats above the baseline for 15 seconds.

00:33 For a fetus that's less than 32-weeks, it would just need to beat 10-beats for ten seconds.

00:38 Early and late decelerations are periodic changes, meaning they happen with the contractions.

00:44 Early deceleration are normal and really require no intervention except making sure the baby is not getting ready to come out.

00:52 Variable decelerations are episodic changes meaning they can occur with or without a contraction.

00:58 Late and variable decelerations are abnormal fetal heart rate patterns and they require intervention, so we can start with repositioning the client but we definitely need to intervene.

01:10 Research has actually shown us that for low risk clients intermittent auscultation is actually okay so we don't have to hook the client up to all those belts, we can just listen with a Doppler just as we would during an antepartum visit.

01:24 We would still chart the with the same frequency but we can use intermittent auscultation rather than having the discomfort of the belts.

01:30 And then, always remember that our first response to any abnormal strip, whether it's variability that's minimal or bradycardia or lates or anything, it's always, always, always going to be airway or reposition the client.

01:45 There we go, you did it.