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Nursing: Intervention In Pregnancy And Delivery

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Nursing: Intervention In Pregnancy And Delivery Question: Discuss about the Report on Nursing for Intervention in Pregnancy and Delivery?   Answer: What Risk Factors Are Present That May Impact The Way This Fetus Tolerates Labor? For Renee who has Hypertension issue, precautions should be in place for her condition as regulating pressure is imperative to save her kidney, liver, brain and such organs from damage. Also, if the pressure rises too much there is a likelihood of the Placenta separating from the wall of the Uterus (“Fetal Compromise (Acute): Management If Suspected”, 2016). The thick meconium staining is characteristic of Fetal Compromise but the other dissociating factors like stable baseline and presence of accelerations spell safety. So, primary effort should be at maintaining Renee’s Blood Pressure. The fetal heart rate shows a rate of 140, moderate variability, no accelerations, and decelerations to 120 beginning after the peak of most contractions and recovering to baseline 30 seconds after the contraction ends. Contractions are every 4 minutes. How should the nurse describe this pattern? (I suggest drawing this out on a piece of paper to really “see” it) The Fetal Heart rate adheres to the Baseline and the Fetal Heart Rate shows Late Decelerations. What should the nurse do at this point? The nurse should also give Renee oxygen if needed. It is imperative to intimae these findings to physician document in chart. The nurse should be alert and ready to monitor in case of further FHR changes (Van Leeuwen, et. al., 2013). Maternal position must be maintained on left side. There should be efforts to provide good hydration with saline fluids In case oxytocin is being administered it must be discontinued in such a situation.  One more effort is the administering of oxygen at 7–10 L/min with the help of a face mask. Renee is now 8 cm/100%/0 station. She is in the left lateral position with oxygen at 8 L/min. The fetal heart rate is 145. There is moderate variability. Accelerations are not present. There are decelerations in the fetal heart rate beginning at the onset of a contraction, descending to 120 with recovery by the end of a contraction. The contractions are every 3 minutes now. How would the nurse describe the fetal heart rate pattern now? This condition is termed as is Sinusoidal pattern (Hotelling, 2007) Renee is now completely dilated and +1 station. She has been instructed to push with every contraction. The fetal heart rate is now 164. There is absent variability and decelerations to 120 are occurring with maternal pushing that do not resolve until 30 seconds after the contraction. The contractions are every 1½ minutes. What should the nurse do in this situation? The Nurse should assist in the delivery process by using techniques for Fetal Stimulation. (Van Leeuwen, et. al., 2013)   References: Fetal Compromise (Acute): Management If Suspected. (2016), 1-305. Hotelling, B. (2007). High-Touch Nursing Care During Labor. Birth, 34(3), 271-272. Van Leeuwen, P., Cysarz, D., Edelhauser, F., & Gronemeyer, D. (2013). Heart rate variability in the individual fetus. Autonomic Neuroscience, 178(1-2), 24-28.

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