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n No conflicts to report
n Subjective at times
n May be difficult to reach consensus
1. Zero
2. 0 – 2 bpm
3. Less than 5 bpm
4. Undetectable
Minimal FHRV + Recurrent Late
Decels:
n 1. Category I
n 2. Category II
n 3. Category III
Define Fetal Tachycardia
n Indicator
of infant neurological outcome
n Moderate: no hypoxia/acidosis
n Or
if UC intensity less than 25 mm Hg
above baseline
Ripening Agents
n Oxytocin
receptors increase in uterine
myometrium throughout pregnancy and
labor
Nursing Assessments
n Current guidelines ~
n 1:2 for ripening with pharmacologic tx
n 1:1 nurse/patient ratio for oxytocin
induction or augmentation
If…
n Infusionshould be discontinued
n Subsequent doses of misoprostol
delayed
Continued Oxytocin Increases
n Resolving oxytocin-induced
tachysystole
n Oxytocin D/C: resolution in 14.2 mins
n Oxytocin D/C + 500 cc LR IV fluid bolus:
resolution in 9.8 mins
n Oxytocin D/C + 500 cc LR bolus +
change to lateral position: resolution in
6.1 mins
Resume Pit Only After
Tachysystole Resolved
n If oxytocin discontinued less than 20 - 30
mins, may restart at half previous rate if EFM
reassuring
n Discontinue pit
n Lateral position
n IV bolus, 500 cc LR
n Possible oxygen until FHR normal
n Possible 0.25 mg terbutaline SQ
Cord Blood Gases
n Adopt
reference - based values for
normal
EFM Associations/Cord Gases
n mketner@Wakehealth.edu