[sweetcheekers]

I'm orienting to L & D and have taken a class in fetal monitoring. I've been working with a L & D nurse in our unit taking care of labor patients for the past couple of weeks. The problem is that yesterday I had a decel at the end of my strip, mom was about 9 cm and delivered about 19 minutes later. There was a late and then a couple minutes later a decel that was shaped like a U and mirrored the contraction. One nurse told me it was a variable and another said it was an early. How do I decipher? I thought variables tended to be shaped like a V and I believed that earlies began before the contraction. This one was a mirror of the contraction. HELP! Differing opions among my experienced co-workers is not helping to build my confidence.

[JaneyW]

Time and further experience and classes will help build your confidence. Earlies mirror the UC. Lates start after the UC and reach their lowest point after the apex of the UC. I will often use my pen to see where the tops of each really are in relation to each other. Variables can be of many different sizes, lengths and depths, but start with an abrupt descent from the baseline (V-shaped, you're correct!). That being said, you can bring a strip to ten different people and get ten different interpretations. Even the "experts" differ on their opinion of terminology and efforts to make it more uniform.

Now is the time to get the basics down and get experience. After a while, you will notice certain patterns that make you think certain things (fast descent of head, nuchal cord, etc). L&D is a constant learning experience. Good Luck!

[SmilingBluEyes]

Moved to the OB forum for more help.

[babyktchr]

With the NICHD nomenclature, a variable is a variable is a variable, no matter what the timing. So if you see a V, U, or W with contraction, after or otherwise..it is a variable. Its all a matter of looking at physiology, and you will acquire more expertise as you walk further down the path of OB and strip reading.

[nrse4evr]

Best advise: Treat the pt not the numbers!
One of anything is nothing! Look at the strip as a whole not as individual decels or accels. Think about what is happening to your baby and can he or she tolerate the incident. Will my baby deliver soon? Am I remote from delivery and this is a consistant pattern? Is my baby sleelping? What is Mom's position?
L and D is about more that just reading fetal monitor strips. That's a VERY important part but just a Part.
Good Luck on your L and D nursing. I've been doing it for 30 years and LOVE IT!!!!!!!!!

[SmilingBluEyes]

great post nrse4ever!!!!! Welcome to allnurses.com and our forum.