Nursing student curious about FHR decels and monitoring?

[mille173]

I am a nursing student currently working on a L&D unit and I would like to learn more about early and lates when it comes to the fetal heart rate. I would like to learn as much as possible about decels and such.

[CEG]

Google "NICHD Fetal Monitoring Teminology" for an article released last fall and get your textbook. Between the the article from NICHD and your text you should be able to sort out a lot.

[nicoleRN831]

I remembered VEAL CHOP in school for what the decelerations meant

Variable Decelerations------- Cord Compression

Early Decelerations------ Head Compression

Accelerations------ Ok

Late Decelerations-------- Placental Insufficiency

[LouisVRN, RN]

I remembered VEAL CHOP in school for what the decelerations meant

Variable Decelerations------- Cord Compression

Early Decelerations------ Head Compression

Accelerations------ Ok

Late Decelerations-------- Placental Insufficiency

That's an interesting way to remember it! I always learned for variable decels you mainly want to try repositioning mom to see if that helps, early decels pretty much the same thing, although they are sometimes not preventable. Accelerations are an indicator of fetal well being and late decels indicate that the baby is in trouble, and you want to try to put o2 on mom, have her reposition and if that doesnt work prepare for an emergency delivery. Although I've been out of school for over 2 years and work med-surg.

[babyktchr, BSN, RN]

Late decels don't necessarily mean the baby is in trouble, but that the placenta isn't doing what it is supposed to be at that moment. If there is good variability with the late decels, then you want to identify your differential diagnosis....for instance, what is your mom's BP? what is her position..is she lying flat? Lates do not always need oxygen....sometimes just getting her off her back is enough to perfuse that placenta again. When lates are associated with decreased/absent variability it is much more of an ominous sign. Your baby is telling you via the variability that its oxygenation is compromised and the lates are a reaction to that and decreased placental perfusion. If you cannot resolve this, then an birthday sooner than later is prudent. You really have to look at the big picture when dealing with decels of any kind. Just looking at the decel alone will not give you what you need to act. Always look at variability to determine your oxygenation status along with your decel.

AWHONN Fetal Heart Rate Monitoring Principles and Practices textbook is an excellent resource for learning this subject. It is easy to read and does a fine job of teaching this. Your OB unit should have one, or you can buy one from the AWHONN website.

[cnmbfa]

If you are seripous about working in OB, take the AWHONN Fetal monitoring course online. It is excellent, and meets the standards for OB nursing nationwide. There is way too much to this to respond well in a post.

Here is a cheaper aleternative: order the Fetal Monitoring CD program for ~$40 form the Wiscosnins Association for Perinatal care. Web address is www.perinatalweb.org.

[mille173]

Thank you all very much for all the helpful information. The textbook doesn't give you all the little hints that you all have become aware of. Thanks again.

[SmilingBluEyes]

ONLY EXPERIENCE will offer you more complete insight to the little hints and details...it takes several years' experience before you are truly highly competent in FHM and all its ins and outs.