question

Specialties Ob/Gyn

Published

I'm studying for the NCLEX and I came across an LD concept I'm not sure about, and was hoping someone could help me:)

I know you can only use internal fetal heart rate montoring once the membranes have broke. But I know that digital exams are to be avoided d/t risk of infection...is internal FHR monitoring often contraindicated also due to risk of infection? Or does the benefit of this monitoring sometimes outweight the risk? I'm a little confused...

Thanks for any help!

NPinWCH

374 Posts

Specializes in Family NP, OB Nursing.

Basically the answer to all your questions is, Yes. I won't use internals unless I have to, because of the increased infection risk, but sometimes you have to. If the pt is obese, or the baby is in a position that makes external monitoring difficult, or the pt wishes to change positions AND the baby must remain monitored then internal monitors are beneficial.

htrn

379 Posts

I know docs are pretty reluctant to use them if mom is GBS + and I think it is absolutely contraindicated if mom has herpes.

strn96

59 Posts

Internal monitors should only be used when the benefits outweigh the risk, and are contraindicated if mom has HIV, Hepatitis, Herpes, etc, and used with caution with a GBS+ pt because they increase the infant's exposure to mom's disease.

As previously stated, there are situations where they are beneficial, especially when -for whatever reason- external monitoring is not adequate.

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