question

[sweetieann]

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]

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]

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]

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.