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1st Lecture High Risk Prenatal Client NCM102
1st Lecture High Risk Prenatal Client NCM102
Diagnostic Tests
1.
Transvaginal Ultrasound:
Transabdominal Ultrasound:
Ultrasonography
EMPTY BLADDER
FULL BLADDER
A. Transvaginal Ultrasound
Uses a probe inserted into the vagina
Used to visualize the baby
Used for placental grading
Instruct client to VOID FIRST
B. Transabdominal Ultrasound
The transducer is moved across the womans abdomen
Instruct client to HAVE A FULL BLADDER
Nursing Responsibility~
Inform~
Provide COMFORT and PRIVACY
2.
Gastroschisis
Amniocentesis
Done when in 15 17 weeks of gestation
Aspirates 20mL of fluid from the amnion of the mother
Instruct mother to INCREASE oral fluid~
Use of Amniocentesis
Early Pregnancy
1. Identifies chromosomal abnormalities
Late Pregnancy
1. Identifies severity of maternal fetal
blood incompatibility and assesses fetal
lung maturity
20 Weeks
FULL BLADDER
Contraction Test
Means of evaluating the respiratory function of the placenta
Use:
Identifies the fetus at risk for intrauterine asphyxia by observing the response
of the FHR to the stress of the uterine contractions (spontaneous or induced)
Perform Nipple Rolling
Interpretation:
A. Negative (GOOD!! )
Shows 3 contraction of good quality lasting for 40 / more secs on 10 minutes
WITHOUT EVIDENCE OF FETAL HR DECELERATION
Implication: Fetus can handle the hypoxic stress of uterine contractions
B. Positive (BAD!! )
Shows repetitive persistent late decelerations with more than 500 of the
contractions
Implication: The hypoxic stress of the uterine contraction causes slowing of
the FHR DONE in LATE PREGNANCY
C. Equivocal / Suspicious
Shows non-persistent late deceleration or decelerations associated with
hyperstimulation
Nursing Responsibility
Explain!
Semi-fowlers!
Assess and monitor!
7
Biophysical Profile
I.
FHR and Reactivity (NST)
II.
Fetal Breathing, Movement
III.
Fetal Body Movements
IV.
Fetal Tone (Closure of the hand)
V.
Volume of amniotic fluid (AFI)
Biophysical profile is used to check the CNS function of the FETUS~
Use:
o
o
o
Observation
1.
Non-Stress Test
2.
Fetal Breathing
Movement
Abnormal (0 pts)
Non-reactive
Breathing period less than 60
seconds or no breathing observed
3.
4.
5.
Scoring:
8 10: Maximal score
0 4: Severe fetal compromise; delivery indicated