Question

1. What signs are possible indicators of increasing fetal distress?

3. Identify conditions that might cause a sudden, prolonged deceleration.

4. Identify three interventions that a nurse should implement in the event of cord compression.

5. Discuss the differences between late decelerations and variable decelerations.

6. What is the significance of the Apgar score in determining neonatal status?

7. What nursing actions should be implemented to support a newborn exhibiting signs of distress? What actions should be taken to support the newborn’s family?

8. Interpret the strip below noting the baseline FHR, Variability, and Decelerations, and if there are any uterine contractions.

Answer 1

¤The possible signs of increasing fetal distress are

• A change in fetal heart rate either tachycardia or bradycardia
• The changes can be seen in the deceleration like variable deceleration or late deceleration
• There can be decreased movement in the fetus
• Abnormal vaginal bleeding

¤Some of the cause of prolonged deceleration are

• Placental abnormality like abruptio placenta
• Rupture of uterus
• Hypoxia
• Prolapse of cord or coed prolapse
• Maternal hypotention
• Abnormal uterine contractions

¤The three intervention which the nurse has to implement are

• Provide the mother left lateral position or side lying position with head low
• Lift the head of the fetus to prevent compression
• Administration of oxygen to prevent any hypoxia or anoxia

¤The difference between late deceleration and variable deceleration are

Late deceleration	Variable deceleration
They are regular with smooth dips Happen due decrease in oxygen supply	The waves are often very irregular . The dips are usually jagged Happen if there is compression of cord It can be seen before the delivery if the fetus /baby

¤The importance of Agar score are

• During the first minute it can help to identify how the baby as accepted the process of birth
• The fifth minute reveals whether the baby has accustomed to external environment after birth .
• It can help to assess the neurological status of the newborn
• The fetus to neonatal state can be ruled out in regards to its transition
• In simple the overall health status of the newborn can be identified

¤The following nursing actions has to be taken to address newborn with distress

• Administer oxygen
• Place the baby in incubator as per order
• Monitor vital signs and oxygen saturation
• Support the mother and family psychologically
• Reveal the truth and be genuine without hiding things because in future if there is any consequences it can be a legal issues. Simultaneously it can relieve tension in the family and get them prepared themselves knowing about the newborn