Question

Janice, a 26-year-old G3P2, has been in labor for 5 hours and is 7 cm, 90% effaced, and +2 station. She has external fetal monitoring in place, which reveals a baseline fetal heart rate of 120 bpm, minimal variability, and occasional variable decelerations. Suddenly, as a contraction is beginning to subside, the fetal heart rate drops to a low of 80 bpm and has a slow return to the baseline 1 minute after the contraction has ended. (Learning Objectives 3 and 4)

A. What is happening to Janice’s baby at this point in time? What does this mean?

B. What role do you, as the nurse, play regarding fetal assessment and what interventions do you need to implement/recommend at this point in time?

Answer 1

1. Janice's baby is at distress. Fetal distress . Fading contractions may be due to uterine rupture and this leads to fetal distress.Fetal distress is used to express as intrauterine fetal  jeopardy as a result of fetal Hypoxia.
2. A nurse plays an important role for the well being of mother and baby during labor.fetal assessment primarily comprises of monitoring fetal heart rate and pattern. Color of amniotic fluid should be checked during rupture of membrane and it should be clear. fetal heart rate is an indicator of fetal oxygen saturation.

Interventions :

• monitor FHR
• Report to the concerned consultant and document.
• Administer oxygen to the mother and check her oxygen saturation.
• Reduce or discontinue Oxytocin according to the doctor's order, if its being administered.
• Administer IV fluid.
• Reassure the client.