Page 209 - كتاب تمريض نسا الاكتروني

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5) Kocher's forceps
Procedure:
1-Hand washing
2-Keep the privacy

3- Facing the mother
4- Explain the procedure 

5- Ask the patient to undress completely and put on a hospital gown and lie on labor
bed with her feet separated and knee flexed as for pelvic exam
* If the amniotic sac still intact, the doctor use Kocher and rupture the membranes but
we should make sure that there is cervical dilatation through PV to insert the sensors.

* tell the women that she will feel worm water in vagina
* the nurse will insert the fetus electrodes on fetal scalp. The nurse should avoid apply
the electrodes on fontanelle or gentile area.

*the nurse will insert the other catheter "intra uterine pressure catheter. * Fix the
electrodes around the thigh with a bond.
* Observe fetal heart rate and Record.

Nursing responses to non-reassuring fetal heart rate patterns

• Stop oxytocin or other uterine stimulants. Tocolytic such as terbutaline may be
ordered.
• Reposition the woman, avoiding the supine position for patterns/ cord compression -

Repositioning of ten improves other non-reassuring patterns as well.
• Increase the rate of perfusion of a non-additive iv fluid. - To expand the mother's

blood volume and improve placental perfusion.
• Administer oxygen by facemask at 8 to 10 L/min to increase maternal blood oxygen
saturation, making more oxygen available to the fetus. 44 Fetal monitoring - Maternal

pulse oximetry, available on many fetal monitors, allows ongoing assessment of
maternal oxygen saturation and documentation on the strip if the information is crucial.

• Consider starting continuous internal devices. - If no contraindication exists.
• Notify the physician or ask another nurse to notify Report and document the
following. - The pattern that as ID'd

• Nursing interventions taken in response to the pattern - The fetal response after
nursing intervention Response of doctor or other response.

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