Page 78 - 2023 Elctronic Book (3) Normal Labor_Neat

* 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.

• If non reassuring pattern is severed, other staff members should be alerted to the
possibility of immediate delivery usually cesarean, unless operative vaginal birth is
possible and quicker. - Birth prep should include staff prepared for neonatal

resuscitation. 45 Fetal monitoring

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