Antepartal_Fetal_Assessment_2012
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Transcript Antepartal_Fetal_Assessment_2012
Introduction
http://www.youtube.com/watch?v=nja-
UB7WnHs&feature=related
ANTEPARTAL FETAL
ASSESSMENT
Developed by
D. Ann Currie, R.N.,M.S.N.
2012
ANTEPARTAL FETAL ASSESSMENT
TERMINOLOGY
ULTRASOUND
LABORATORY TESTS
FETAL MOVEMENT COUNT
BIOPHYSICAL PROFILE-(BPP)
NONSTRESS TEST-(NST)
CONTRACTION STRESS TEST-(CST)
ANTEPARTAL FETAL ASSESSMENT
AMNIOTIC FLUID INDEX-(AFI)
DOPPLER FLOW STUDIES
PLACENTA LOCATION &GRADING
AMNIOCENTESIS
CHORIONIC VILLUS SAMPLING-(CVS)
PERCUTANEOUS UMBILICAL BLOOD SAMPLING-
(PUBS)
ANTEPARTAL FETAL ASSESSMENT
FETOSCOPY
FETAL FIBRONECTIN
OTHER
NURSE’S ROLE WITH ANTEPARTAL
FETAL ASSESSMENT
KNOWLEDGE OF THE TESTS :
INDICATIONS/USES OF TEST
MEANING OF THE RESULTS OF THE TEST
HOW PROCEDURE IS DONE.
WHAT TO PREPARE PRIOR TO TEST
WHAT TO DO DURING &AFTER TEST
NURSE’S ROLE
RISKS/COMPLICATIONS
WHEN TEST WILL BE PREFORMED DURING
PREGNANCY
CLIENT EDUCATION
CLIENT ADVOCATE
SUPPORT CLIENT
ULTRASOUND
WHAT IS AN ULTRASOUND? & HOW DOES IT
WORK?
TYPES-TRANSVAGINAL & TRANSABDOMINAL
USES
NURSE’S ROLE WITH ULTRASOUND
ULTRASOUND
DX TEST
USES HIGH FREQUENCY SOUND WAVES
EXCEEDING 20,000 CYCLES PER SECOND TO
PRODUCE AN IMAGE.US USES A TRANSDUCER TO
TURN SOUND WAVES INTO AN ELECTRONICAL
SIGNAL
SONOGRAM
Ultrasound
ULTRASOUND-INDICATIONS
AND/OR USES
POSITIVE DX OF
MULTIPLE
PREGNANCY
GESTATIONAL AGE
VIABILITY
FETAL GROWTH
FETAL
PRESENTATION
GESTATIONS
BPP
WITH
AMNIOCENTESIS,
CVS,or PUBS.
AFI
PLACENTA GRADING
CONT.ULTRASOUND
DX OF ETOPIC
PREGNANCY,
HYDATIDIFORM
MOLE,FETAL
ANOMALY, UTERINE
ANOMALY,CAUSE OF
VAGINAL BLEEDING
OTHER
NURSE’S ROLE WITH ULTRASOUND
KNOW THE
ASSESSMENT OF
PROCEDURE AND
PURPOSE
CLIENT EDUCATION
CLIENT ADVOCATE
ANSWER
QUESTIONS AND
CONCERNS
CLIENT
PREPARATION OF
CLIENT
SUPPORT
LABORATORY TESTS
ALPHA-
FETAL FIBRONECTIN
FETOPROTEIN
MATERNAL SERUM
ALPHAFETOPROTEIN(MSAFP)
Quad SCREENINGMSAFP,HCG ,
diametric inhibin-A,
&ESTRIOL
L/S RATIO
PHOSPHATIDYL-
GLYEROL-(PG)
AMNIOCENTSIS
SAMPLE STUDIES
GENETIC STUDIES
FETAL MOVEMENT COUNT
NONVASIVE
COST-EFFECTIVE
CAN BE USED IN FETAL SURVEILLANCE IN LOW
RISK & HIGH RISK PREGNANCIES..
DONE BY CLIENT
DOCUMENT BY USE OF A LOG
FETAL MOVEMENT COUNT
SEVERAL METHODS- CARDIFF METHOD , DAILY
FETAL MOVEMENT RECORD (DFMR),or OTHER.
NURSE’S ROLE IN DFMC.
BIOPHYSICAL PROFILE
FETAL HEART RATE
FETAL MOVEMENT
FETAL BREATHING
FETAL TONE
AMNIOTIC FLUID INDEX/VOLUME
PLACENTA GRADING
(BPP)
NONSTRESS
NST
DX TEST DONE WITH EXTERNAL ELECTRIC FETAL
MONITOR
FHR ACCELERATIONS WITH FM
REACTIVE STRIP-REASSURING-15-20 BEAT
ACCELERATION IN FHR ABOVE BASELINE WITH
FM.FHR-110-160@BASELINE,AVE VARIBILITY.
Reactive NST
NST
NONREACTIVE STRIP-NONREASSURING-NO
ACCELERATIONS WITH FM,ABSENT OR MINIMAL
VARIBILITY.
CAN BE USED IN PRETERM PREGNANCIES.
CAN BE DONE OUTPATIENT OR CLINICS.
Nonreactive NST
CONTRACTION STRESS TESTCST
DONE WITH EXTERNAL FETAL MONITOR &
STIMULATION OF UTERUS BY VARIOUS
METHODS.
POSITIVE TEST- NONREASSURING3 UC IN 10
MIN. PERIOD, LATE DECELERATIONS WITH UC,
NO ACCELERATIONS OF FHR WITH UC OR FM,
ABSENT OR MIN VARIABLITY
Positive CST- Nonreassuring
FHR Pattern
CST
NEGATIVE TEST-REASSURING-NO LATE
DECELERATIONS WITH UC, FHR 110-160, AVE.
VARIABILITY,& FHR ACCELERATIONS WITH FM
AND UC.
USUALLY DONE IN HOSPITAL.
MAY CAUSE LABOR.
Negative CST
AMNIOCENTESIS
INVASIVE PROCEDURE USED TO DX GENETIC
,CHROMOSOMAL , OR BIOCHEMICAL
PROBLEMS,OR LUNG MATURITY.
DONE WITH US.
STERILE TECHNIQUE USED.
RISKS/SIDE EFFECYS
NURSE’S ROLE.
Aminocentesis
CHORIONIC VILLUS SAMPLINGCVS
INVASIVE PROCEDURE DONE WITH US.
USED TO DX GENETIC,METABOLIC,& DNA
ABNORMALITIES
1ST TRIMESTER
RISKS
NURSE’S ROLE
Chorioic Villus Sampling-CVS vs
Aminocentesis
PERCUTANEOUS UMBILICAL
BLOOD SAMPLING-PUBS
INVASIVE PROCEDURE DONE WITH US TO
OBTAIN FETAL BLOOD.
USED TO DX VARIOUS CONDITIONS.
RISKS
NURSE’S ROLE.
FETOSCOPY
INVASIVE PROCEDURE USED TO DIRECTLY
OBSERVE FETUS AND/OR OBTAIN BLOOD OR
SKIN SAMPLES. ALSO SOME SURGERIES CAN BE
DONE /
RISKS
NURSE’S ROLE
OTHER
QUESTIONS
THANK YOU
http://www.youtube.com/watch?v=UPPbnB5Gs4s&fea
ture=related