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Introductionhttp://www.youtube.com/watch?v=nja-UB7W
nHs&feature=related
ANTEPARTAL FETAL ASSESSMENT
Developed by D. Ann Currie, R.N.,M.S.N.2012
ANTEPARTAL FETAL ASSESSMENTTERMINOLOGYULTRASOUNDLABORATORY TESTSFETAL MOVEMENT COUNTBIOPHYSICAL PROFILE-(BPP)NONSTRESS TEST-(NST)CONTRACTION STRESS TEST-(CST)
ANTEPARTAL FETAL ASSESSMENTAMNIOTIC FLUID INDEX-(AFI)DOPPLER FLOW STUDIESPLACENTA LOCATION &GRADINGAMNIOCENTESISCHORIONIC VILLUS SAMPLING-(CVS)PERCUTANEOUS UMBILICAL BLOOD
SAMPLING-(PUBS)
ANTEPARTAL FETAL ASSESSMENTFETOSCOPYFETAL FIBRONECTINOTHER
NURSE’S ROLE WITH ANTEPARTAL FETAL ASSESSMENT
KNOWLEDGE OF THE TESTS :INDICATIONS/USES OF TESTMEANING OF THE RESULTS OF THE TESTHOW PROCEDURE IS DONE.WHAT TO PREPARE PRIOR TO TESTWHAT TO DO DURING &AFTER TEST
NURSE’S ROLERISKS/COMPLICATIONSWHEN TEST WILL BE PREFORMED
DURING PREGNANCYCLIENT EDUCATIONCLIENT ADVOCATESUPPORT CLIENT
ULTRASOUNDWHAT IS AN ULTRASOUND? & HOW DOES
IT WORK?TYPES-TRANSVAGINAL &
TRANSABDOMINALUSESNURSE’S ROLE WITH ULTRASOUND
ULTRASOUNDDX TESTUSES 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 PREGNANCY
GESTATIONAL AGE
VIABILITYFETAL GROWTHFETAL
PRESENTATION
MULTIPLE GESTATIONS
BPPWITH
AMNIOCENTESIS, CVS,or PUBS.
AFIPLACENTA
GRADING
CONT.ULTRASOUNDDX OF ETOPIC
PREGNANCY, HYDATIDIFORM MOLE,FETAL ANOMALY, UTERINE ANOMALY,CAUSE OF VAGINAL BLEEDING
OTHER
NURSE’S ROLE WITH ULTRASOUNDKNOW THE
PROCEDURE AND PURPOSE
CLIENT EDUCATION
CLIENT ADVOCATE
ANSWER QUESTIONS AND CONCERNS
ASSESSMENT OF CLIENT
PREPARATION OF CLIENT
SUPPORT
LABORATORY TESTSALPHA-
FETOPROTEINMATERNAL
SERUM ALPHA- FETOPROTEIN-(MSAFP)
Quad SCREENING-MSAFP,HCG , diametric inhibin-A, &ESTRIOL
FETAL FIBRONECTIN
L/S RATIOPHOSPHATIDYL-
GLYEROL-(PG)AMNIOCENTSIS
SAMPLE STUDIESGENETIC
STUDIES
FETAL MOVEMENT COUNTNONVASIVECOST-EFFECTIVECAN BE USED IN FETAL SURVEILLANCE IN
LOW RISK & HIGH RISK PREGNANCIES..DONE BY CLIENTDOCUMENT BY USE OF A LOG
FETAL MOVEMENT COUNTSEVERAL METHODS- CARDIFF METHOD ,
DAILY FETAL MOVEMENT RECORD (DFMR),or OTHER.
NURSE’S ROLE IN DFMC.
BIOPHYSICAL PROFILE (BPP)FETAL HEART RATEFETAL MOVEMENTFETAL BREATHINGFETAL TONEAMNIOTIC FLUID INDEX/VOLUMEPLACENTA GRADING
NONSTRESS NSTDX TEST DONE WITH EXTERNAL ELECTRIC
FETAL MONITORFHR ACCELERATIONS WITH FMREACTIVE STRIP-REASSURING-15-20 BEAT
ACCELERATION IN FHR ABOVE BASELINE WITH FM.FHR-110-160@BASELINE,AVE VARIBILITY.
Reactive NST
NSTNONREACTIVE 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 TEST-CSTDONE WITH EXTERNAL FETAL MONITOR &
STIMULATION OF UTERUS BY VARIOUS METHODS.
POSITIVE TEST- NONREASSURING- 3 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
CSTNEGATIVE 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
AMNIOCENTESISINVASIVE PROCEDURE USED TO DX
GENETIC ,CHROMOSOMAL , OR BIOCHEMICAL PROBLEMS,OR LUNG MATURITY.
DONE WITH US.STERILE TECHNIQUE USED.RISKS/SIDE EFFECYSNURSE’S ROLE.
Aminocentesis
CHORIONIC VILLUS SAMPLING-CVS
INVASIVE PROCEDURE DONE WITH US.USED TO DX GENETIC,METABOLIC,& DNA
ABNORMALITIES1ST TRIMESTERRISKSNURSE’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.RISKSNURSE’S ROLE.
FETOSCOPYINVASIVE PROCEDURE USED TO DIRECTLY
OBSERVE FETUS AND/OR OBTAIN BLOOD OR SKIN SAMPLES. ALSO SOME SURGERIES CAN BE DONE /
RISKSNURSE’S ROLE
OTHER
QUESTIONS
THANK YOUhttp://www.youtube.com/watch?v=UPPbnB5
Gs4s&feature=related