Amniotomy may be contraindicated in the following situations: Known or suspected vasa previa. Contraction Stress Test (CST) By Nursing Lecture. by Holly BSN, RN | Jun 30, 2020 | Maternal Nursing. The variability is Reassuring, if it is between5 25 bpm. Najee Harris Parents Nationality, compare to the MAR as you remove the drug from the storage area 2. compare the drug to the MAR as you prepare the drug 3. compare the drug to the MAR at the patients bedside before giving the drug fetal monitoring: external - ANSWER-US, and tocodynamometer: used during labor to monitor fetal HR and check for fetal distress and monitor uterine . Category I: Normal- associated with fetal well-being; accelerations, Category II: Indeterminate- ambiguous data- describes patterns or elements of reassuring characteristics but also data that may be nonreassuring; not an emergency but important to continue monitoring, Category III: abnormal- nonreassuring- favorable signs are absent, Category II= NOT GOOD= nursing intervention required. AccelerationAccelerating fetus heart. External User Login - Lippincott Advisor for Education. And typically, it is an indication of a well-oxygenated and non-acidemic fetus. and nursing literature have explored these com-munication barriers, especially between nurses and physicians. Objective: To compare fetal heart rate (FHR) signals acquired simultaneously by an external ultrasound probe and a scalp electrode during the second stage of labor. Since the fetus is inside the mothers uterus, physical assessment is not a viable option. During labor, a woman's uterus contracts to dilate, or open, the cervix and push the fetus into the birth canal. Take up to 20% OFF all BoardVitals question banks during our Memorial Day Sale! with a duration of 95-100 sec. Unengaged presenting part (although this obstacle may be overcome with the use of a controlled amniotomy or the application of fundal or suprapubic pressure) Previous. >Normal; reassuring FHR 110-160 BPM with increases and decreases from baseline There are 545 NCLEX -style practice questions partitioned into 8 sets. Two basic mechanisms of US interaction with biological systems have been identified: thermal and non-thermal. Step 3. Non-stress test evaluates FHR by electronic fetal monitor (EFM) in response to fetal movement (FM) as early as 27 weeks Mother should eat 2 hours before and may be given snacks during to enhance . >Discontinue oxytocin if being infused To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. There are 4 different categories of variability: Go check out this helpful guide on how to read basic fetal heart rate patterns. if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[468,60],'nurseship_com-large-mobile-banner-1','ezslot_4',646,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0'); To ensure that, palpate the mothers radial pulse simultaneously while the FHR is being auscultated through the abdomen. >Maternal infection, chorioamnionitis What are some disadvantages of Continuous internal fetal monitoring? -Maternal complications Leopold Maneuvers: determine the part that is presenting over the true pelvis inlet, Gently grasping the lower segment of the uterus between the thumb and fingers. Our mission is to empower and support nurses caring for women, newborns, and their families through research, education, and advocacy. Use Leopolds maneuvers to locate the back of the fetus. To clarify the fetal condition when baseline variability is absent, the nurse should first. Nursing Care Plan for Placental Abruption 2. can disconnect the monitor temporarily. Answer: A. Placenta . >Marked baseline variability Background. TEAS Tuesday: Answers to your most frequently asked ATI TEAS, Version 7 questions May 25, 2022 / by Kari Porter Tips for Coping with Stress During Nursing School It also entails having the necessary knowledge, training, and experience in dealing with a complicated pregnancy and childbirth situation because these patients' circumstances will provide safe and effective care. -Empty your bladder before we begin. Fetal monitoring during labor include intermittent auscultation of the fetal heart rate and palpation of uterine contractions, and internal monitoring of the FHR and uterine contractions. Contractions are firm (100mmHg with a intrauterine pressure catheter) occur every 1 to 2 min. a. monitor fetal oxygen saturation using fetal pulse oximetry. Perinatal nurses are most often the primary health care professionals responsible for FHM. How Does Temperature Affect Oxygen Concentrations Gizmo, What Is Popular Culture John Storey Summary, beachfront bargain hunt north wildwood nj. Do not administer within 36 hours of switching from or to an ACEi. >Palpate the fundus to identify uterine activity for proper placement of the tocotransducer to monitor uterine contractions. >Reposition client from side to side or into knee-chest c. apply pressure to the fetal scalp with a glove finger using a circular motion. Fetal heart rate monitoring measures the heart rate and rhythm of the fetus. Pitocin is a prescription medicine used to treat the symptoms of postpartum hemorrhage, labor induction, and incomplete or inevitable abortion. Decelerations which are caused by a parasympathetic response during labor can be benign in nature (a normal pattern occurrence) or can be abnormal or nonreassuring. >Ensure electronic fetal monitoring equipment is functioning properly I'm so frustrated when the professor tells you one thing and the ATI exam tells you something else. -Fetal distress, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Fetal heart rate monitoring measures the heart rate and rhythm of the fetus. d. to implement interventions as soon as . Designed by Elegant Themes | Powered by WordPress, Supplies more data about the fetus than auscultation, Narcotics, sedatives, alcohol, illicit drugs, Caused by reduced flow through the umbilical cord- cord compression, Shape, duration, and degree of fall below baseline rate are variable- fall and rise in rate is abrupt, Return to baseline fetal heart rate by the end of the contraction, Head compression during contractions- increases intracranial pressure, Maternal position changes usually have no effect on pattern, Temporary increases in fetal heart rate; periodic or nonperiodic, Peaks at 15 bpm above the baseline for at least 15 seconds, Begins after contraction begins (often near peak). Take up to 20% OFF all BoardVitals question banks during our Memorial Day Sale! The goal of fetal heart rate monitoring during labor is: Severe hypoxia in labor along with metabolic acidosis can cause fetal organ damage or fetal death. nursing considerations for internal fetal monitoring ati. Cross), The Methodology of the Social Sciences (Max Weber), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Give Me Liberty! This applies to all medical and nursing personnel. Engage with clear and concise video lessons, take practice questions, view cheatsheets . securing it with a belt. Drugs such as opiates, benzodiazepines, methyldopa, and magnesium sulphate. >Place a small, rolled towel under the client's left or right hip to displace the uterus off the major blood vessels to prevent supine hypotensive syndrome, Leopold Maneuvers: Identify the fetal part occupying the fundus, The head should feel round, firm, and move freely Key safety elements >Abruptio placentae: Suspected or actual Any contraindications to vaginal delivery. Due to large amounts of blood lost, the heart tries to pump faster in order to compensate for blood loss. June 7, 2022 . What are some nursing interventions for fetal tachycardia? o 1:1 nursing should be employed when auscultation is used . It can vary by 5 to 25 beats per minute. Step 3. Perinatal nurses are most often the primary health care professionals responsible for FHM. REVIEW ATI NURSING ACTIONS COMPLICATIONS pg 150-151 25 Changes in FHR patterns are categorized as episodic or periodic changes. Your healthcare provider may do fetal heart monitoring during late pregnancy and labor. >Supine hypotension secondary to internal monitor placement, Nursing Care of Children Health Promotion and, Nursing Care of Children Alternate Item Forma, Industrial Revolution Test (1/10) - Acc. Keywords Electronic fetal monitoring, Nursing instructions, Maternity nurses 1. >Fetal distress, Consideration for preping of the client for continuous electronic fetal monitoring. >Anesthetic medications ATI guidelines for intermittent auscultation or continuous electronic fetal monitoring, During Latent phase: Every 30 to 60 minutes. An experienced labor and delivery nurse without a patient care assignment was designated to continuously assess all active fetal monitoring tracings, via an electronic display away from the main nurses' station, as an adjunct to the care and assessment of the nurse with primary responsibility for the patient. What to look for when you are monitoring FHR intermittently: The Benefits of intermittent fetal heart rate monitoring include:Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-banner-1','ezslot_12',640,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-banner-1-0'); The limitations of intermittent fetal heart rate monitoring include: As the name states, it is continuously monitoring fetal behavior using an electronic device during labor. Patients with feeding tubes are at risk for such complications as aspiration, tube malpositioning or dislodgment, refeeding syndrome, medication-related complications, fluid imbalance, insertion-site infection, and agitation. To identify these problems, thoroughly assess the patient before tube feeding begins . You have a . At the end of the video, Meris provides a quiz to help you test your knowledge of the key facts . decelerations). This lets your healthcare provider see how your baby is doing. She also discusses the components and scoring of the Bishop Score. Discuss the role renewable energy should play in a sustainable society. >A provider, nurse practitioner/midwife or specially trained registered nurse must perform this procedure. It is an important clinical indicator that is predictive of fetal acid-base balance and cerebral tissue perfusion. Electronic Fetal Monitoring Techniques for Fetal Surveillance in the United States Today, EFM is the routine method of fetal surveillance in most U.S. intrapartum care settings (ACOG, 2009; Stout & Cahill, 2011). ASSESSMENT OF FETAL WELL-BEING ATI: Maternal Newborn Nursing Chapters 6 & 13 PRENATAL SCREENING Why do we It helps the physician in selecting the optimal time for delivery of the high-risk fetus. Fetal heart monitoring is a method used to check the well being of the fetus by finding the fetal heart rate and rhythm. The advantages of internal fetal heart monitoring are early detection of abnormal FHR patterns suggestive of fetal distress, accurate assessment of FHR variability, accurate measurements of uterine contractions intensity, and allows for . Nursing considerations. >Fetal congenital heart block -Palpate mother's abdomen to asses the uterus and Additionally, types of labor induction (cervical ripening, amniotomy, and oxytocin) and nursing care for all. Manage Settings > Early detection of abnormal FHR patterns suggestive of fetal distress Gravity Intermittent auscultation Click card to see definition A form of fetal heart rate monitoring. >Short cord Common contraindications include the presence of non-reassuring fetal status, in fetal prematurity where the lungs are not fully developed, cephalopelvic disproportion, cervical cancer, active genital herpes infection, unfavorable fetal position, placenta previa, vasa previa, and any other obstetric emergencies that could require surgical Moderate - 6-25 bpm kennan institute internship; nascar heat 5 challenge rewards The three utilities serving the islands had 405,000 customers as of 2004 , so there is much room to add solar capacity. Fetal heart rate monitoring measures the heart rate and rhythm of your baby (fetus). early intervention speech therapy activities teletherapy Danh mc Increases of the fetal heart rate of at least 15 beats per minute above baseline that start and peak within 30 seconds, but not less than 15 seconds are termed accelerations. Acceleration is typically a sign of reassuring fetal status and no special nursing interventions is needed. Nursing intervention? Additionally, Meris reviews types of labor induction (cervical ripening, amniotomy, and oxytocin) and nursing care for all. Objective: To compare fetal heart rate (FHR) signals acquired simultaneously by an external ultrasound probe and a scalp electrode during the second stage of labor. Category I from three-tier system FHR monitoring, All of the following are included in the fetal heart rate tracing. ATI Maternal Newborn & Peds Maternal Newborn A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. It is mandatory to do this procedure during the late pregnancy and in active labor. What Is Popular Culture John Storey Summary, Periprocedure. >Membranes do not have to be ruptured It assists the fetal ability to cope with the contraction of high-risk pregnancy and the stress of labor. The population was women in labor with uneventful singleton pregnancies at term. -Continue monitoring FHR, -Misinterpretation of FHR patterns >Early decelerations: Present or absent The method that is used depends on the policy of your ob-gyn or hospital, your . Objective: To compare fetal heart rate (FHR) signals acquired simultaneously by an external ultrasound probe and a scalp electrode during the second stage of labor. Baseline fetal heart rate can be interpret as reassuring,non-reassuringorominous signs. Auscultate and count the FHR during a uterine contraction and for 30 seconds thereafter to identify the fetal response Click again to see term 1/67 It is most commonly measured via electronic fetal monitor. >Fetal tachycardia wrong with your baby. An intrauterine pressure catheter (IUPC) is a device placed inside a pregnant woman's uterus to monitor uterine contractions during labor. -Non-reassuring FHR patterns (bradycardia, Ensure that the patient is not taking concomitant ACEi or ARB therapy. You have a . >Fundal pressure Methods: This was a prospective observational study in a labor ward of a tertiary care university hospital. 7, 14, 15 Typically, the labor nurse auscultates the fetal heartbeat with a . -Meconium-stained amniotic fluid Aspiring nurses can learn about the different types of nurses, education requirements, and nurse salary statistics.Nursing students can access care plan examples, nursing school study tips, NCLEX review lectures and quizzes, nursing skills, and more. Fetal tachycardiais defined as a baseline fetal heartrate more than160bpm and lasts longer than 10 minutes. However, we aim to publish precise and current information. Note: the cephalic prominence is referring to the back of the head In this section are the practice quiz and questions for maternity nursing and newborn care nursing test banks. TEAS Tuesday: Answers to your most frequently asked ATI TEAS, Version 7 questions May 25, 2022 / by Kari Porter Tips for Coping with Stress During Nursing School REVIEW ATI NURSING ACTIONS COMPLICATIONS pg 150-151 25 Changes in FHR patterns are categorized as episodic or periodic changes. What are some considerations for prep of the client and ongoing care for Continuous internal fetal monitoring? >Cultural considerations, emotional, educational and comfort needs of the mother and the family incorporated into the care plan. Fetal Heart Tone Monitoring of Decelerations For Nursing Students and Nurses. Baseline rate: Labor is the process by which the pregnant body prepares for the delivery of the fetus. Digital examination of the cervix can lead to maternal and fetal hemorrhage. Purpose: Your healthcare provider may do fetal heart monitoring during late pregnancy and labor. >Uteroplacental insufficiency causing inadequate fetal oxygenation Periodic baseline changes are temporary, recurrent changes made in response to a stimulus such as a contraction. Prematurity: variability is reduced at earlier gestation (<28 weeks), variability is less than 5 bpm for between 30-50 minutes, or, variability less than 5 bpm for more than 50 minutes, more than 25 bpm for more than 25 minutes, or, visually apparent with elevations of FHR of at least 15 bpm above the baseline, usually, last longer than 15 seconds but not for longer than 2 minutes, prolonged acceleration is when it lasts longer than 2 minutes but less than 10 minutes, if acceleration lasts more than 10 minutes, it is considered a change in baseline, informing the primary healthcare provider about pattern change, persists at that level for at least 60 seconds. >Maternal hyperthyroidism. with a belt. External monitoring is subject to loss of signal related to maternal positioning, fetal positioning, maternal body fat. . Published by at 29, 2022. >Accurate measurement of uterine contraction intensity Your baby's heart rate is a good way to tell if your baby is doing well or may have some problems. a. BUN 25 mg/dL b. serum creatinine 0.8 mg/dL c. urine output of 280 mL w/ 8 hr d. urine negative for ketones A nurse is providing teaching about family planning to a client who . Risks of internal monitoring include, but are not limited to, infection and bruising of the fetal scalp or other body part. Internal spiral electrode that is compatible with the electronic fetal monitor Internal monitoring should be employed when the externally derived tracing is . and so much more . Doctors usually perform fetal monitoring during labor and delivery, but may also need to do it during late pregnancy. The other one is called an ultrasound transducer. Describe three (3) important nursing considerations when caring for a client with internal fetal monitoring. Palpation of contractions at the fundus for frequency, intensity, duration, and resting tone is used to evaluate fetal well-being. Document the finding from the maneuvers, What are some indications for intermittent auscultation and uterine contraction palpation, >Determine active labor pdf, Applying the Scientific Method - Pillbug Experiment, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. Monitor lab results and report abnormalities to the healthcare provider (HCP), including serum potassium and creatinine levels and blood urea nitrogen. Internal fetal monitoring involves inserting an electrode through the dilated cervix and attaching the electrode to . What to look for when you are monitoring FHR intermittently: Increase in fetal heart rate to over 160 bpm Electronic fetal monitoring is a procedure in which instruments are used to continuously record the heartbeat of the fetus and the contractions of the woman's uterus during labor. Use code: MD22 at checkout. Fetal heart rate patterns can be categorized into three different categories. >umbilical cord prolapse The nurse should be mindful of the following mechanisms that influence heart rate: Variability is the fluctuation of the baseline fetal heart rate. Explain the various comfort-promotion and pain-relief strategies used during labor and birth. What Happened To Tadd Fujikawa. Take up to 20% OFF all BoardVitals question banks during our Memorial Day Sale! A transducer is placed over the point of maximal impulse (PMI), the location on the patient's abdomen where fetal heart tones can be heard best. Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-leader-3','ezslot_9',642,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-leader-3-0'); In a breech presentation, it is heard at or above the level of the mothers umbilicus. The average pressure is usually 50 to 85 mm Hg. Electronic fetal monitoring (EFM) is a commonly used practice on labor and delivery (L&D) units and is a focus of this customizable bundle within the AHRQ Safety Program for Perinatal Care. Secondly, the word CHOP represents the cause for these pattern variations. Sale ends in: 6 days 10 hours 42 mins 1 sec. No interventions required >Based on findings obtained using Leopold maneuvers auscultate FHR using listening device To clarify the fetal condition when baseline variability is absent, the nurse should first. Teach patients to: Follow our Facebook Page for the NCLEX-Style Question of the Week as well as relevant posts and live events to help you on your road to becoming a . >Variable or late decelerations: Absent, Category II from three-tier system FHR monitoring, Category II tracings include all FHR tracings not categorized as category I or III. Decelerations which are caused by a parasympathetic response during labor can be benign in nature (a normal pattern occurrence) or can be abnormal or nonreassuring. It truly is a beautiful process from conception to birth and thereafter. Nursing implications Assessment & Drug Effects. American College of Obstetricians and Gynecologists. >Intrauterine growth restriction >Prolonged umbilical cord compression What to look for when you are monitoring FHR intermittently: Increase in fetal heart rate to over 160 bpm Risks of fetal monitoring during pregnancy and labor. >Uterine contractions It also gives you a clue as to what the correlating nursing interventions should be for each pattern. Fetal Monitoring During Labor- Maternal (OB) Nursing A review for nursing students studying fetal monitoring during labor. michael thomas berthold emily lynne. >Variable decelerations with additional characteristics including "Overshoots" "shoulders" or slow return to baseline FHR Current recommendations for fetal monitoring include a three-tier fetal heart rate interpretation system. As labor progresses, the FHR location will change accordingly as the fetus descends lower into the mothers pelvis for the birthing process. Salpingectomy After Effects, level nursing practice. >Maternal complications (gestational diabetes mellitus, gestational hypertension, kidney disease) By contrast, in the 1980s about 62% of U.S. women had EFM (Albers & Krulewitch, 1993). Both the methods will be discussed in detail. And the chop stands for cord compression, head compression, oxygenated or OK, and placental insufficiency. -If you need to walk or use the bathroom, we Nursing interventions during labor include: Location of fetal heart rate during intrapartum. ATI Maternal Newborn & Peds Maternal Newborn A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Disadvantages of internal fetal monitoring . and so much more . Start flow charts to record maternal BP and other vital signs, I&O ratio, weight, strength, duration, and frequency of contractions, as well as fetal heart tone and rate, before instituting treatment. What is the difference between the throw statement and the throws clause? Check out our blog for articles and information all about nursing school, passing the NCLEX and finding the perfect job. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of antepartal, intrapartal, postpartum, and newborn care in order to: Assess client's psychosocial response to pregnancy (e.g., support systems, perception of pregnancy, coping mechanisms) In late stages of pregnancy, AFP levels in fetal and maternal serum . When the timing of deceleration is delayed, it means that the lowest point is occurring past the peak of your uterine contraction. Fetal heart rate monitoring is a process that lets your doctor see how fast your baby's heart is beating. Continue with Recommended Cookies. Doctors can use internal or external tools to measure the fetal heart rate (1). It is important to monitor variability while monitoring fetal heart rate as it can indicate how the fetus is tolerating the birthing process. Med-Surg. Methods: This was a prospective observational study in a labor ward of a tertiary care university hospital. Outline the nurse's role in fetal assessment. >Preeclampsia Indication for Continuous Electronic Fetal Monitoring (EMF). -Abnormal uterine contractions Absent baseline variability not accomplished by recurrent decelerations -Administer oxygen via facemask 8 - 10 L Intermittent fetal heart rate monitoring involves periodic auscultation of FHR using an ordinary stethoscope or a fetoscope or a hand-held Doppler. Categories . Fetal movements of less than 3 per hr or movements that cease entirely for 12 hr indicate a need for further evaluation Diagnostic testing for fetal . Plug the cable into the new monitor and rezero the system. Fetal heart monitoring is a method used to check the well being of the fetus by finding the fetal heart rate and rhythm. It gives an indirect indication of the oxygen status of the fetus. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of antepartal, intrapartal, postpartum, and newborn care in order to: Assess client's psychosocial response to pregnancy (e.g., support systems, perception of pregnancy, coping mechanisms) Your health provider will check your baby's heart rate either continuously with an electronic fetal monitor, or periodically (this is called intermittent auscultation). This maneuver validate the presenting part. Once deceleration starts, it takes about 20 to 30 seconds to reach its lowest point. Read theprivacy policyandterms and conditions. One is called toco-transducer. >Umbilical cord compression >Fetal heart failure The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) is a 501(c)3 nonprofit membership organization. Obtaining the fetal heart rate can be done in a few different ways. The nurse notes that the fetal heart rate (internal monitor) is near its baseline of 120-130 bpm with variability of 10 bpm. Hand-held Doppler ultrasound probe. >Placenta previa nursing considerations for internal fetal monitoring ati nursing considerations for internal fetal monitoring ati. The patient, the mother, and the fetus will be free from infection prevention of complications or fetal infection. Nursing considerations. Memorial Day Sale. >Continuous assessment of FHR patterns response to uterine contractions during the labor process. The advantages of internal fetal heart monitoring are early detection of abnormal FHR patterns suggestive of fetal distress, accurate assessment of FHR variability, accurate measurements of uterine contractions intensity, and allows for . Delayed timing of the deceleration occurs with the nadir of the uterine contraction. What is used in conjunction with intermittent auscultation of FHR? Describe three (3) important nursing considerations when caring for a client with internal fetal monitoring. L&D/Maternal Fetal Monitoring/Quick Notes L&D/Fetal Monitoring/Fhr Internal L&D/Fetal Monitoring Strips Care for a high-risk pregnant patient necessitates more than a basic understanding of pregnancy, labor, and delivery. Summerfest 1976 Lineup, Fetal bradycardia is defined as a baseline fetal heart rate of less than 110 bpm and lasts longer than 10 minutes. titration of phosphoric acid with naoh lab report. >Following vaginal examination VEAL CHOP MINE is further described in the table below. "VEAL" is the acronym for fetal heart rate pattern, "CHOP" stands for the causes of it, and the "MINE" represents the nursing interventions. Reflect possible impaired placental exchange; Absence of accelerations after fetal stimulation, Increase placental perfusion- turn mother to left side, administer oxygen, infuse Lactated Ringers, Tocolytic drug, such as terbutaline, may need to be administered to lessen uterine activity, Prepare for c-section if fetal compromise is suggested, Update and educate the mother and partner, Communicate nonreassuring signs with the healthcare provider. Fetal Heart Rate Monitoring - Freeman 2012 "Fetal heart rate monitoring is widely used by almost every obstetrician as a way to document the case and to help decrease health care costs. -Assist mother to a side-lying position Start with an evaluation, and a personalized study plan . Labor is the process by which the pregnant body prepares for the delivery of the fetus. It also entails having the necessary knowledge, training, and experience in dealing with a complicated pregnancy and childbirth situation because these patients' circumstances will provide safe and effective care. simplify Topics you are currently struggling With. >Perform or assist with a vaginal exam Placenta Previa is the development of placenta in the lower uterine segment partially or completely covering the internal cervical os. >Abnormal uterine contractions >Count FHR for 30 to 60 seconds between contractions to determine baseline rate Any contraindications to vaginal delivery.