Maternal Child Nursing
- Briefly discuss the impact of technology on the growing number of ethical concerns and debates related to perinatal nursing and women’s health care.
- Tara has been in labor for 4 hours. Her blood pressure had been stable, averaging 130/80 when assessed between contractions, and the FHR pattern consistently exhibited criteria of a reassuring pattern. A lumbar epidural block was initiated. Shortly afterward, during assessment of maternal vital signs and FHR, Tara’s blood pressure decreased to 102/60 and the FHR pattern began to exhibit a decrease in rate and variability.
- State what Tara is experiencing. Support your answer and explain the physiologic basis for what is happening to Tara.
- List the immediate nursing actions.
- Nurses caring for laboring women use a variety of methods to assess fetal health and well-being during labor. State the advantages and disadvantages of each of the following methods to assess FHR and pattern as well as uterine activity. Outline the nursing care measures required for each of the monitoring methods.
- External fetal monitoring
- Internal fetal monitoring
- Portable telemetry
Maternal Child Nursing
Impacts of Technology on Perinatal Nursing Concerns
The recent trend in the emergence of technology has been proven to contribute to the growing number of ethical issues in perinatal nursing for women. The most common form of technology that yields ethical issues in nursing is Assisted Reproduction Technology (ART) (Berman et al., 2020). ART was founded to help in treating infertility, formerly known as assisted fertilization. ART yields to perinatal ethical issues through arousing the pregnancy-induced hypotension in mothers.
Tara’s Perinatal Concern
Tara is likely to be experiencing hypotension. The initiation of the lumbar epidural block during labor may withdraw some side effects such as lowering the mother’s blood pressure, also known as hypotension and decreasing the vulnerability of the FHR ratio for the fetus (Anim-Somuah, et al 2018). However, the lumbar epidural block is significant during the labor process.
Immediate Nursing Actions
The perinatal nurses should be ready to address this situation immediately to avoid further complications. Perinatal nurses use several methods to treat hypotension in women. Firstly, a vasopressor’s additional minor circulatory doses, then 500-100ml of isotonic electrolyte solution. Additionally, administering boluses of crystalloid elucidation such as 5-10 mg dosage of ephedrine and reduce women’s overall low blood pressure during labor.
External Fetal Monitoring
External fetal monitoring devices used to test FHR are such as the electronic dropper in ultrasound. The advantage of this method is that it is not intrusive, while the disadvantage is that it increases the capability of women to have a cesarean section which is fatal (The Healthline Editorial Team, 2016).
Internal Fetal Monitoring
Internal fetal monitoring initiates by placing an electrode fetal scalp through the cervix to determine the FHR. The advantage of this method is that it allows the direct monitoring of the fetal heart, while the disadvantage is that it can be invasive (The Healthline Editorial Team, 2016).
Mobile telemetry is a device that monitors continuous ECG through electrodes. It is advantageous in that it screens vibrant signs of the patient while disadvantageous in that it is relatively expensive.