摘要:

The concept of intrapartum “monitoring” of the fetal heart rate by auscultation has been extant for almost 200 years and by electronic means for more than 30 years. This article explores historical aspects of fetal monitoring, the advent of electronic fetal monitoring and its controversies, and present and future research opportunities to enhance the reliability, validity, and efficacy of fetal monitoring.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The purpose of electronic fetal heart rate (FHR) monitoring is the ongoing assessment of fetal oxygenation. FHR tracings are analyzed for characteristic patterns that signify specific hypoxic or nonhypoxic events. A working knowledge of fetal physiology and the fetal response to hypoxia can aid and refine clinical interpretation of FHR patterns during labor. This article reviews the fetal response to decreased oxygenation, the physiology of subsequent FHR patterns and the clinical presentation of asphyxia in the newborn.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Electronic fetal monitoring (EFM) has the potential to promote fetal health and improve neonatal status at birth; however, EFM as a stand-alone tool is ineffective in avoiding preventable adverse outcomes. It is effective only when used in accordance with published standards and guidelines by professionals skilled in correct interpretation and when appropriate timely intervention is based on that interpretation. Interpretation and intervention are best accomplished as a collaborative perinatal team rather than individual activity. Only in these circumstances can EFM optimally contribute to fetal well-being and subsequent neonatal health. Risk management strategies to decrease potential liability are presented that can be accomplished with careful planning and collaboration among perinatal team members.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Multiple randomized clinical trials have been unsuccessful in providing evidence of efficacy of electronic fetal monitoring; thus, there is renewed interest in intermittent auscultation during labor for women with low-risk pregnancies. Auscultation must be used with palpation or external or internal electronic monitoring of uterine contractions. Auscultation and palpation require education, experience, and competency validation at regular intervals. Institutional policies and standards of care are mandatory for intermittent auscultation. Concerns exist regarding the personnel costs for auscultation; however, these costs may ultimately be shown to be offset by significant benefits in improved outcomes and patient satisfaction.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Nipple feeding of premature infants presents a challenge to neonatal nurses who are trying to prepare the infants for eventual discharge from the hospital. To determine what empirical evidence there was to support interventions that positively influence feeding performance and feeding efficiency a meta-analysis is presented. The effects of NPO, nasogastric tubes, different nipples, breast versus bottle feeding, gestational age, oral support, oral stimulation, and nonnutritive sucking on volume intake are evaluated. The results suggest that nursing care should: (a) consider the infant's gestational age; (b) maturational ability and development; (c) keep track of and attempt to minimize the length of time an infant is NPO; and (d) provide prefeeding oral stimulation and oral support.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Providing nursing care in the highly technical environment of the neonatal intensive care unit is changing as concepts of developmentally supportive caregiving merge with conventional nursing interventions and are integrated into routine practice. Medical knowledge with the use of technology is insufficient in guiding the whole of neonatal nursing care. Integration of other patterns and concepts is essential to expert nursing practice with high risk infants and their families.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The goal of this column is to provideJPNNreaders with a periodic update of additional Internet resources they may find useful for their practice, for recommending to clients and their families, or for teaching.

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0893-2190    

出版商:OVID    

年代:2000

数据来源: OVID