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✨ Leson an Vedèt · Leson 6 sou 8 · 60 sec

Deselerasyon Ta: Kat Mouvman an Swasant Segonn

Late Decels: Four Moves in Sixty Seconds

📉 Frekans kè fetal la desann ta epi li reprann ta. San k ap koule ale nan plasenta a pa swiv ritm kontraksyon yo. Ou gen kat mouvman ak anviwon yon minit pou ou fè yo.

📉 The fetal heart rate dips late and recovers late. Blood flow to the placenta is not keeping up with the contractions. You have four moves and about one minute to make them.

💡 Ide prensipal

Ta vle di plasenta. Kote, kanpe oxytocin, likid, avèti; oksijèn sèlman si li ipoksik.

Late means placenta. Side, stop oxytocin, fluids, notify; oxygen only if she is hypoxic.

🧠 Poukisa sa enpòtan

VEAL CHOP: Variable se Cord [kòd lonbrit], Early se Head [tèt], Accelerations se Okay [oke], Late se Placenta [plasenta]. Pou deselerasyon ta yo: vire pasyan an sou KOTE li, KANPE oxytocin nan, bay yon bolus LIKID IV, epi AVÈTI founisè a. Bay OKSIJÈN sèlman si li ipoksik oswa selon pwotokòl; ACOG pa rekòmande oksijèn matènèl abityèl ankò. Pou deselerasyon varyab yo, repozisyone an premye epi tcheke si gen yon kòd lonbrit ki prolabe. Pou yon kòd lonbrit ki prolabe, leve pati ki prezante a soti sou kòd la ak yon men ki gen gan epi rele pou yon akouchman ijans.

VEAL CHOP: Variable is Cord, Early is Head, Accelerations are Okay, Late is Placenta. For late decelerations: turn the client to her SIDE, STOP the oxytocin, give an IV FLUID bolus, and NOTIFY the provider. Give OXYGEN only if she is hypoxic or per protocol; ACOG no longer recommends routine maternal oxygen. For variable decelerations, reposition first and check for a prolapsed cord. For a prolapsed cord, lift the presenting part off the cord with a gloved hand and call for an emergency delivery.

🏥 Nan lavi reyèl

🔄 Modèl la sou monitè a diskrè epi chanm nan kalm. Enfimyè ki konnen VEAL CHOP la wè desant yo rive nan pwen pi ba yo aprè pik chak kontraksyon epi li kòmanse kat mouvman yo anvan nenpòt lòt moun remake. De minit aprè, tras la sanble rasiran ankò. Pèsonn p ap janm konnen jan sa te pre, e se sa ki pwen an.

🔄 The pattern on the monitor is subtle and the room is calm. The nurse who knows VEAL CHOP sees the dips bottoming out after each contraction's peak and starts the four moves before anyone else notices. Two minutes later the strip looks reassuring again. Nobody will ever know how close it was, which is the point.

📌 Sa pou retni

  • Varyab kòd, bonè tèt, akselerasyon oke, ta plasentaVariable cord, early head, accelerations okay, late placenta
  • Sa ki ta yo: kote, oxytocin kanpe, likid, avèti; oksijèn sèlman si ipoksikLates: side, oxytocin off, fluids, notify; oxygen only if hypoxic
  • Kòd prolabe: leve pati ki prezante a epi rele pou akouchmanProlapsed cord: lift the presenting part and call for delivery

✅ Teste tèt ou

Ki modèl frekans kè fetal ki endike ensifizans iteroplasentè?Which fetal heart rate pattern indicates uteroplacental insufficiency?
  1. AkselerasyonAccelerations
  2. Deselerasyon bonèEarly decelerations
  3. Deselerasyon varyabVariable decelerations
  4. Deselerasyon taLate decelerations

Repons: D · Deselerasyon ta

Deselerasyon ta yo reflete yon plasenta ki pa ka bay ase oksijèn pandan kontraksyon yo. Deselerasyon varyab yo se desant brid sou kou ki koze pa konpresyon kòd lonbrit la, se pa move livrezon oksijèn plasenta a.

Late decelerations reflect a placenta that cannot deliver enough oxygen during contractions. Variable decelerations are abrupt drops caused by umbilical cord compression, not by poor placental oxygen delivery.

Yon pasyan k ap resevwa oxytocin gen deselerasyon ta ki repete. Ki aksyon ki kòrèk?A client receiving oxytocin has recurrent late decelerations. Which action is correct?
  1. Ogmante oxytocin nan pou akselere akouchman anIncrease the oxytocin to speed delivery
  2. Kanpe oxytocin nan epi repozisyone liStop the oxytocin and reposition her
  3. Prepare sèlman pou yon egzamen vajinalPrepare for a vaginal exam only
  4. Kontinye siveye pandan 30 minitContinue to monitor for 30 minutes

Repons: B · Kanpe oxytocin nan epi repozisyone li

Resisitasyon entraiterin kòmanse imedyatman: kanpe oxytocin nan, repozisyone li kouche sou kote, ouvri likid yo, avèti founisè a, epi bay oksijèn si li ipoksik oswa selon pwotokòl. Kontinye siveye pandan 30 minit sèlman gade pwoblèm nan pandan chak kontraksyon kontinye limite rezèv oksijèn fetis la.

Intrauterine resuscitation starts immediately: stop the oxytocin, reposition to side-lying, open the fluids, notify the provider, and give oxygen if she is hypoxic or per protocol. Continuing to monitor for 30 minutes only watches the problem while each contraction keeps limiting the fetus's oxygen supply.

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