Essentials of Fetal and Uterine Monitoring, Fifth Edition / Edition 5

by Michelle Murray PhD, RNC

Overview

Written for labor and delivery nurses, nurse midwives, and maternal–child and family birth nurses, Essentials of Fetal and Uterine Monitoring, Fifth Edition, expertly presents how to identify fetal well-being and the signs of potential fetal and uterine compromise. An accurate interpretation of fetal heart rate patterns and uterine activity helps to ensure the safest labor and delivery process for mother and baby.

Chapters present the best practices for distinguishing normal from abnormal fetal heart rate patterns and uterine activity. Designed in an engaging workbook-style format with step-by-step instruction, this evidence-based resource is for the beginning learner as well as the seasoned professional.

Key Features

• Covers systematic assessment of the pregnant patient
• Addresses external and internal fetal and maternal monitoring
• Includes a step-by-step guide to fetal monitoring equipment and procedures
• Based on peer-reviewed clinically applicable research
• Contains detailed reproductions of actual fetal monitor tracings
• Clarifies differences between maternal and fetal heart rate patterns
• Contains a dedicated section on chronic hypoxia, acute asphyxia, and the nursing role
• Identifies ineffective actions that can delay timely interventions
• Sets forth legal issues
• Provides skill-testing exercises

What’s NEW

• Includes a NEW evidence-based section on normal vs. excessive uterine activity discussing prevention of hypoxic ischemic encephalopathy
• Increased focus on the uterus and the effect of contractions on fetal health.
• All relevant sections updated to include latest evidence, research, equipment, clinical practice considerations, and interventions.

Product Details

ISBN-13:	9780826172266
Publisher:	Springer Publishing Company
Publication date:	11/21/2018
Edition description:	Revised
Pages:	478
Product dimensions:	8.40(w) x 10.90(h) x 1.10(d)

About the Author

Michelle L. Murray, PhD, RNC-OB, is an international educator, author, and expert in obstetric nursing. She is the editor-in-chief of the International Journal of Childbirth. Dr. Murray has taught nursing students and nurses in the United States, Canada, and Bahrain and has spent the majority of her career as a labor and delivery nurse and obstetric nursing educator. She was appointed by the provost at the University of New Mexico as a clinical associate professor. Dr. Murray’s company, Learning Resources International, Inc., produces clinical and educational products, and she has delivered seminars to nurses, midwives, and physicians.

Table of Contents

CONTENTS

List of Reviewers

Introduction

Section 1 Systematic Assessment of the Pregnant Woman

Section 2 The Paper Output and the Computer Image

Section 3 External and Internal Fetal Monitoring

Section 4 Maternal Heart Rate Patterns

Section 5 Uterine Contractions

Section 6 Abnormal Uterine Activity

Section 7 The Baseline

Section 8 Baseline Variability

Section 9 Short-Term Variability

Section 10 Accelerations

Section 11 Early Decelerations

Section 12 Late and Spontaneous Decelerations

Section 13 Variable Decelerations and the Checkmark Pattern

Section 14 Prolonged Decelerations

Section 15 Fetal Hypoxia, Acidosis, and Asphyxia

Section 16 Strip Evaluation and Categorization of Fetal Heart Rate Patterns

Section 17 Fetal Monitoring Workshops Sponsored by the National Institute of Child Health and Human Development

Section 18 Skills Validation

Glossary

Index

Editorial Reviews

Reviewer: Mary Smith, MSN, RN-BC, NPD-BC, C-EFM, CCE (Rush University Medical Center)
Description: This is a comprehensive guide to understanding the use of an electronic fetal monitor and interpretation of fetal heart rate patterns and uterine activity. It includes many fetal monitor tracing illustrations/photos as visual aids in the descriptions of heart rate and uterine activity patterns, as well as for readers to practice interpretation. This edition includes access to an online version. The previous edition was published in 2011,
Purpose: The purpose is to present "how to identify fetal well-being and the signs of potential fetal and uterine compromise," with the goal of ensuring "the safest labor and delivery process for mother and baby." Considering the lifelong impact that a birth imparts for a family, this is clearly critical in the care of the pregnant woman and the fetus. The book is an excellent resource for understanding the physiology and pathophysiology of the fetal heart rate and uterine activity, providing comprehensive explanations of the biological roots of the fetal monitor tracing, in addition to the functions of several types of electronic fetal monitors.
Audience: The target audience is labor and delivery nurses, nurse midwives, and maternal-child and family birth nurses, from novice to experienced. The book is written with bedside clinicians (primarily the nurse) in mind, noting when nurses should consider contacting the provider/physician. The book was reviewed by nurses and physicians in the field of obstetrics from around the U.S. All three authors hold national certification in obstetrical nursing. Michelle Murray, PhD, RNC-OB, has been an educator, author, and expert in obstetrical nursing for many years. Gayle Huelsmann, BSN, RNC-OB, C-EFM has been a certified obstetrical nurse for over three decades. Nanci Koperski, RNC-OB, LNCC, MBA, MHSA, is a nurse paralegal with extensive experience in obstetrical nursing.
Features: For nurses using an electronic fetal monitor, this book is an excellent resource for understanding fetal and maternal biology, physiology, and pathophysiology. Both nurses new to the field of obstetrics and seasoned nurses would benefit from learning or reviewing this content. Concepts are clear and concise, with actionable steps outlined for monitor tracings requiring intervention. The tracing illustrations/photos are ideal for visualization in pairing with the written descriptions. While the book is solidly referenced, some references are not recent (some predate the fourth edition). The authors refer to fetal monitor tracing interpretation and nomenclature that does not conform to National Institute of Child Health and Human Development (NICHD) guidelines. The authors devote an entire chapter to why they have disagreements with specific components of the NICHD guidelines and are transparent in their rationale. Because major U.S. and foreign governing bodies for clinicians providing clinical care to pregnant women (such as the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, and the Association of Women's Health, Obstetric and Neonatal Nurses) have adopted the recommendations of the NICHD, readers must exercise caution in adoption of some of the descriptive verbiage and tracing categorization in the book to be sure they are in compliance with their organization/practice's policies.
Assessment: The use of an electronic fetal monitor is limited to clinicians appropriately trained in its use, which for many is acquired in practice early in their careers. This book is a solid reference for clinicians to understand the biology, physiology, and pathophysiology underlying the tracings that result from electronic fetal monitoring, providing insights into what cannot be seen or directly examined (the fetus and the maternal uterus). The authors stress the importance of appropriate clinical response to monitor tracing interpretation for the best fetal and maternal outcome, which is at the center of every clinician's practice when working with pregnant women.

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