VEAL CHOP Nursing
VEAL CHOP nursing is a mnemonic used in maternal and newborn nursing. Maternal and child health nurses work to promote the optimal health of pregnant women, their partners, and also the child. This area of healthcare encompasses medical care for expecting mothers through the entire process of pregnancy and childbirth.
These professionals are just as responsible for keeping infants safe as the parents are. To make identifying the mother’s medical condition straightforward in the labor and delivery room (LDR), nurses have developed numerous mnemonics — VEAL CHOP being one of them.
Learning these mnemonics can also help parents recognize medical conditions. I’ve broken down VEAL CHOP in detail in this post.
What Are Nursing Mnemonics?
A mnemonic is any system that aids in memorizing something. For example, these can be used to remember patterns of letters, and nurses often use them to remember important details that can save lives.
Labor and delivery nurses and neonatal (NICU) nurses need to think and act fast, and a mnemonic is a tool they use to act appropriately when the fetal heart rate pattern changes rapidly.
Besides VEAL CHOP nursing, BUBBLE HE, LARA CROFT, and HELLP are other mnemonics that maternal and child health nurses use to identify conditions.
These mnemonics are relevant to every parent — learning them can help you understand delivery stages and identify medical conditions.
What Does VEAL CHOP Nursing Mean?
VEAL CHOP is a mnemonic that nurses use in the LDR during delivery to identify changes in Fetal Heart Rate (FHR) patterns. Identifying fetal heart rate patterns is crucial since acceleration and deceleration in fetal heart rate can be concerning.
To understand how nurses use VEAL CHOP, you must first understand the meaning of every letter in the mnemonic. The VEAL part of the mnemonic represents the symptom while the CHOP part of the mnemonic represents the cause.
VEAL CHOP Meaning
V
Variable deceleration
E
Early deceleration
A
Accelerations
L
Late decelerations
C
Cord compression
H
Head compression
O
Oxygenated / OK
P
Placental insufficiency
The mnemonic allows nurses in the LDR to recognize what the infant is experiencing in the womb. It also helps the nurses determine if action is needed.
It’s important to note that the mnemonic VEAL CHOP works by putting together the letters in the first abbreviation together with the letters in the second abbreviation – the symptom and the cause. Simply put, V correlates to C, E correlates to H, A to O, and L to P.
Interventions Based On VEAL CHOP Stages
Variable Deceleration — Cord Compression
Variable decelerations in Fetal Heart Rate (FHR) are abrupt, visually apparent declines in the heart rate of the fetus. These fetal heart rate decelerations occur because there’s too much pressure on the umbilical cord, causing cord compression.
When variable fetal heart rate deceleration is identified, nurses quickly change the mother’s position to relieve the pressure and stop the cord from getting compressed. However, there’s a chance that changing the mother’s position will not alleviate the cord compression or the fetal heart rate deceleration.
If changing the position doesn’t work, nurses may call for an amnioinfusion to stop cord compression. Amnioinfusion is the process of reintroducing fluids into the uterine cavity. A 2012 study confirmed that amnioinfusion improves fetal heart rate decelerations, cord compression, and also the umbilical artery’s pH. Amnioinfusion also reduces the risk of infection in the pregnancy endometrium.
Early Deceleration — Head Compression
Undulations in fetal heart rate that typically mirror uterine contractions are early decelerations. Early fetal heart rate decelerations begin if the baby’s head is compressed, indicating that the infant is descending the birth canal. Early decelerations due to fetal head compression indicate that the mother is ready to deliver the child.
Accelerations — Oxygenated
While the idea of an abrupt increase in fetal heart rate accelerating can sound scary, it indicates that the baby is healthy and does not have hypoxemia. In this stage, no action is required, and nurses monitor the mother and the fetus for progress.
Late Decelerations — Placental Insufficiency
The gradual decrease in the fetal heart rate (for 30 seconds or more) is called late deceleration. It typically occurs after contractions. Late fetal heart rate decelerations indicate a potential placental insufficiency.
Placental insufficiency is the most concerning fetal heart rate decelerations and can cause complications. The baby may not grow well, and the condition can also cause health problems for the mother.
If late decelerations occur due to placental insufficiency, nurses help the mother turn to her left or right side. Nurses may also bring the mother’s knees to her chest to improve blood circulation.
If late fetal heart rate decelerations continue, the mother is given intravenous hydration or an oxygen mask. Uterotonics are discontinued. Depending on the severity, the mother may require surgery to birth the child safely.
There is also a mnemonic “MINE”, that is added to VEAL CHOP to help nurses remember the required intervention for every symptom. Here’s a table that puts it all together:
Symptom
Cause
Intervention
Variable deceleration (symptom)
Cord compression (cause)
Movement (intervention)
Early deceleration (symptom)
Head compression (cause)
Identify progress (intervention)
Acceleration (symptom)
Oxygenated / OK (cause)
Nothing (Monitor) (intervention)
Late decelerations (symptom)
Placental insufficiency (cause)
Execute delivery (intervention)
Other Maternal Nursing Mnemonics
VEAL CHOP is only one of the many mnemonics that nurses in the labor and delivery unit need to remember. Other mnemonics that these professionals use include BUBBLE HE, HELLP, and LARA CROFT.
LARA CROFT
LARA CROFT is used to identify the causes of abdominal pain when a woman is expecting a child. Abdominal pain is common during pregnancy; however, it can also be an indicator of a bigger problem.
It is important for expecting mothers to learn when addressing abdominal pain is important. Learning this mnemonic can help the mother cope better and recognize health issues before they become severe. The mnemonic LARA CROFT stands for:
- Labor: Pain in the abdomen could mean the expecting mother is going into labor.
- Abruptio placentae: If the placenta separates from the uterus prematurely, it can cause bleeding and pain. Abruptio placentae can be extremely dangerous if left untreated.
- Rupture (ectopic/uterine): A ruptured ectopic pregnancy can damage other organs and cause internal bleeding accompanied by abdominal pain. It is also possible for the uterus to rupture, which can be extremely painful and requires critical care. That said, uterus ruptures are very rare.
- Abortion (miscarriage): It is the spontaneous loss of pregnancy.
- Cholestasis: It is a condition where bile from the liver does not escape. It is painful, and while not dangerous for the expecting mom, it can be very dangerous for the baby.
- Rectus sheath hematoma: It is a rare hematoma that causes the rectus to tear.
- Ovarian tumor: Functional cysts resolve naturally and are not dangerous for the baby or the expecting mother.
- Fibroids: These are benign tumors in the uterus that are made of muscle fibers (myometrium). These rarely pose a risk to the mother and the baby. However, fibroids can be a cause for concern if they're too large or in a painful location.
- Torsion of the uterus: It happens if there is a rotation of more than 45 degrees along the long axis of the uterus.
Lindsay Smith
Lindsay is an Adult-Gerontology Primary Care Nurse Practitioner with Nephrology Associates in Nashville, Tennessee. She is passionate about working with patients with End-Stage Renal Disease (ESRD) to maximize their function and wellness.