Understanding VEAL CHOP: Nursing Mnemonic Explainer
What is VEAL CHOP? Nursing is full of mnemonics — ABCs, MONA, ADPIE — all designed to help you remember key information. This one is specific to labor and delivery, and it helps nurses manage changes in fetal heart rate during labor.
During hospital delivery and diagnostic tests, fetal health is tracked through fetal heart rate (FHR) monitors. Fetal heart rates are much faster and more irregular than those of children or adults — between 110 and 160, with variations of up to 25 beats per minute. Learning about the VEAL CHOP tool can help you understand FHR readings and know what to do if something changes.
What do you need to know about VEAL CHOP, whether you’re a nursing student attending clinicals or a practicing nurse needing a review? Here’s an overview of this tool.
The VEAL CHOP Mnemonic, Explained
VEAL CHOP helps nurses remember what causes different types of FHR irregularities. To understand it, you’ll first need to understand accelerations and decelerations:
- Accelerations: FHR quickens temporarily.
- Decelerations: FHR slows temporarily.
Depending on the timing of accelerations or decelerations alongside uterine contractions, these changes may or may not be a sign of a problem in how the birth is progressing. The first part of the mnemonic, VEAL, is a list of FHR findings, while the CHOP part is a list of reasons that correspond with each finding:
| Letter | Definition | Letter | Definition |
|---|---|---|---|
| V |
Variable decelerations: FHR is slowing at random times. |
C |
Cord compression: The fetus’s blood supply, which comes from the umbilical cord, may be limited. |
| E |
Early decelerations: FHR is slowing before contractions. |
H |
Head compression: The uterus is squeezing the fetus’s head, which is often normal as birth progresses. |
| A |
Acceleration: FHR increases up to 15 beats, lasting 15 seconds or more. |
O |
Okay: This finding is normal. |
| L |
Late decelerations: FHR decreases for 30 seconds or more after a contraction. |
P |
Placental insufficiency: The fetus is not receiving enough oxygen during contractions. |
How is VEAL CHOP used in nursing? Nurses use this mnemonic to quickly interpret FHR patterns during labor and connect them to their likely causes. It’s especially useful for nursing students and newer OB nurses as they learn the birthing process and what to watch out for. Experienced nurses may automatically make these connections, lessening the need for memory devices like this one.
VEAL CHOP: Nursing Interventions
An additional mnemonic helps suggest nursing actions for each FHR finding — VEAL CHOP MINE. Nursing interventions possible at each stage are outlined below:
- M: Move or reposition the patient in the case of variable decelerations. This can help decompress the umbilical cord, restoring circulation to the fetus.
- I: Identify labor progress and continue to assess early decelerations. These are common as labor progresses and the fetus’s head moves into the birth canal.
- N: No action is needed in the case of accelerations since this is an expected finding.
- E: Execute actions immediately (such as repositioning, applying oxygen, or giving IVF hydration) in the case of late decelerations. These can indicate that the fetus does not have enough oxygen, so interventions need to happen quickly.
VEAL CHOP FAQ
When should VEAL CHOP be used?
Nurses, nurse midwives, and obstetricians use VEAL CHOP whenever fetal heart rate monitoring is performed during labor, whether through external electronic fetal monitoring or internal fetal scalp electrodes. It’s also used during certain tests, such as nonstress tests and contraction stress tests. It helps to quickly identify whether the fetus is tolerating labor well or showing signs that interventions may be necessary.
What are common mistakes when using VEAL CHOP?
Some nurses may rely solely on the mnemonic without considering the whole picture. When in doubt, ask for a second opinion, and don’t forget to update other providers. VEAL CHOP should always be used in context — alongside maternal vitals, labor progress, and other assessment findings. While the mnemonic is a helpful quick guide, it doesn’t replace a holistic interpretation of the fetal monitoring strip.
For example, variable decelerations are linked to cord compression, but they may also be caused by medications, maternal pushing, or movement. Remember to correlate FHR changes with uterine contractions and the full clinical picture.
Some variables can make FHR monitoring less accurate. For example, polyhydramnios is when there is too much amniotic fluid present in the uterine cavity, making it harder for the monitor to pick up a heart rate. Maternal weight, positioning, and cervical dilation also impact FHR monitoring capabilities.
What fetal heart pattern is the most concerning?
A pattern of late decelerations is the most concerning because it indicates that the fetus’s oxygen needs are not being met. As labor progresses, early decelerations are expected because uterine contractions naturally squeeze the cord and fetus’s head. A slowed heart rate after contractions is a worrying sign. This may mean that the fetus is experiencing hypoxemia during contractions, and can be a sign of fetal distress.
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