A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?
The fetal heart rate decreases after the start of a contraction and returns to the baseline 60 seconds after the end of the contraction.
There is a six to ten beat-to-beat variability in the fetal heart rate.
The fetal heart rate accelerates five to seven beats just prior to the beginning of a contraction.
The fetal heart rate decreases at the start of the contraction and returns to baseline by the end of the contraction.
The Correct Answer is A
The correct answer is choice A and it indicates fetal distress because it is a sign of late deceleration. Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia and can lead to fetal acidosis and neurological damage.
Choice B is wrong because it indicates a normal variability in the fetal heart rate, which reflects a healthy autonomic nervous system. A normal fetal heart rate is 120-160 beats per minute.
Choice C is wrong because it indicates an early acceleration in the fetal heart rate, which is a benign finding that may occur with fetal movement or stimulation.
Choice D is wrong because it indicates an early deceleration in the fetal heart rate, which is a normal response to fetal head compression during contractions.
It does not indicate fetal distress.
Normal ranges for fetal heart rate patterns are:
• Baseline: 120-160 beats per minute
• Variability: 6-25 beats per minute
• Accelerations: at least 15 beats per minute above baseline for at least 15 seconds
• Decelerations: none or early (mirror contractions)
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This means that the uterus is constantly contracted and does not relax between contractions.This can cause the placenta to separate from the uterine wall, which is called placental abruption or abruptio placentae.Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.
Choice B is wrong because strong uterine contractions every 3-4 minutes are normal during labor and do not indicate placental abruption.
Choice C is wrong because bile-colored vomitus is not a sign of placental abruption, but rather a sign of hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy.
Choice D is wrong because fetal heart rate acceleration with fetal activity is a normal finding and indicates a healthy baby.Placental abruption can cause fetal distress and a decrease in fetal heart rate.
Correct Answer is D
Explanation
The correct answer is choice D. Rest on your side as much as possible.This is because resting on the side can improve blood flow to the placenta and lower blood pressure.It can also reduce the risk of supine hypotensive syndrome, which occurs when the weight of the uterus compresses the inferior vena cava and reduces venous return.
Choice A is wrong because spicy foods have no effect on blood pressure or pregnancy outcomes.Choice B is wrong because limiting fluid intake can lead to dehydration and increase blood viscosity, which can worsen hypertension.Choice C is wrong because urinating frequently does not lower blood pressure or prevent complications of pregnancy-induced hypertension.
Pregnancy-induced hypertension (PIH) is a condition that causes high blood pressure during pregnancy.It can lead to serious problems for both the mother and the baby, such as pre-eclampsia, eclampsia, placental abruption, fetal growth restriction, and stillbirth.
Women with PIH should follow their doctor’s advice on medication, diet, exercise, and monitoring.They should also report any symptoms of pre-eclampsia, such as severe headache, blurred vision, abdominal pain, or swelling.
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