A nurse is assisting in the care of a client who is in active labour. The nurse notes variable decelerations of the FHR. The nurse should identify which of the following is a cause of variable decelerations.

The correct answer is choice B: “You must be feeling very scared.” This response is an example of therapeutic communication, where the nurse acknowledges the client’s feelings and provides emotional support without making assumptions or giving false reassurances.

Choice A rationale: While it’s true that the presence of a neonatal unit equipped to handle emergencies is reassuring, this response does not address the client’s immediate emotional needs or fears. It’s important for the nurse to recognize and validate the client’s feelings rather than focusing solely on the facilities available.

Choice B rationale: This choice demonstrates empathy and understanding. It allows the client to express their feelings and concerns, which is a crucial aspect of providing emotional support during labor. By acknowledging the client’s potential fear, the nurse opens the door for further communication and support.

Choice C rationale: This response minimizes the client’s individual feelings by suggesting that everyone has the same worries. It can make the client feel that their concerns are not unique or taken seriously, which is not conducive to establishing trust or providing individualized care.

Choice D rationale: This choice provides false reassurance. At 32 weeks of gestation, while the prognosis for the baby is generally good, there are still risks associated with preterm birth. It’s important not to make definitive statements about outcomes that cannot be guaranteed.

Choice D rationale:

The nurse should state, "The purpose of this medication is to boost fetal lung maturity.”. The rationale behind this choice is that betamethasone is a corticosteroid medication commonly administered to women at risk of preterm delivery between 24 and 34 weeks of gestation. Its primary goal is to accelerate fetal lung maturation by promoting the production of surfactant, a substance that coats the lungs and prevents their collapse. By enhancing lung development, the medication helps reduce the risk of respiratory distress syndrome and other respiratory complications that premature infants might face. It does not directly impact fetal heart rate (Choice A), halt cervical dilation (Choice B), or stop preterm labor contractions (Choice C).

Choice A rationale:

The nurse should not state, "The purpose of this medication is to increase the fetal heart rate.”. Betamethasone does not affect the fetal heart rate, as it is primarily used to enhance lung maturity, as mentioned earlier. The incorrect statement may lead to confusion and misunderstanding of the medication's intended purpose.

Choice B rationale:

The nurse should not state, "The purpose of this medication is to halt cervical dilation.”. Betamethasone does not stop or halt cervical dilation. Its main action is on the fetal lungs to promote surfactant production. Cervical dilation is a natural process that occurs during labor and is not influenced by this medication.

Choice C rationale:

The nurse should not state, "The purpose of this medication is to stop preterm labor contractions.”. Betamethasone is not used to stop or prevent preterm labor contractions directly. Instead, its focus is on improving fetal lung maturity to enhance the baby's respiratory function once born prematurely.