A nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones (FHT)?
Just above the umbilicus
Just above the symphysis pubis
The right lower quadrant
The left lower quadrant
The Correct Answer is B
The correct answer is B. Just above the symphysis pubis.
A. Just above the umbilicus: At the end of the first trimester, the uterus is still within the pelvic cavity, and fetal heart tones are typically not detectable above the umbilicus at this stage.
B. Just above the symphysis pubis: This is the correct placement for assessing fetal heart tones during the first trimester. The fetal heart is usually located low in the pelvis during early pregnancy, making it most easily heard just above the pubic bone.
C. The right lower quadrant: Fetal heart tones are typically assessed in the midline of the abdomen, and focusing on the lower quadrants may not be the optimal location, especially in the first trimester.
D. The left lower quadrant: Similar to the right lower quadrant, focusing on the lower quadrants may not be the most appropriate location for assessing fetal heart tones during the first trimester.
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Related Questions
Correct Answer is D
Explanation
The correct answer is D.
A. Slowing the client's rate of breathing is not directly related to the observed uniform decelerations. The primary concern is the fetal heart rate pattern.
B. Decreasing the rate of infusion of the maintenance IV solution is not the appropriate intervention for addressing the observed fetal heart rate decelerations. The focus should be on the oxytocin infusion rate.
C. Increasing the rate of infusion of the IV oxytocin is not the appropriate action.
The patient is already experiencing frequent and strong contractions, and increasing the oxytocin rate can exacerbate the decelerations and compromise fetal well-being.
D. Discontinuing the infusion of the IV oxytocin is the correct action.
The observed uniform decelerations are likely related to oxytocin-induced hyperstimulation of the uterus. Stopping or decreasing the oxytocin infusion allows for the uterine activity to decrease, potentially improving fetal heart rate patterns.
Correct Answer is D
Explanation
The correct answer is D. Prolonged labor
A. Umbilical cord prolapse is more commonly associated with breech presentations or other abnormal fetal positions. It is not a typical complication of occipital brow presentation.
B. Precipitous labor refers to an unusually rapid labor, and it is not a typical complication associated with occipital brow presentation. Prolonged labor is more likely.
C. Hypertonic uterine dysfunction involves excessive uterine contractions, and it is not specifically associated with occipital brow presentation. It is more commonly associated with other factors, such as maternal anxiety or use of oxytocin.
D. Prolonged labor is a complication that can be associated with occipital brow presentation.
Occipital brow presentation involves the fetal head being partially extended, and it can lead to difficulties in descending through the birth canal. This may result in a prolonged labor process.

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