A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination, the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?
Transvaginal fetal Doppler probe
External ultrasound transducer monitor
DeLee Hillis fetoscope
Internal fetal scalp electrode
The Correct Answer is B
A. A transvaginal fetal Doppler is not commonly used for continuous monitoring and is typically reserved for early pregnancy.
B. An external ultrasound transducer is appropriate for continuous fetal monitoring when the membranes are intact. It is noninvasive and safe for use during labor.
C. A DeLee Hillis fetoscope is used for intermittent auscultation, not continuous monitoring.
D. An internal fetal scalp electrode requires ruptured membranes and cervical dilation; it is contraindicated with intact membranes.
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Related Questions
Correct Answer is C
Explanation
A. Changing a perineal pad every 4 hours is within expected postpartum norms for moderate bleeding. This client’s condition does not indicate an urgent issue.
B. A urine output of 750 mL over 6 hours is adequate (approximately 125 mL/hr) and does not signal immediate concern.
C. Deep tendon reflexes of 1+ in a client receiving IV magnesium sulfate may indicate early magnesium toxicity or impending hyporeflexia. Magnesium sulfate toxicity can lead to respiratory depression and cardiac arrest, making this the highest-priority client.
D. Abdominal cramping during breastfeeding is common due to uterine contractions (afterpains) and is generally expected and non-life-threatening. This can be addressed after assessing higher-priority clients.
Correct Answer is C
Explanation
A. Effleurage is used during the first stage of labor to promote relaxation and decrease pain, not during the pushing stage, so using it while pushing is ineffective.
B. Counterpressure is most effective when applied to the lower back or sacral area during contractions, not the upper abdomen. Applying pressure to the upper abdomen would not relieve labor pain effectively.
C. Hydrotherapy involves immersing the laboring client in warm water to promote relaxation and reduce discomfort. Maintaining the water temperature between 36–37°C is safe for both mother and fetus while providing soothing pain relief.
D. A TENS unit is typically applied to the lower back during labor, not the lower abdomen, to reduce contraction-related pain. Applying it to the abdomen is not the standard practice and may not be effective.
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