A nurse is collecting data from a newborn who has an infection of Candida albicans.
Which of the following findings should the nurse expect?

Choice A rationale

A nonstress test (NST) typically takes 20 to 40 minutes to complete, not 2 to 4 hours. The duration is usually sufficient to observe fetal heart rate accelerations in response to fetal movement, which is the primary indicator of fetal well-being during the test.

Choice B rationale

A nonstress test is performed to assess fetal well-being, especially in pregnancies at risk for uteroplacental insufficiency, such as those with post-term gestation, pre-eclampsia, or diabetes, not specifically because it is a first pregnancy.

Choice C rationale

The nonstress test primarily measures the fetal heart rate patterns in response to fetal movement. Contraction strength is measured during a contraction stress test or by internal uterine pressure catheter, which is a different diagnostic procedure.

Choice D rationale

The nonstress test evaluates the fetal heart rate accelerations in response to spontaneous fetal movement. This indicates a healthy central nervous system and adequate oxygenation of the fetus. A reactive NST shows at least two accelerations of 15 bpm above baseline, lasting at least 15 seconds, within a 20-minute period.

Choice A rationale: Increasing the rate of maintenance IV fluids improves maternal intravascular volume and enhances uteroplacental perfusion. Late decelerations are indicative of uteroplacental insufficiency, where fetal oxygenation is compromised during contractions. By increasing fluid volume, the nurse can help optimize cardiac output and improve oxygen delivery to the fetus, potentially reducing the frequency or severity of late decelerations.

Choice B rationale: Assisting the client into a lateral position, preferably left lateral, helps relieve pressure on the inferior vena cava and improves venous return. This position enhances uteroplacental blood flow and oxygen delivery to the fetus. It is a first-line intervention for late decelerations, as it can reduce fetal hypoxia by improving maternal-fetal circulation without requiring pharmacologic measures.

Choice C rationale: Oxygen via nasal cannula at 2 L is insufficient to address fetal distress. When supplemental oxygen is indicated for intrauterine resuscitation, it should be administered via a non-rebreather mask at 10 L/min to maximize maternal oxygenation and fetal oxygen delivery. A nasal cannula at 2 L does not provide the high concentration needed to improve fetal oxygenation during late decelerations.

Choice D rationale: Misoprostol is a prostaglandin used for cervical ripening and labor induction. It is contraindicated in the presence of fetal distress, such as late decelerations, because it can cause uterine hyperstimulation and worsen fetal hypoxia. Administering misoprostol in this context could exacerbate the situation and increase the risk of adverse outcomes for the fetus.

Choice E rationale: Notifying the primary health care provider is essential when late decelerations are observed, as they indicate potential fetal compromise. Timely communication allows for further evaluation and potential interventions, such as adjusting oxytocin, initiating intrauterine resuscitation, or preparing for operative delivery if the fetal status does not improve. This action ensures collaborative and responsive care.