A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

Accelerations

Early decelerations

Late decelerations

Variable decelerations

Answer and Explanation

The Correct Answer is D

The correct answer is D. Variable decelerations.

A. Accelerations in the fetal heart rate are generally considered reassuring. Accelerations are an indication of fetal well-being and are often seen in response to fetal movement.

B. Early decelerations are typically associated with head compression during contractions and are considered a normal response to the pressure on the fetal head.

C. Late decelerations are indicative of uteroplacental insufficiency.

Late decelerations occur after the peak of the contraction and are associated with inadequate oxygenation to the fetus. This pattern raises concerns about the baby's well-being.

D. Variable decelerations are associated with umbilical cord compression.

Variable decelerations are abrupt decreases in the fetal heart rate that vary in duration, depth, and timing. They often coincide with contractions and suggest compression or occlusion of the umbilical cord.

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Correct Answer is B

Explanation

The correct answer is B. Administer a 500 mL bolus of 5% dextrose in water prior to induction.

A. Informing the client that the anesthetic effect will last for approximately 6 hours is not the nurse's responsibility. The anesthesia provider usually communicates this information to the client.

B. Administering a 500 mL bolus of 5% dextrose in water prior to induction is the correct action.

This helps prevent maternal hypotension, which can be a side effect of epidural analgesia. The fluid bolus helps maintain adequate blood pressure for both the mother and the baby.

C. Having the client stand at the bedside with her arms at her side is not necessary for the administration of epidural analgesia. The client is usually positioned sitting up or lying on her side during the procedure.

D. Obtaining a 30-minute electronic fetal monitoring (EFM) strip prior to induction is not a standard requirement for epidural analgesia. However, continuous fetal monitoring is typically initiated after the epidural is placed to assess the baby's well-being during labor.

A. Oligohydramnios B. Hyperemesis gravidarum C. Leukorrhea D. Periodic tingling of the fingers

Correct Answer is A

Explanation

The correct answer is A.

A. Oligohydramnios: Oligohydramnios is a condition characterized by a lower-than-normal level of amniotic fluid in the uterus. Fetal assessment using electronic fetal monitoring may be indicated to monitor the well-being of the fetus, as oligohydramnios can be associated with fetal growth restriction and other complications.

B. Hyperemesis gravidarum: Hyperemesis gravidarum refers to severe nausea and vomiting during pregnancy. While it can be a challenging condition, it is not typically an indication for electronic fetal monitoring. Fetal monitoring is generally performed for conditions that directly impact the well-being of the fetus.

C. Leukorrhea: Leukorrhea refers to an increase in vaginal discharge, which is a common and normal occurrence during pregnancy. It is not an indication for electronic fetal monitoring, as it does not directly impact fetal well-being.

D. Periodic tingling of the fingers: Periodic tingling of the fingers is not typically an indication for fetal assessment using electronic fetal monitoring. It may be related to factors such as nerve compression or changes in circulation but is not a direct indication for monitoring the fetus.

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A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

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