What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?
Cerebral compression
Cord compression
Uteroplacental insufficiency
Spontaneous rupture of membranes
The Correct Answer is A
Choice A reason: Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.
Choice B reason: Cord compression is not the cause of early decelerations but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.
Choice C reason: Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.
Choice D reason: Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A fetal heartbeat auscultated with a Doppler or a fetoscope is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. A Doppler is an electronic device that uses sound waves to detect the fetal heart rate, while a fetoscope is a stethoscope-like instrument that amplifies the fetal heart sounds. The fetal heartbeat can be heard as early as 10 to 12 weeks of gestation with a Doppler and 18 to 20 weeks of gestation with a fetoscope.
Choice B reason: Quickening is the first perception of fetal movement by the pregnant woman, usually felt between 16 and 20 weeks of gestation for first-time mothers and 13 to 16 weeks of gestation for experienced mothers. However, quickening is not a positive sign of pregnancy, as it can be subjective and mistaken for other sensations, such as gas, hunger, or muscle spasms².
Choice C reason: Morning sickness is a common symptom of pregnancy that involves nausea and vomiting, usually in the first trimester. However, morning sickness is not a positive sign of pregnancy, as it can be caused by other factors, such as food poisoning, stress, or medication.
Choice D reason: A positive pregnancy test is a probable sign of pregnancy, not a positive sign. A pregnancy test detects the presence of human chorionic gonadotropin (hCG), a hormone produced by the placenta, in the urine or blood of the woman. However, a positive pregnancy test does not guarantee a viable pregnancy, as it can be influenced by the timing, the quality, or the interpretation of the test. A positive pregnancy test can also occur in cases of ectopic pregnancy, molar pregnancy, or miscarriage.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.
Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.
Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.
Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.
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