What is the most likely cause for variable fetal heart rate (FHR) decelerations?
Fetal hypoxemia.
Altered fetal cerebral blood flow.
Uteroplacental insufficiency.
Umbilical cord compression.
The Correct Answer is D
Choice A rationale
Fetal hypoxemia, a deficiency in oxygen reaching the fetal tissues, typically manifests as late decelerations in the fetal heart rate tracing, which reflect uteroplacental insufficiency. While severe hypoxemia can lead to various FHR patterns, variable decelerations are more directly associated with mechanical factors affecting the umbilical cord.
Choice B rationale
Altered fetal cerebral blood flow can be a consequence of various factors, including hypoxemia and cord compression, and can influence the fetal heart rate. However, variable decelerations are specifically caused by events that directly impede blood flow through the umbilical vessels rather than a generalized alteration in cerebral circulation.
Choice C rationale
Uteroplacental insufficiency, a condition where the placenta is unable to deliver an adequate supply of oxygen and nutrients to the fetus, typically results in late decelerations, indicating fetal distress due to chronic hypoxia. Variable decelerations, in contrast, have a more abrupt onset and recovery, reflecting acute changes in umbilical cord blood flow.
Choice D rationale
Umbilical cord compression occurs when the umbilical cord, which carries oxygen and nutrients to the fetus, is squeezed or constricted. This compression leads to a transient decrease in fetal blood flow and oxygenation, resulting in a rapid drop and subsequent return of the fetal heart rate, which is characteristic of variable decelerations. The shape, timing, and abrupt nature of variable decelerations directly correlate with the intermittent pressure on the umbilical cord.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Applying constant firm pressure to the penis for five minutes if bleeding occurs is an appropriate initial intervention for bleeding after a circumcision. However, it does not address the routine care needed after each diaper change to promote healing and prevent infection.
Choice B rationale
Cleansing the penis gently with water after each diaper change removes urine and stool, preventing irritation and potential infection. Applying a thin layer of petroleum jelly around the glans helps to keep the diaper from sticking to the healing circumcision site, reducing discomfort and promoting healing.
Choice C rationale
Prepackaged diaper wipes often contain fragrances and alcohol, which can irritate the sensitive skin of a newly circumcised penis and potentially delay healing or cause discomfort. Gentle cleansing with water is preferred.
Choice D rationale
The yellow exudate that forms on the glans after circumcision is a normal part of the healing process, known as granulation tissue. It should not be washed off, as this can disrupt healing and increase the risk of infection. It will typically disappear on its own over a few days.
Correct Answer is C
Explanation
Choice A rationale
Placenta previa is a condition where the placenta partially or totally covers the cervix. While it poses risks for hemorrhage during labor and delivery, it does not directly increase the risk of postpartum infection. The primary risks associated with placenta previa are related to bleeding, not infection.
Choice B rationale
Meconium aspiration occurs when a fetus inhales meconium-stained amniotic fluid. This primarily affects the newborn's respiratory system and does not directly increase the postpartum client's risk of infection. The complications of meconium aspiration are focused on the neonate.
Choice C rationale
A midline episiotomy is a surgical incision made in the perineum during childbirth to enlarge the vaginal opening. This incision creates a break in the skin and mucous membranes, providing a potential portal of entry for bacteria. Therefore, a midline episiotomy places the postpartum client at an increased risk for local infection at the incision site.
Choice D rationale
Gestational hypertension is high blood pressure that develops during pregnancy and typically resolves after delivery. While it poses risks to both the mother and the fetus, it does not directly increase the postpartum client's risk of infection. The primary concerns with gestational hypertension are related to blood pressure control and potential end-organ damage.
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