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 A
Explanation
Choice A rationale
Pounding headache, visual changes, and epigastric pain in a patient with pregnancy-induced hypertension (PIH), now known as gestational hypertension or preeclampsia, are classic signs of worsening disease and indicate central nervous system irritability and potential hepatic involvement. These symptoms suggest the condition is progressing towards severe preeclampsia and increase the risk of eclampsia, which is characterized by seizures.
Choice B rationale
Magnesium sulfate is used to prevent seizures in severe preeclampsia. While it can cause side effects such as flushing, warmth, and muscle weakness, it does not typically cause pounding headache, visual changes, or epigastric pain. These symptoms are more indicative of the underlying disease process rather than the treatment.
Choice C rationale
Anxiety due to hospitalization can cause various symptoms, but the specific combination of pounding headache, visual changes, and epigastric pain is more strongly associated with the physiological changes occurring in worsening preeclampsia rather than solely psychological distress.
Choice D rationale
Gastrointestinal upset can cause epigastric pain, but it would not typically be accompanied by pounding headache and visual changes in the context of pregnancy-induced hypertension. The constellation of these symptoms strongly points towards a worsening of the hypertensive condition and potential end-organ involvement. .
Correct Answer is D
Explanation
Choice A rationale
Applying heat to the breasts in mastitis can increase blood flow and potentially worsen inflammation. While heat can be comforting for engorgement, in mastitis, it may exacerbate the inflammatory response and should be used cautiously or avoided in the acute phase. The primary goal is to remove milk and reduce inflammation.
Choice B rationale
Removing the nursing bra might provide some temporary comfort if the bra is too tight and constricting milk flow. However, it does not address the underlying infection or inflammation of mastitis. Supportive nursing bras are generally recommended to provide support without restricting milk ducts.
Choice C rationale
Given the early indications of mastitis, such as a hard, warm area in the breast, moderate lochia rubra (which is normal for postpartum day 3), and a fundus appropriately descended, additional interventions are indeed indicated to prevent the progression of the infection and promote healing. Ignoring these signs could lead to a more severe infection.
Choice D rationale
Continued breastfeeding is crucial for managing mastitis. Frequent emptying of the breasts helps to remove the stagnant milk, which can contribute to the infection. Breast milk has antimicrobial properties that can aid in resolving the infection. Encouraging the client to breastfeed frequently on the affected side, starting with that side, promotes drainage and healing.
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