While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate during the contraction's peak, with the nadir of the decelerations occurring when the contraction end. The nurse's first priority is to:
Select one:
Insert a scalp electrode.
Notify the care provider.
Assist with amnioinfusion.
Reposition the patient.
The Correct Answer is D
a. A scalp electrode is not indicated unless there is a problem with the external monitor tracing or if further assessment of the fetal heart rate variability is needed.
b. This is important but repositioning the patient is the priority.
c. Amnioinfusion is only done if repositioning the patient does not resolve the late decelerations.
d. The nurse is observing late decelerations of the fetal heart rate, which indicate uteroplacental insufficiency and fetal hypoxia. The nurse's first priority is to reposition the patient to improve placental blood flow and oxygen delivery to the fetus. Repositioning can be done by turning the patient to her side, elevating her legs, or placing a wedge under her hip.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
a. Idiopathic thrombocytopenia is a condition characterized by a low platelet count without an identifiable cause, which is not the case in this scenario.
b. Disseminated intravascular coagulation (DIC) is a condition characterized by widespread activation of the clotting system, which is not the case in this scenario.
c. HELLP syndrome is a serious complication of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count.
d. Eclampsia is a severe complication of preeclampsia characterized by seizures, which is not the case in this scenario.
Correct Answer is ["D"]
Explanation
a. This is a potential complication of diabetes during pregnancy but is not a primary reason for preconception counseling.
b. This is a potential complication of pregnancy but is not a primary reason for preconception counseling.
c. This is a potential complication of diabetes during pregnancy but is not a primary reason for preconception counseling.
d. Poor glycemic control before and during early pregnancy can increase the risk of birth defects in the fetus, making preconception counseling critical for women with diabetes.
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