Nokea
Proper placement of the tocotransducer for electronic fetal monitoring is
- A. Inside the uterus.
- B. On the fetal scalp.
- C. Over the uterine fundus.
- D. Over the mother's lower abdomen.
Correct Answer: C
Rationale: The tocotransducer is a device used for electronic fetal monitoring to measure uterine contractions. Proper placement of the tocotransducer is over the uterine fundus, which is the upper part of the uterus where contractions are most accurately detected. Placing the tocotransducer there allows for optimal monitoring of uterine activity during labor, ensuring accurate readings and appropriate interventions if necessary. Placing the tocotransducer inside the uterus, on the fetal scalp, or over the mother's lower abdomen would not provide accurate readings of uterine contractions.
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What is the most likely cause for this fetal heart rate pattern?
- A. Administration of an epidural for pain relief during labor
- B. Cord compression
- C. Breech position of fetus
- D. Administration of meperidine (Demerol) for pain relief during labor
Correct Answer: B
Rationale: The fetal heart rate pattern described in the question, which likely includes decelerations, is indicative of cord compression. Cord compression occurs when there is pressure on the umbilical cord, leading to temporary reduction or blockage of blood flow and oxygen supply to the fetus. This can result in variable decelerations in the fetal heart rate pattern. Common scenarios that can cause cord compression include changes in fetal position, cord prolapse, or excessive uterine contractions. It is important to promptly address cord compression to prevent fetal distress and potential complications during labor and delivery. The other options listed may also influence fetal heart rate, but in this scenario, cord compression is the most likely cause based on the described heart rate pattern.
The nurse is caring for a pregnant person who was in a motor vehicle accident when she was younger and broke a bone in her pelvis. For what complication should the nurse be prepared?
- A. fetal dystocia
- B. pelvic dystocia
- C. uterine dystocia
- D. age dystocia
Correct Answer: B
Rationale: Pelvic dystocia can result from previous pelvic fractures.
To clarify the fetal condition when baseline variability is absent, the nurse should first
- A. monitor fetal oxygen saturation using fetal pulse oximetry.
- B. notify the physician so that a fetal scalp blood sample can be obtaine
- C. apply pressure to the fetal scalp with a glove finger using a circular motion.
- D. increase the rate of nonadditive IV fluid to expand the mother's blood volume
Correct Answer: C
Rationale: When baseline variability is absent in fetal monitoring, it may indicate fetal hypoxia or acidemia. The appropriate action to further evaluate the fetal condition would be to notify the physician so that a fetal scalp blood sample can be obtained. This blood sample can provide important information about the oxygenation status of the fetus, helping to guide the management and interventions needed to support the baby's well-being. Monitoring fetal oxygen saturation using fetal pulse oximetry (choice A) or performing other interventions such as applying pressure to the fetal scalp (choice D) or increasing IV fluids for the mother (choice E) would not provide as direct or specific information about the fetal condition as obtaining a blood sample would.
If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess the fetal heart rate in which quadrant of the maternal abdomen?
- A. Right upper
- B. Left upper
- C. Right lower
- D. Left lower
Correct Answer: C
Rationale: When the fetus is in a right occiput anterior position, the back of the fetus is on the mother's right side, and the fetal heart is also located on the right side of the mother's abdomen. It is typically heard in the lower right quadrant due to the location of the fetal back and heart. The nurse should assess the fetal heart rate in the right lower quadrant of the maternal abdomen to accurately assess the well-being of the fetus in this position.
What is a common reason for cesarean birth?
- A. cephalic presentation
- B. laboring person’s BMI of 23
- C. labor dystocia
- D. lack of adequate pain control
Correct Answer: C
Rationale: Labor dystocia, or failure to progress, is a common reason for a cesarean birth.