Nokea
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.
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A pregnant woman is being seen at her first prenatal visit. The RN should correct which action of a student nurse who is preparing the client for a pelvic examination?
- A. Asking the client if she needs something to drink
- B. Assembling the necessary equipment for the pelvic examination
- C. Positioning the client in the lithotomy position
- D. Explaining the procedure prior to the pelvic examination
Correct Answer: A
Rationale: Multipara is a term used for a woman who has given birth more than once, which is consistent with the birth history provided. Primigravida refers to a woman who is pregnant for the first time, and primipara refers to a woman who has had one pregnancy outcome.
The nurse in labor and delivery notices an increase in the number of women requesting cesarean births. Which are the parameters and criteria used when making the decision to perform a cesarean delivery on maternal request (CDMR)? Select all that apply.
- A. Patient is able to self-pay for the procedure.
- B. Patient is willing to defer from legal litigation.
- C. Mother is planning to only have one child.
- D. Patient is aware of possible neonatal complications.
Correct Answer: D
Rationale: Choice B is correct because CDMR (cesarean delivery on maternal request) is often performed after 39 weeks gestation when the mother is fully aware of the risks and potential complications involved with the procedure.
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.
The nurse is providing care for a prenatal patient who is told she will require a cesarean delivery because of cephalopelvic disproportion. Which explanation of the condition will the nurse provide to the patient?
- A. The patient has a preexisting medical condition that supports cesarean birth.
- B. The size and/or shape of either the fetal head or patient pelvis is an issue.
- C. The placenta is implanted in an unfavorable position in the uterus.
- D. The patient had a surgery with an incision through the myometrium of the uterus.
Correct Answer: B
Rationale: Choice B is the correct answer because cephalopelvic disproportion refers to a situation where the size or shape of the fetal head or the mother's pelvis causes difficulty during vaginal birth. This is the most accurate explanation for why a cesarean may be required.
The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)
- A. Post-term fetus
- B. Maternal fever
- C. Placenta previa
- D. Induction of labor
Correct Answer: A
Rationale: A. Post-term fetus: Fetal scalp stimulation can be contraindicated in post-term fetuses due to the potential risks associated with uterine hyperstimulation and decreased fetal reserve in these pregnancies.