The labor and delivery nurse is assigned to four patients in ...

[P68T]

The labor and delivery nurse is assigned to four patients in early labor. Which electronic fetal monitoring finding would require immediate intervention?
 
  1. Early decelerations with each contraction
  2. Variable decelerations that recover to the baseline
  3. Late decelerations with minimal variability
  4. Accelerations

Question 2

The patient is at 6 weeks' gestation, and is spotting. The patient had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order:
 
  1. A urine pregnancy test.
  2. The patient to be seen next week for a full examination.
  3. A serum pregnancy test.
  4. An ultrasound to be done.

[Alyson.hiatt@yahoo.com]

Answer to Question 1

3
Rationale 1: Early decelerations are usually benign.
Rationale 2: Variable decelerations indicate cord compression, but those that recover to the baseline indicate that the fetus is tolerating the decelerations.
Rationale 3: Late decelerations are considered a nonreassuring fetal heart rate (FHR) pattern, and therefore require immediate intervention.
Rationale 4: Accelerations of the fetal heart rate indicate good oxygen reserve.

Answer to Question 2

3
Rationale 1: Urine pregnancy tests are not quantifiable.
Rationale 2: It is not appropriate to wait until next week to see the patient.
Rationale 3: A patient with a history of an ectopic pregnancy is at risk for another ectopic pregnancy, and spotting is a common symptom of ectopic pregnancy. A serum quantitative beta hCG test will be performed. The enzyme-linked immunosorbent assay may also be used, as it can detect hCG very early.
Rationale 4: An ultrasound may be used to diagnose an ectopic pregnancy, but would not be needed now.

[P68T]

TYSM

[Bigfoot1984]

Gracias!