When evaluating an external monitor tracing of a woman in active ...

[acc299]

When 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 late in the con-traction, with the nadir of the decelerations occurring
 
  after the peak of the contraction. The nurse's first priority is to: 1. change the woman's position.
  2. notify the care provider.
  3. assist with amnioinfusion.
  4. insert a scalp electrode.

Question 2

Fetal bradycardia is most common during:
 
  1. intraamniotic infection.
  2. fetal anemia.
  3. prolonged umbilical cord compression.
  4. tocolytic treatment using ritodrine.

[Missbam101]

Answer to Question 1

1
1. Correct. Late decelerations may be caused by maternal supine hypotension syndrome. They are usually corrected when the woman turns onto her side to displace the weight of the gravid uterus off the vena cava.
2. Incorrect. If the fetus does not respond to primary nursing interventions for late decelera-tions, the nurse would continue with subsequent intrauterine resuscitation measures including notifying the care provider.
3. Incorrect. An amnioinfusion may be used to relieve pressure on a nonprolapsed umbilical cord. The fetal heart rate pattern associated with this situation mostly likely reveals variable deceleration.
4. Incorrect. A fetal scalp electrode would provide accurate data to evaluate fetal well-being, but is not a nursing intervention that would alleviate late decelerations, nor is it the nurse's first priority.

Answer to Question 2

3
1, 2, 4. Incorrect. These situations would most likely result in fetal tachycardia.
3. Correct. Fetal bradycardia can be considered a later sign of fetal hypoxia and is known to oc-cur before fetal death. Bradycardia can result from placental transfer of drugs, prolonged com-pression of the umbilical cord, maternal hypothermia, and maternal hypotension.

[acc299]

Excellent

[Alyson.hiatt@yahoo.com]

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