A patient in early labor has mild contractions seven to nine minutes apart and blood pressure of 130/80 mm Hg.
Maternalfetal monitoring is started and the nurse engages the patient in conversation as a distraction technique. At first she seems happy, excited, and confident, but eventually she becomes introverted and restless. Her pulse is rapid, her blood pressure is now 137/85 mm Hg, and she is hyperventilating. The fetal monitor shows no variability for almost 20 minutes; variability then becomes evident but there are no late decelerations. What should the nurse do?
A) Notify the physician of the patient's blood pressure increase
B) Notify the physician about the lack of FHR variability
C) Help the patient regain control of her breathing technique
D) Assist the patient into a squatting position
Question 2
During contractions, the electronic fetal monitor
(EFM) shows variable V-shaped decelerations in the FHR lasting about 30 seconds with accelerations of about 5 bpm before and after each deceleration. Overshoot is absent and the baseline FHR is within normal limits. What should the nurse do first?
A) Help the woman change positions
B) Discontinue supplemental oxygen
C) Position the woman on her side with a pillow under her left hip
D) Start an oxytocic infusion and decrease the rate of IV fluids
The patient interview often requires note taking.
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