,The nurse evaluates a pattern on the fetal monitor that appears similar to early
decelerations. The deceleration begins near the acme of the contraction and continues
well beyond the end of the contraction. Which nursing action indicates the proper
evaluation of this situation?
A: this pattern reflects variable decelerations. no interventions are necessary at this
time.
B: document this Category I fetal heart rate pattern and decrease the rate of the IV fluid
C: continue to monitor these early decelerations, which occur as the fetal head is
compressed during a contraction
D: this deceleration pattern is associated with uteroplacental insufficiency. the nurse
must act quickly to improve placental blood flow and fetal oxygen supply. - D: this
deceleration pattern is associated with uteroplacental insufficiency. the nurse must act
quickly to improve placental blood flow and fetal oxygen supply.
A pattern similar to early decelerations, but the deceleration begins near the acme of
the contraction and continues well beyond the end of the contraction, describes a late
deceleration. Oxygen should be given via a snug face mask. Position the patient on her
left
side to increase placental blood flow. Variable decelerations are caused by cord
compression. A vaginal examination should be performed to identify this potential
emergency. This is not a normal pattern, rather it is a Category III tracing, predictive of
abnormal fetal acid status at the time of observation. The IV rate should be increased in
order to add to the mother's blood volume. These are late decelerations, not early;
therefore interventions are necessary.
Which maternal condition should be considered a contraindication for the application of
internal monitoring devices?
A: unruptured membranes
B: cervix dilated to 4 cm
C: fetus has known heart defect
D: maternal HIV - A: unruptured membranes
To apply internal monitoring devices, the membranes must be ruptured. Cervical dilation
of 4 cm would permit the insertion of fetal scalp electrodes and an intrauterine catheter.
A compromised fetus should be monitored with the most accurate monitoring devices.
An internal electrode should not be placed if the patient has hemophilia, maternal HIV,
or genital herpes.
The nurse is instructing a nursing student on the application of fetal monitoring devices.
Which method of assessing the fetal heart rate requires the use of a gel?
Doppler is the only listed method involving ultrasonic transmission of fetal heart rates; it
requires the use of a gel. The fetoscope does not require gel because ultrasonic
transmission is not used. The scalp electrode is attached to the fetal scalp; gel is not
necessary. The tocodynamometer does not require gel. This device monitors uterine
contractions.
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 - C: over the uterine fundus
The tocotransducer monitors uterine activity and should be placed over the fundus,
where the most intensive uterine contractions occur. The tocotransducer is for external
use. The tocotransducer monitors uterine contractions. The most intensive uterine
contractions occur at the fundus; this is the best placement area.
Which clinical finding can be determined only by electronic fetal monitoring?
Beat-to-beat variability cannot be determined by auscultation because auscultation
provides only an average fetal heart rate (FHR) as it fluctuates. Tachycardia can be
determined by any of the FHR monitoring techniques. Bradycardia can be determined
by any of the FHR monitoring techniques. The fetal response to the contractions is
usually noted by an increase or decrease in fetal heart rate. These can be determined
by any of the FHR monitoring techniques.
Which method of intrapartum fetal monitoring is the most appropriate when a woman
has a history of hypertension during pregnancy?
A: continuous auscultation with a fetoscope
B: continuous electronic fetal monitoring
C: intermittent assessment with a Doppler transducer
D: intermittent electronic fetal monitoring for 15 minutes each hour - B: continuous
electronic fetal monitoring
Maternal hypertension may reduce placental blood flow through vasospasm of the spiral
arteries. Reduced placental perfusion is best assessed with continuous electronic fetal
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