A client presents to the triage unit for a non-stress test (NST) after being diagnosed with oligohydramnios.
Which fetal heart rate characteristic could be seen during the NST related to the client’s diagnosis?

Choice A rationale

Marijuana use during pregnancy should be avoided. The active compound, tetrahydrocannabinol (THC), crosses the placenta and can impact fetal development. Studies suggest a link between marijuana use and adverse outcomes, including placental abruption, fetal distress, and congenital anomalies. Additionally, neonates born to mothers who used marijuana may experience withdrawal symptoms, such as tremors and irritability, similar to those seen with other substance exposures.

Choice B rationale

While marijuana use during pregnancy is linked to adverse outcomes, the specific effects mentioned, such as anemia and intrauterine growth restriction (IUGR), are not the primary or most well-documented effects of marijuana use. Anemia is more commonly associated with nutritional deficiencies, while IUGR is linked to various factors including smoking, hypertension, and placental issues. Behavioral concerns in childhood are a more recognized risk, but the other associations are less accurate.

Choice C rationale

This statement is incorrect as it downplays the known risks. The effects of marijuana on pregnancy are not unknown; research has clearly established that cannabis use is associated with several adverse outcomes. THC is a known teratogen and can disrupt normal fetal development. Therefore, advising a client to use it cautiously and minimally is inappropriate and does not align with current medical and scientific understanding of its risks to the developing fetus.

Choice D rationale

This statement is incorrect because marijuana use does affect the fetus in utero. As noted previously, THC crosses the placental barrier and can directly impact fetal development, leading to conditions like placental abruption, fetal distress, and neonatal withdrawal. The risk of sudden infant death syndrome (SIDS) is linked to a variety of factors, including maternal smoking and substance use, but marijuana's effect in utero is a distinct and well-documented concern separate from the postpartum risk. .

Choice A rationale

A recommended method for fetal kick counts is to choose a time when the baby is most active, often after a meal due to increased maternal glucose levels stimulating fetal activity. The recommended duration is typically 2 hours, during which the client should aim to feel a minimum of 10 movements. This timing provides a reliable snapshot of fetal well-being.

Choice B rationale

Counting fetal movements for only 5 minutes is insufficient to accurately assess fetal well-being and identify potential distress. The standard recommendation is to count movements over a longer period, typically up to 2 hours, to provide a more comprehensive evaluation of fetal activity patterns. A shorter duration may lead to false assurances or missed signs of distress.

Choice C rationale

Recording kicks in a daily log helps establish a baseline pattern of fetal movement specific to that pregnancy. Any significant or sudden decrease from this established baseline, such as fewer than 10 movements in a 2-hour period, is a critical sign that warrants immediate reporting to the healthcare provider for further evaluation and intervention to ensure fetal health.

Choice D rationale

Performing the kick count at the same time each day is crucial for consistency and helps to identify any deviation from the established baseline pattern of fetal activity. Consistency in timing, such as after a specific meal, helps to minimize variables and ensures that the data collected is reliable for monitoring fetal well-being over time.

Choice E rationale

The optimal position for performing fetal kick counts is a reclining or side-lying position, which maximizes blood flow to the uterus and promotes fetal activity. A standing position can compress the vena cava, reducing blood flow to the placenta and potentially decreasing fetal movement, which could lead to an inaccurate or falsely low kick count.

Choice F rationale

Fetal kick counts are generally recommended to begin around the 28th week of gestation. This is when fetal movements become more regular and consistent, making it easier for the client to track a meaningful baseline. Starting the counts earlier at 15 weeks is not useful as the movements are too sporadic and inconsistent for reliable monitoring. *.