A nurse is assessing a client who is in labor and has meconium-stained amniotic fluid.
The nurse observes variable decelerations on the EFM tracing, which are decelerations that have an abrupt onset and vary in shape, duration, and degree of fall below the baseline FHR.
What is the most appropriate nursing intervention for this situation?
Reposition the client to improve placental blood flow
Administer oxygen to the client to increase fetal oxygenation
Prepare for an amnioinfusion to dilute the meconium and relieve cord compression
Notify the provider and prepare for an emergency cesarean delivery
The Correct Answer is C
Prepare for an amnioinfusion to dilute the meconium and relieve cord compression.
An amnioinfusion is a procedure in which sterile fluid is infused into the uterus through a catheter to increase the volume of amniotic fluid and reduce the risk of fetal distress caused by meconium aspiration or cord compression.
Variable decelerations are a sign of cord compression and can be alleviated by an amnioinfusion.
Choice A is wrong because repositioning the client may not be enough to improve placental blood flow and prevent fetal hypoxia.
Choice B is wrong because administering oxygen to the client may not be sufficient to increase fetal oxygenation if the cord is compressed.
Choice D is wrong because an emergency cesarean delivery may not be necessary if an amnioinfusion can resolve the variable decelerations and improve fetal well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Prepare for an amnioinfusion to dilute the meconium and relieve cord compression.
An amnioinfusion is a procedure in which sterile fluid is infused into the uterus through a catheter to increase the volume of amniotic fluid and reduce the risk of fetal distress caused by meconium aspiration or cord compression.
Variable decelerations are a sign of cord compression and can be alleviated by an amnioinfusion.
Choice A is wrong because repositioning the client may not be enough to improve placental blood flow and prevent fetal hypoxia.
Choice B is wrong because administering oxygen to the client may not be sufficient to increase fetal oxygenation if the cord is compressed.
Choice D is wrong because an emergency cesarean delivery may not be necessary if an amnioinfusion can resolve the variable decelerations and improve fetal well-being.
Correct Answer is C
Explanation
Uteroplacental insufficiency.Late decelerations are decelerations that begin after the peak of the contraction and return to baseline after the contraction ends.They are caused by inadequate blood flow and oxygen delivery to the fetus through the placenta.This can be due to maternal hypotension, uterine hyperstimulation, placental abruption, or other factors.
Choice A is wrong because fetal head compression causes early decelerations, which are decelerations that begin and end with the contraction.
Choice B is wrong because umbilical cord compression causes variable decelerations, which are abrupt drops in the fetal heart rate that vary in shape and timing.
Choice D is wrong because maternal hypotension can cause uteroplacental insufficiency, but it is not the only cause.Also, maternal hypotension would affect the fetal heart rate baseline, not just the decelerations.
Normal ranges for fetal heart rate are 110 to 160 beats per minute for baseline and 15 beats per minute above or below baseline for variability.
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