A nurse is caring for a client who is on the electronic fetal monitor and the nurse notices that the client is experiencing tachysystole.
Which of the following describes tachysystole?
A reaction from an epidural.
When the fetus's heart rate drops below baseline.
More than five contractions in 10 minutes.
Initiating the use of Pitocin.
The Correct Answer is C
Choice A rationale
A reaction from an epidural can cause side effects such as hypotension and shivering, but it is not related to tachysystole.
Choice B rationale
When the fetus's heart rate drops below baseline, it is termed bradycardia, not tachysystole. This condition can occur due to various reasons, including cord prolapse or placental insufficiency.
Choice C rationale
Tachysystole is defined as more than five contractions in 10 minutes. This condition can lead to reduced blood flow to the fetus, resulting in fetal distress.
Choice D rationale
Pitocin is a medication used to induce labor and can cause tachysystole, but the administration of Pitocin itself is not the definition of tachysystole. It's the increased frequency of contractions that defines the condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
Based on the provided information:
- The client had a vacuum-assisted vaginal delivery with a heavy lochia and small clots noted.
- A boggy fundus and the need for oxytocin infusion also indicate an increased risk for excessive bleeding.
Given these observations, the client is at the highest risk for developing Postpartum hemorrhage (Option A) due to Heavy lochia with small clots (Option C).
So, the completed sentence would be:
"The client is at highest risk for developing Postpartum hemorrhage due to Heavy lochia with small clots."
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Explanation
Indicated:
B. Remove the newborn from phototherapy every 4 hours for thorough assessment of adverse effects of phototherapy.
D. Maintain an eye mask over the newborn's eyes.
E. Reposition the newborn every 2 hours.
F. Report sunken fontanels to the provider.
Contraindicated:
A. Apply lotion to the skin every 4 hours.
C. Newborn feedings should be every 8 hours.
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