A nurse is caring for a client who is pregnant and is at the end of her first trimester. The nurse should place the Doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones (FHT)?
Just above the umbilicus
Just above the symphysis pubis
The right lower quadrant
The left lower quadrant
The Correct Answer is B
The correct answer is B. Just above the symphysis pubis.
A. Just above the umbilicus: At the end of the first trimester, the uterus is still within the pelvic cavity, and fetal heart tones are typically not detectable above the umbilicus at this stage.
B. Just above the symphysis pubis: This is the correct placement for assessing fetal heart tones during the first trimester. The fetal heart is usually located low in the pelvis during early pregnancy, making it most easily heard just above the pubic bone.
C. The right lower quadrant: Fetal heart tones are typically assessed in the midline of the abdomen, and focusing on the lower quadrants may not be the optimal location, especially in the first trimester.
D. The left lower quadrant: Similar to the right lower quadrant, focusing on the lower quadrants may not be the most appropriate location for assessing fetal heart tones during the first trimester.
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Related Questions
Correct Answer is D
Explanation
A. Resting tone of 15 mmHg:A resting tone of 15 mmHg is generally acceptable and indicates normal uterine resting pressure, which should be between 5 and 20 mmHg.
B. Frequency of every two minutes. A frequency of every two minutes can be acceptable during labor, especially if the contractions are not too long or intense. The key consideration is the duration and intensity of the contractions.
C. Intensity of 60 to 90 mmHg: This intensity is typically acceptable for labor induction and signifies effective contractions. There’s no indication to stop oxytocin based solely on this intensity range.
D. Duration of 90 to 120 seconds:A contraction lasting 90 to 120 seconds is concerning and indicates potential uterine hyperstimulation, warranting the discontinuation of oxytocin to protect both the mother and fetus from adverse effects.
Correct Answer is D
Explanation
A. Decreased vaginal discharge is not typically associated with the onset of labor. In fact, an increase in vaginal discharge may be observed as the cervix begins to soften and efface.
B. Weight gain of 0.5 to 1.5 kg is not a specific sign that precedes labor. Weight gain during late pregnancy is more related to fluid retention, and it does not necessarily indicate imminent labor.
C. Urinary retention is not a common sign that precedes labor. However, increased pressure on the bladder from the descending fetus may lead to more frequent urination rather than retention.
D. A surge of energy is known as the "nesting instinct" and is a common sign that precedes labor. Some women experience a burst of energy and motivation to prepare for the upcoming birth.
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