A nurse is caring for a laboring patient with an external fetal monitor. The nurse notices late decelerations on the monitor strip.

What does the nurse interpret this as indicating?

Choice A rationale
Infective endocarditis is an infection of the inner lining of the heart’s chambers or valves. It’s typically caused by bacteria entering the blood and settling in the heart. It is considered an acquired heart disease because it develops during a person’s lifetime.
Choice B rationale
Kawasaki disease is an illness that causes inflammation in arteries, veins, and capillaries. It’s most common in children younger than 5 years old. While it’s not a heart disease, it can lead to serious heart problems if not treated.
Choice C rationale
Hypoplastic left heart syndrome is a type of congenital heart defect, meaning it’s present at birth. Therefore, it’s not considered an acquired heart disease.
Choice D rationale
Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body. It can be acquired or inherited.
Choice E rationale
Transposition of the great vessels is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). Therefore, it’s not considered an acquired heart disease.

Choice A rationale
Vaginal bleeding during pregnancy can be a sign of a serious complication such as placenta previa or placental abruption. Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to severe bleeding during pregnancy and delivery. Placental abruption is a serious condition in which the placenta separates from the uterus before the baby is born, which can cause heavy bleeding and can be life-threatening for both the mother and the baby. Therefore, any vaginal bleeding during pregnancy should be promptly reported to the healthcare provider.
Choice B rationale
Lightheadedness when lying on the back, also known as supine hypotensive syndrome, can occur in pregnancy when the enlarged uterus compresses the inferior vena cava, reducing blood return to the heart and causing a drop in blood pressure. While this can be uncomfortable, it is generally not considered a serious complication and can be alleviated by changing position.
Choice C rationale
Heartburn after eating is a common discomfort during pregnancy due to hormonal changes that relax the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus. While it can be uncomfortable, it is generally not a sign of a serious complication.
Choice D rationale
Swelling of the ankles, also known as edema, is common in pregnancy due to increased fluid volume in the body. While it can be uncomfortable, it is generally not a sign of a serious complication unless it is sudden or severe, which could be a sign of preeclampsia.