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
Acute rheumatic fever is a complication that can occur after an infection with group A streptococcus, which causes strep throat and sometimes scarlet fever. The most common symptoms of rheumatic fever include fever, painful and tender joints, pain in the chest, fatigue, fast heart rate, palpitations, and multiple-joint inflammation. Therefore, asking if the child has had a sore throat recently is relevant as it could indicate a recent strep throat infection, which is a common precursor to acute rheumatic fever.
Choice B rationale
While injuries can lead to various health complications, they are not directly related to the development of acute rheumatic fever. Acute rheumatic fever is primarily caused by an overreaction of the body’s immune system to a strep throat or scarlet fever infection.
Therefore, recent injuries would not typically be a relevant factor in a suspected case of acute rheumatic fever.
Choice C rationale
Acute rheumatic fever is not a congenital condition, meaning it is not present from birth. It develops as a complication of strep throat or scarlet fever. Therefore, asking if the child was born with a cardiac defect would not typically be relevant in a suspected case of acute rheumatic fever.
Choice D rationale
While aspirin is often used in the treatment of rheumatic fever to reduce inflammation and pain, it is not a cause of the condition. Therefore, asking if the child has been given aspirin in the past 2 weeks would not typically be relevant in a suspected case of acute rheumatic fever.

Choice A rationale
The G in GTPAL stands for gravida, which is the number of times an individual has conceived, including any current pregnancy. In this case, G3 means the client has had three pregnancies, which includes two prior pregnancies and the current one.
Choice B rationale
The client’s record does not indicate that she is currently pregnant with twins, making this choice incorrect.
Choice C rationale
The A in GTPAL stands for the number of abortions, which refers to all times the individual has lost a pregnancy before 20 weeks. In this case, A1 means the client has had one abortion, indicating a risk for miscarriage.
Choice D rationale
The T in GTPAL stands for term births, which refers to the number of times an individual has carried a pregnancy to at least 37 weeks of gestation and delivered. In this case, T1 means the client has had one full-term birth.
Choice E rationale
The L in GTPAL stands for living children. In this case, L1 means the client has one living child.