A nurse is discussing intermittent fetal heart monitoring with a newly licensed nurse. Which of the following statements should the nurse include?

"Count the fetal heart rate for 15 seconds to determine the baseline."

"Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor."

"Auscultate the fetal heart rate every 30 minutes during the second stage of labor."

"Count the fetal heart rate after a contraction to determine baseline changes."

Answer and Explanation

The Correct Answer is D

A. "Count the fetal heart rate for 15 seconds to determine the baseline." The fetal heart rate (FHR) should be counted for a full minute to determine the baseline, not just for 15 seconds.

B. "Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor." The fetal heart rate is typically auscultated every 30 minutes in low-risk clients during the first stage of labor.

C. "Auscultate the fetal heart rate every 30 minutes during the second stage of labor." The fetal heart rate should be auscultated every 15 minutes during the second stage of labor, not every 30 minutes.

D. "Count the fetal heart rate after a contraction to determine baseline changes." It is important to assess the fetal heart rate after a contraction to determine if there are any decelerations or baseline changes that may indicate fetal distress.

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Correct Answer is A

Explanation

A. "The purpose of this medication is to boost fetal lung maturity." Betamethasone is a corticosteroid given to promote fetal lung maturity by stimulating surfactant production, especially in preterm labor.

B. "The purpose of this medication is to stop preterm labor contractions." Tocolytics, not corticosteroids, are used to stop preterm labor contractions. Betamethasone is not designed to halt contractions.

C. "The purpose of this medication is to halt cervical dilation." Betamethasone does not affect cervical dilation. Its role is to support fetal lung development.

D. "The purpose of this medication is to increase the fetal heart rate." Betamethasone does not directly influence fetal heart rate. Its primary use is to mature fetal lungs in anticipation of early birth.

A. Wipe from the back to front when performing perineal hygiene B. Keep a daily record of fetal kick counts. C. Avoid bubble bath solution when taking a tub bath. D. Use a condom with sexual intercourse.

Correct Answer is B

Explanation

A. Wipe from the back to front when performing perineal hygiene: The correct method for perineal hygiene is to wipe front to back to reduce the risk of introducing bacteria into the vaginal area, especially in a client with PROM who is at risk for infection.

B. Keep a daily record of fetal kick counts: Monitoring fetal kick counts helps assess fetal well-being, particularly in a high-risk pregnancy like PROM at 26 weeks. It helps detect potential fetal distress early.

C. Avoid bubble bath solution when taking a tub bath: While avoiding bubble bath may help prevent irritation or infection, tub baths should be avoided entirely in cases of PROM to reduce the risk of ascending infection.

D. Use a condom with sexual intercourse. Sexual intercourse is contraindicated in clients with PROM due to the risk of infection.

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A nurse is discussing intermittent fetal heart monitoring with a newly licensed nurse. Which of the following statements should the nurse include?

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