A nurse is reinforcing teaching to a student on newborn erythromycin 0.9% ophthalmic ointment administration.
Which of the following statements by the nurse should be included in the teaching? (Select All that Apply.)

Choice A rationale

This statement incorrectly defines both terms. Multigravida refers to a woman who has experienced multiple pregnancies, while primigravida specifically denotes a woman who is pregnant for the very first time, regardless of the outcome of any previous pregnancies.

Choice B rationale

This statement is incorrect as there is a distinct difference between multigravida and primigravida based on the number of prior pregnancies. These terms are fundamental in obstetrics for assessing maternal risk factors and guiding clinical management.

Choice C rationale

This statement is incorrect. Multigravida refers to a woman who has been pregnant more than once, not someone who has never been pregnant. Nulligravida is the term for a woman who has never been pregnant. Primigravida, in contrast, specifically describes a woman in her first pregnancy.

Choice D rationale

This statement correctly differentiates the terms. Multigravida is a woman who has experienced two or more pregnancies, regardless of whether they resulted in a live birth. Primigravida refers exclusively to a woman who is currently pregnant for the first time. These classifications are critical for anticipating potential complications and providing appropriate care.

Choice A rationale

Variable decelerations are abrupt, unpredictable decreases in fetal heart rate, often V, W, or U shaped. They are caused by umbilical cord compression, which reduces umbilical blood flow, leading to hypoxia and acidemia. This compromises fetal oxygenation and can indicate fetal distress requiring intervention to optimize fetal well-being.

Choice B rationale

Early decelerations are symmetrical, gradual decreases in fetal heart rate that mirror uterine contractions. They are caused by head compression during labor, stimulating the vagus nerve and slowing the heart rate. This is generally considered a benign finding and indicates normal fetal response to uterine contractions.

Choice C rationale

Decreased fetal heart rate (FHR) variability refers to a reduction in the normal fluctuations of the FHR. This indicates reduced central nervous system (CNS) oxygenation and autonomic nervous system activity, often due to fetal hypoxia, acidemia, or CNS depressant medications. Sustained decreased variability is a significant nonreassuring sign.

Choice D rationale

Absent accelerations mean the fetal heart rate does not spontaneously increase by 15 beats per minute for at least 15 seconds. Fetal accelerations indicate a healthy, oxygenated fetal central nervous system and are a sign of fetal well-being. Their absence suggests potential fetal hypoxemia or acidosis.

Choice E rationale

A fetal heart rate baseline higher than expected, typically above 160 beats per minute, is classified as fetal tachycardia. This can be caused by maternal fever, infection, fetal hypoxia, or certain medications. Sustained tachycardia can increase fetal metabolic demand and potentially lead to fetal decompensation.