A patient was given a fentanyl injection during labor.
The nurse noted the expected outcome of loss of variability along with a pattern indicating uteroplacental insufficiency.
Which of the following strips illustrates this?
Normal fetal heart rate variability with no decelerations.
Fetal heart rate pattern showing early decelerations.
Fetal heart rate pattern with loss of variability and late decelerations.
Fetal heart rate pattern showing variable decelerations.
The Correct Answer is C
Choice A rationale
Normal fetal heart rate variability indicates a healthy, well-oxygenated fetus with a functioning autonomic nervous system. This is a reassuring pattern and would not be the expected outcome of a fentanyl injection, which is known to depress the central nervous system, leading to a decrease in variability.
Choice B rationale
Early decelerations are a benign physiological response caused by head compression during a contraction. They are characterized by a gradual decrease in heart rate that mirrors the contraction and are not associated with uteroplacental insufficiency or the effects of fentanyl.
Choice C rationale
The administration of a narcotic like fentanyl, a central nervous system depressant, can reduce fetal heart rate variability. Loss of variability coupled with late decelerations is a key indicator of uteroplacental insufficiency, which is a concern after some pain medication administrations and requires immediate intervention to improve fetal oxygenation.
Choice D rationale
Variable decelerations are abrupt decreases in the fetal heart rate caused by umbilical cord compression. The shape, depth, and duration of these decelerations are variable, and they are not typically the primary pattern associated with either uteroplacental insufficiency or the direct central nervous system depressant effects of fentanyl.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Ritodrine is a beta-mimetic tocolytic that can cause maternal and fetal tachycardia. Betamethasone does not reduce this side effect. The primary purpose of betamethasone is to enhance fetal lung maturity. Tachycardia from ritodrine is a known side effect that is managed by monitoring and dosage adjustment, not by administering corticosteroids.
Choice B rationale
The purpose of betamethasone is not to suppress uterine contractions. Betamethasone is a corticosteroid that enhances the production of surfactant in the fetal lungs. Tocolytic medications like nifedipine or magnesium sulfate are used to suppress uterine contractions in preterm labor, allowing time for the betamethasone to take effect.
Choice C rationale
Magnesium sulfate therapy can cause respiratory depression as a side effect. Betamethasone does not maintain maternal respiratory effort or ventilation during this treatment. Calcium gluconate is the antidote for magnesium toxicity. The role of betamethasone is specific to fetal lung maturity, not maternal respiratory support during magnesium sulfate administration.
Choice D rationale
Betamethasone is a corticosteroid that stimulates the production and release of surfactant in the fetal lungs. Surfactant is a substance that reduces surface tension in the alveoli, preventing them from collapsing and improving gas exchange. Administering this medication to the mother improves fetal lung maturity and reduces the risk of respiratory distress syndrome in preterm infants.
Correct Answer is C
Explanation
Step 1 is: Identify the start and end of the first stage of labor. The first stage begins with the onset of regular uterine contractions and ends with full cervical dilation (10 cm) and effacement (100%). The patient's contractions started at 3 a.m., and she arrived at the hospital at 8: a.m. with 5 cm dilation. She delivered at 3: p.m. but her labor progression is noted up to 2 p.m. with an overwhelming need to push which indicates she was likely in the second stage of labor.
Step 2 is: The first stage of labor is from 3 a.m. (onset of regular contractions) to the overwhelming need to push at 2 p.m., which indicates the end of the first stage and the beginning of the second stage.
Step 3 is: Calculate the duration. From 3 a.m. to 2 p.m. is 11 hours. The final calculated answer is 11 hours.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.