The nurse will implement the following interventions based on the fetal heart rate.
(Select All that Apply.)

Choice A rationale

The fetal heart indeed pumps blood to both the placenta, where oxygen and nutrients are obtained, and to the developing organs, which require these substances for growth and function. This dual circulation is essential for fetal development. The normal circulatory pattern ensures that oxygenated blood returns from the placenta to nourish the fetal tissues, while deoxygenated blood is transported back to the placenta for gas exchange.

Choice B rationale

Maternal and fetal blood do not mix under normal physiological conditions. The exchange of gases, nutrients, and waste products occurs across the placental barrier, which consists of fetal and maternal tissues but keeps their bloodstreams separate. This separation prevents potential immune reactions and maintains distinct circulatory systems for the mother and the fetus.

Choice C rationale

The placenta serves as the vital site for gas exchange in the fetus. Oxygen and carbon dioxide are exchanged between the maternal and fetal blood across the placental membranes via diffusion. Oxygen-rich blood from the mother is delivered to the fetus, while carbon dioxide, a waste product of fetal metabolism, moves from the fetus to the mother for elimination.

Choice D rationale

The umbilical arteries are responsible for carrying deoxygenated blood and waste products from the fetus to the placenta. This deoxygenated blood is then oxygenated and cleared of waste at the placenta before returning to the fetus via the umbilical vein. This flow pattern is crucial for maintaining the fetal environment and supporting its development.

Choice A rationale

While magnesium sulfate can sometimes lead to a mild diuresis, its primary therapeutic effect in severe preeclampsia is not a direct reduction in swelling and fluid retention. These symptoms are more effectively managed by addressing the underlying hypertension and potential fluid overload through other interventions.

Choice B rationale

Magnesium sulfate is primarily used as an anticonvulsant and to lower blood pressure in severe preeclampsia. While it might indirectly alleviate some discomfort associated with preeclampsia, a direct reduction in pain and headaches is not the primary indicator of its therapeutic effectiveness.

Choice C rationale

Magnesium sulfate does have antihypertensive properties and can help lower blood pressure in severe preeclampsia. However, its most critical role is in preventing seizures. Therefore, monitoring blood pressure alone is not the most appropriate way to determine if the medication is working effectively in preventing seizures. Normal blood pressure is typically less than 120/80 mmHg.

Choice D rationale

Magnesium sulfate is administered in severe preeclampsia primarily to prevent seizures and may also have a relaxing effect on smooth muscles, which can improve hyperreflexia. A decrease in seizure activity and the normalization of deep tendon reflexes (normal range is 2+) are key indicators that the magnesium sulfate is achieving its therapeutic goals.