What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?
Cerebral compression
Cord compression
Uteroplacental insufficiency
Spontaneous rupture of membranes
The Correct Answer is A
Choice A reason: Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.
Choice B reason: Cord compression is not the cause of early decelerations but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.
Choice C reason: Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.
Choice D reason: Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not the correct action, as the rate is not within normal limits. A normal FHR at 30 weeks of gestation is between 110 and 160 beats/min. A rate of 82 beats/min is considered bradycardia (slow heart rate), which can indicate fetal distress or hypoxia (low oxygen).
Choice B reason: This is not the first action, but it may be necessary after confirming the FHR. The nurse should first rule out the possibility of a maternal-fetal heart rate confusion, which can occur when the maternal heart rate is mistakenly counted as the FHR. This can happen if the Doppler or the electronic fetal monitor is placed too close to the maternal pulse or if the maternal heart rate is unusually slow².
Choice C reason: This is the correct action, as it can help differentiate between the maternal and the fetal heart rate. The nurse should assess the woman's radial pulse at the same time as listening to the FHR and compare the rates and rhythms. If the rates are the same or very close, it is likely that the nurse is hearing the maternal heart rate instead of the FHR. If the rates are different, it is likely that the nurse is hearing the FHR and that the fetus has bradycardia.
Choice D reason: This is not the correct action, as it may cause unnecessary anxiety or distress for the woman. The nurse should not allow the woman to hear the heartbeat until the FHR is confirmed and the cause of the bradycardia is determined. The nurse should also explain the situation to the woman and provide reassurance and support.
Correct Answer is D
Explanation
Choice A reason: Syphilis is a bacterial STI caused by Treponema pallidum. It is characterized by three stages: primary, secondary, and tertiary. It can cause serious complications such as neurosyphilis, cardiovascular syphilis, and congenital syphilis. However, it is not the most common bacterial STI.
Choice B reason: Candidiasis is a fungal infection caused by Candida albicans. It is not a STI, but rather an opportunistic infection that can affect the vagina, mouth, skin, or other mucous membranes. It can cause symptoms such as itching, burning, discharge, and inflammation.
Choice C reason: Gonorrhea is a bacterial STI caused by Neisseria gonorrhoeae. It can infect the urethra, cervix, rectum, throat, or eyes. It can cause symptoms such as dysuria, discharge, pelvic pain, and bleeding. It can also lead to complications such as pelvic inflammatory disease, epididymitis, infertility, and disseminated gonococcal infection. However, it is not the most common bacterial STI.
Choice D reason: Chlamydia is a bacterial STI caused by Chlamydia trachomatis. It is the most common bacterial STI, affecting about 2.86 million people in the United States in 2018. It can infect the urethra, cervix, rectum, throat, or eyes. It can cause symptoms such as dysuria, discharge, pelvic pain, and bleeding. It can also lead to complications such as pelvic inflammatory disease, epididymitis, infertility, and ectopic pregnancy.
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