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

Answer and Explanation

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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Correct Answer is D

Explanation

Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.

Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.

Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.

Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

A. an antiemetic such as pyridoxine to control vomiting. B. IV therapy to correct fluid and electrolyte imbalances. C. enteral nutrition to meet nutritional needs. D. corticosteroids to reduce inflammation.

Correct Answer is B

Explanation

Choice A reason: An antiemetic such as pyridoxine may be used to control vomiting in women with hyperemesis gravidarum, but it is not the initial treatment. The first priority is to restore fluid and electrolyte balance and prevent dehydration and hypovolemia.

Choice B reason: IV therapy is the initial treatment for women with hyperemesis gravidarum. It helps to correct fluid and electrolyte imbalances, prevent dehydration and hypovolemia, and restore normal blood pressure and urine output. IV fluids may also contain glucose, vitamins, and electrolytes to replenish losses.

Choice C reason: Enteral nutrition may be used to meet nutritional needs in women with hyperemesis gravidarum, but it is not the initial treatment. Enteral nutrition involves feeding through a tube inserted into the stomach or intestine. It may be considered if oral intake is not tolerated or adequate after IV therapy.

Choice D reason: Corticosteroids are not used to treat hyperemesis gravidarum. They are used to reduce inflammation in conditions such as asthma, rheumatoid arthritis, and allergic reactions. They have no effect on nausea and vomiting in pregnancy.

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What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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