What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

Spontaneous rupture of membranes.

Fetal head compression.

Umbilical cord compression.

Utero-placental insufficiency.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Spontaneous rupture of membranes (SROM) can sometimes be associated with variable decelerations due to potential cord compression if the presenting part is not well applied, but it is not the most likely cause of early decelerations. Early decelerations reflect a physiological response to fetal head compression.

Choice B rationale

Fetal head compression during a contraction leads to vagal nerve stimulation, causing a transient decrease in the fetal heart rate. This deceleration is typically gradual in onset and recovery, mirroring the contraction pattern, and is considered a benign finding.

Choice C rationale

Umbilical cord compression typically results in variable decelerations, which are abrupt decreases in FHR that are not necessarily associated with uterine contractions. The shape and timing of variable decelerations differ significantly from the gradual, consistent pattern of early decelerations.

Choice D rationale

Utero-placental insufficiency usually manifests as late decelerations, which are gradual decreases in FHR that begin after the peak of the contraction and recover after the contraction ends. This pattern indicates fetal hypoxia and is a concerning finding, distinct from early decelerations.

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Correct Answer is ["B","F","G"]

Explanation

Choice B rationale

Prostaglandin administration, either vaginally or orally, helps to ripen the cervix by increasing collagenase activity and water content, leading to cervical softening, thinning (effacement), and dilation, which are necessary for labor to begin.

Choice F rationale

Amniotomy, or artificial rupture of membranes (AROM), involves the deliberate rupture of the amniotic sac. This can stimulate labor by releasing prostaglandins, increasing uterine contractility, and allowing the presenting part of the fetus to descend further into the pelvis, putting pressure on the cervix.

Choice G rationale

Oxytocin is a synthetic hormone that mimics the action of endogenous oxytocin, stimulating uterine contractions. It is commonly administered intravenously to initiate or augment labor once cervical ripening has occurred or the cervix is favorable.

Choice A rationale

Epidural anesthesia is a method of pain relief during labor, not a method for inducing labor. It provides regional analgesia by blocking nerve impulses in the lower body.

Choice C rationale

Bed rest is generally not recommended for labor induction and can even be counterproductive. Ambulation and positional changes can help to encourage fetal descent and uterine activity.

Choice D rationale

Vitamin supplementation is important for overall maternal and fetal health during pregnancy but does not directly stimulate uterine contractions or cervical changes necessary for labor induction.

Choice E rationale

Fetal ultrasound is used to assess fetal well-being, presentation, and amniotic fluid volume but does not initiate the process of labor induction. .

A. She is exhibiting hypotonic uterine dysfunction. B. She is experiencing a normal latent stage. C. She is exhibiting hypertonic uterine dysfunction. D. She is experiencing precipitous labor.

Correct Answer is B

Explanation

Choice A rationale

Hypotonic uterine dysfunction typically occurs in the active phase of labor (after 4 cm cervical dilation) and is characterized by weak, infrequent, and ineffective contractions that do not lead to cervical change. The client in the latent phase with slow cervical change is not yet in the active phase.

Choice B rationale

The latent phase of the first stage of labor is characterized by irregular, mild to moderate contractions that cause slow, gradual cervical dilation and effacement. It can be lengthy, especially in primigravidas, and the discomfort can be significant. A cervical dilation of 2 cm with no change in 3 hours in the presence of painful, erratic contractions every 5 to 10 minutes aligns with a normal latent phase.

Choice C rationale

Hypertonic uterine dysfunction usually occurs in the latent phase and is characterized by frequent, uncoordinated, and strong contractions that are ineffective in causing cervical dilation or effacement. While the contractions are painful, they are not described as excessively strong or uncoordinated, and the client is in the expected early stage of labor.

Choice D rationale

Precipitous labor is a very rapid labor and delivery, typically lasting less than 3 hours from the onset of regular contractions to expulsion of the fetus. The client's labor is progressing slowly, with minimal cervical change over 3 hours, which is the opposite of precipitous labor.

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What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

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Naxlex Comprehensive Predictor Exams

Which of the following are common methods used for the induction of labor in obstetric practice? (Select All that Apply)

Correct Answer is ["B","F","G"]

Explanation

A primigravida at 40 weeks of gestation is having erratic uterine contractions every 5 to 10 minutes and states that they are very painful.Her cervix is dilated 2 cm and has not changed in 3 hours.The woman is crying and wants an epidural.What is the likely status of this woman's labor?

Correct Answer is B

Explanation

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