What is the most likely cause for variable fetal heart rate (FHR) decelerations?

Fetal hypoxemia.

Altered fetal cerebral blood flow.

Uteroplacental insufficiency.

Umbilical cord compression.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Fetal hypoxemia, a deficiency in oxygen reaching the fetal tissues, typically manifests as late decelerations in the fetal heart rate tracing, which reflect uteroplacental insufficiency. While severe hypoxemia can lead to various FHR patterns, variable decelerations are more directly associated with mechanical factors affecting the umbilical cord.

Choice B rationale

Altered fetal cerebral blood flow can be a consequence of various factors, including hypoxemia and cord compression, and can influence the fetal heart rate. However, variable decelerations are specifically caused by events that directly impede blood flow through the umbilical vessels rather than a generalized alteration in cerebral circulation.

Choice C rationale

Uteroplacental insufficiency, a condition where the placenta is unable to deliver an adequate supply of oxygen and nutrients to the fetus, typically results in late decelerations, indicating fetal distress due to chronic hypoxia. Variable decelerations, in contrast, have a more abrupt onset and recovery, reflecting acute changes in umbilical cord blood flow.

Choice D rationale

Umbilical cord compression occurs when the umbilical cord, which carries oxygen and nutrients to the fetus, is squeezed or constricted. This compression leads to a transient decrease in fetal blood flow and oxygenation, resulting in a rapid drop and subsequent return of the fetal heart rate, which is characteristic of variable decelerations. The shape, timing, and abrupt nature of variable decelerations directly correlate with the intermittent pressure on the umbilical cord.

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Correct Answer is ["A","C","D"]

Explanation

Choice A rationale: Weight loss

Weight loss during pregnancy, especially in the second trimester, is unexpected unless there is a medical condition such as hyperemesis gravidarum or other nutritional deficiencies. While mild weight fluctuations can occur, a consistent loss of weight rather than gradual gain suggests inadequate caloric intake due to persistent vomiting and dehydration.

Choice B rationale: Breast tenderness

Breast tenderness is a common and expected physiological change during pregnancy due to hormonal fluctuations, particularly increased estrogen and progesterone levels. It is not considered abnormal or unexpected at this stage of pregnancy.

Choice C rationale: Heart rate

A heart rate of 116/min is unexpected, as it is above the normal range for adults (typically 60–100/min). Pregnancy can cause a mild increase in heart rate, but tachycardia above 110/min may indicate dehydration, anemia, or electrolyte imbalance, all of which can stem from excessive vomiting and fluid loss.

Choice D rationale: Vomiting

While occasional nausea and vomiting (morning sickness) can be expected in early pregnancy, persistent vomiting up to eight times daily and symptoms of dehydration (dry mucosa, poor skin turgor, positive ketones in urine) raise concern for hyperemesis gravidarum, a more severe form of pregnancy-related nausea and vomiting.

Choice E rationale: Nasal congestion

Nasal congestion is common during pregnancy due to increased blood volume and vascular changes affecting the nasal mucosa. It is not unexpected and does not indicate a complication.

Choice F rationale: Respiratory rate

A respiratory rate of 20/min falls within the normal range for adults (typically 12–20/min), making it an expected finding.

A. I will avoid sexual intercourse until the bleeding has stopped, and for two weeks following the last evidence of bleeding. B. I will continue with my normal life after discharge. C. I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad. D. I will watch for the evidence of the passage of tissue.

Correct Answer is B

Explanation

Choice A rationale

Avoiding sexual intercourse is recommended in the presence of threatened abortion to prevent further uterine irritation and potential disruption of the pregnancy. Pelvic rest helps to minimize the risk of increased bleeding or complications.

Choice B rationale

Continuing with normal life after discharge is an inappropriate statement. With a threatened abortion, the client needs to understand the importance of rest and avoiding strenuous activities that could potentially exacerbate bleeding or lead to further complications. Activities that increase intra-abdominal pressure or cause physical strain should be limited.

Choice C rationale

Counting perineal pads and noting the amount and color of blood is an important instruction for monitoring the extent of bleeding. This information helps the healthcare provider assess the progression or resolution of the threatened abortion and identify any signs of increased bleeding or passage of tissue.

Choice D rationale

Watching for the evidence of the passage of tissue is crucial as it could indicate a progressing miscarriage. The client should be instructed on how to collect any passed tissue for examination by the healthcare provider to confirm the outcome of the pregnancy. .

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What is the most likely cause for variable fetal heart rate (FHR) decelerations?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 26-year-old female client who is at 14 weeks of gestation in the antepartum clinic. Exhibits Select the 3 findings that are unexpected.

Correct Answer is ["A","C","D"]

Explanation

Correct Answer is B

Explanation

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