Which of the following pregnancy complications could explain the changes seen in the fetal heart tracing above?
Preeclampsia.
Placental abruption.
Breech positioning.
Hypotension.
Cord compression.
The Correct Answer is E
Choice A rationale
Preeclampsia is a hypertensive disorder of pregnancy that can lead to uteroplacental insufficiency. This condition would most likely cause late decelerations in the fetal heart tracing, as it results in decreased blood flow to the placenta and an inability to compensate during contractions. The tracing is not available, but the choice is being rationalized based on the most likely cause.
Choice B rationale
Placental abruption is the premature separation of the placenta from the uterine wall. This can lead to a variety of fetal heart tracing abnormalities, including severe variable decelerations, late decelerations, or a sinusoidal pattern, often accompanied by uterine hyperactivity. The resulting fetal distress is due to decreased placental surface area for gas exchange.
Choice C rationale
Breech positioning refers to a fetus presenting buttocks or feet first. While it can complicate labor and delivery, it is not a direct cause of a specific fetal heart rate pattern. Fetal heart rate changes in a breech presentation are typically related to cord prolapse or compression during labor, not the position itself.
Choice D rationale
Hypotension in the mother can lead to decreased placental perfusion, as seen with epidural anesthesia. This can cause late decelerations in the fetal heart rate tracing due to uteroplacental insufficiency. It is a common cause of fetal distress but is more directly related to maternal blood pressure than to a specific fetal heart rate pattern.
Choice E rationale
Cord compression is a mechanical issue that obstructs blood flow through the umbilical cord. It is the most common cause of variable decelerations, which are abrupt, visually apparent decreases in the fetal heart rate. The tracing, though not available, would likely show these variable decelerations in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While monitoring for contractions is important, the most critical assessment is the fetal heart rate. Contractions can occur during and after the procedure, but their presence alone is not as indicative of fetal well-being or distress as a change in the fetal heart rate. The contractions themselves are expected and a direct result of the manipulation of the uterus.
Choice B rationale
Checking the amniotic fluid volume is typically done via ultrasound prior to the procedure to ensure there's enough fluid for the fetus to be mobile. A version is contraindicated if there is insufficient fluid (oligohydramnios). However, this is a pre-procedure assessment, and a real-time assessment during and after the procedure is focused on the fetal response.
Choice C rationale
During a version, the fetus is manually repositioned, which can cause transient umbilical cord compression or placental abruption. Monitoring the fetal heart rate is paramount to detect signs of fetal distress, such as bradycardia or persistent decelerations, which would necessitate immediate cessation of the procedure. This assessment is the most direct indicator of fetal tolerance.
Choice D rationale
Monitoring for vaginal bleeding is important post-procedure to detect a placental abruption, which is a potential complication. However, changes in the fetal heart rate are often the earliest and most direct sign of fetal compromise and should be monitored continuously, both during and immediately after the procedure. Vaginal bleeding may be a later sign.
Correct Answer is C
Explanation
Step 1 is: Identify the start and end of the first stage of labor. The first stage begins with the onset of regular uterine contractions and ends with full cervical dilation (10 cm) and effacement (100%). The patient's contractions started at 3 a.m., and she arrived at the hospital at 8: a.m. with 5 cm dilation. She delivered at 3: p.m. but her labor progression is noted up to 2 p.m. with an overwhelming need to push which indicates she was likely in the second stage of labor.
Step 2 is: The first stage of labor is from 3 a.m. (onset of regular contractions) to the overwhelming need to push at 2 p.m., which indicates the end of the first stage and the beginning of the second stage.
Step 3 is: Calculate the duration. From 3 a.m. to 2 p.m. is 11 hours. The final calculated answer is 11 hours.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.