A nurse is caring for a client at 38 weeks gestation who arrived to the triage with complaints of decreased fetal movement. The nurse contacts the provider and reports the findings. The nurse anticipates an order for which of the following?
Non-stress test.
Biophysical profile.
Ultrasound.
Amniocentesis.
The Correct Answer is A
Choice A rationale
A non-stress test (NST) is a common initial assessment for decreased fetal movement. It evaluates fetal heart rate patterns in response to fetal movements, providing information about fetal well-being and oxygenation.
Choice B rationale
A biophysical profile (BPP) is a more comprehensive assessment that includes an NST and ultrasound evaluation of fetal movements, tone, breathing, and amniotic fluid volume. It may be ordered if the NST results are non-reassuring or if there are other concerns.
Choice C rationale
An ultrasound can provide valuable information about fetal growth, amniotic fluid volume, and placental function. It may be used in conjunction with other tests but is not the first-line assessment for decreased fetal movement.
Choice D rationale
Amniocentesis is an invasive procedure used for specific indications, such as genetic testing or assessing fetal lung maturity. It is not typically used for initial assessment of decreased fetal movement.
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Correct Answer is D
Explanation
Choice A rationale
Early decelerations are not caused by umbilical cord compression. Umbilical cord compression typically leads to variable decelerations, which have a different pattern and clinical significance.
Choice B rationale
Early decelerations are not caused by uteroplacental insufficiency. Uteroplacental insufficiency is associated with late decelerations, which occur after the peak of a contraction and indicate reduced blood flow to the fetus.
Choice C rationale
Early decelerations are not a result of the administration of medications. Medications can affect fetal heart rate patterns, but early decelerations are specifically related to fetal head compression.
Choice D rationale
Early decelerations are related to fetal head compression. They occur as the fetal head descends into the maternal pelvis and are generally considered benign, indicating normal labor progression.
Correct Answer is B
Explanation
Choice A rationale
Magnetic Resonance Imaging (MRI) is a non-invasive imaging technique that provides detailed images of the fetus and placenta. However, it is not typically used as the first-line test for assessing placental perfusion and IUGR. Doppler flow studies are more specific for evaluating blood flow and detecting issues related to placental insufficiency.
Choice B rationale
Doppler flow studies are non-invasive tests that assess blood flow in the umbilical artery and other fetal vessels. These studies are particularly useful in evaluating placental perfusion and identifying intrauterine growth restriction (IUGR). Abnormal Doppler flow patterns can indicate compromised blood flow to the fetus, which is a concern in cases of minimal fetal growth.
Choice C rationale
Amniocentesis is an invasive procedure that involves extracting a sample of amniotic fluid for genetic testing and assessment of fetal lung maturity. It is not used for evaluating placental perfusion or IUGR7.
Choice D rationale
Chorionic villus sampling (CVS) is an invasive procedure used for early genetic testing by sampling placental tissue. It is not used for assessing placental perfusion or IUGR7.