A nurse is caring for a client with a new diagnosis of a vaginal fistula.
The client states, "I don't understand how I got this.”. Which of the following is a potential cause of a vaginal fistula?
Open heart surgery.
Tissue trauma from childbirth.
Diabetes mellitus.
Preeclampsia.
The Correct Answer is B
Choice A rationale
Open heart surgery is unrelated to the development of vaginal fistulas.
Choice B rationale
Tissue trauma from childbirth can cause vaginal fistulas, as prolonged labor or obstetric interventions can damage vaginal tissue and lead to fistula formation.
Choice C rationale
Diabetes mellitus does not directly cause vaginal fistulas, although it can affect overall tissue health and healing.
Choice D rationale
Preeclampsia, while a serious pregnancy complication, is not a direct cause of vaginal fistulas.
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Correct Answer is A
Explanation
Choice A rationale
Betamethasone is a corticosteroid that accelerates fetal lung maturity by increasing the production of surfactant, which reduces respiratory distress syndrome in preterm infants.
Choice B rationale
While betamethasone can cause transient increases in fetal heart rate, its primary purpose is not to increase fetal heart rate. Its role is in enhancing lung maturity.
Choice C rationale
Betamethasone does not directly increase amniotic fluid levels. Its main function is in the maturation of fetal lungs.
Choice D rationale
Betamethasone is not used to stop preterm labor contractions. It is used to accelerate fetal lung development in preterm labor cases.
Correct Answer is C
Explanation
Choice A rationale
Category 1 is a normal fetal heart rate pattern with no signs of fetal distress, which is not applicable in this case.
Choice B rationale
Category 2 represents an intermediate category with some concerns, but recurrent late decelerations and absent variability place this scenario in a higher risk category.
Choice C rationale
Category 3 indicates abnormal fetal heart rate patterns, including absent variability with recurrent late decelerations, which is associated with potential fetal hypoxia or acidemia and requires prompt intervention.
Choice D rationale
There is no Category 4 in fetal heart rate monitoring.