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
Uteroplacental insufficiency leads to late decelerations, which are characterized by a gradual decrease in fetal heart rate after the peak of a contraction. This indicates compromised blood flow between the uterus and placenta, affecting the fetus.
Choice B rationale
Umbilical cord compression usually causes variable decelerations, not late decelerations.
Choice C rationale
Maternal bradycardia does not cause changes in fetal heart rate patterns like late decelerations.
Choice D rationale
Fetal head compression causes early decelerations, which coincide with contractions, not late decelerations.
Correct Answer is B
Explanation
Choice A rationale
The fetal heartbeat cannot typically be heard via Doppler as early as 4 weeks of pregnancy. At this stage, the heart is still developing, and it is too soon for external detection with a Doppler device.
Choice B rationale
The fetal heartbeat is generally detectable by an external Doppler device around 10-12 weeks of pregnancy. This is the period when the heartbeat is strong enough to be picked up by the device.
Choice C rationale
Feeling the baby move, known as "quickening," typically occurs around 18-24 weeks of pregnancy, not 6 weeks. This sensation is different from hearing the heartbeat.
Choice D rationale
While the heart begins to form around week 5, it is not detectable by Doppler at 6 weeks. The technology does not have the sensitivity to detect such an early heartbeat externally.