A nurse is caring for a client with irregular uterine contractions that are mild to palpation. FHR is 130/min with moderate variability and accelerations noted. The client has been ambulating in the hallway, took a warm shower, and is now resting in bed. The client rates pain of contractions at 3 on a 0 to 10 scale.
What potential condition does the nurse suspect?
Umbilical cord compression.
Dysfunctional labor.
Chorioamnionitis.
Iron deficiency anemia.
The Correct Answer is B
Choice A rationale
Umbilical cord compression typically results in variable decelerations in the fetal heart rate, not moderate variability or regular accelerations. It can lead to changes in fetal heart rate
patterns, but not regular mild contractions.
Choice B rationale
Dysfunctional labor refers to an abnormal labor pattern, including irregular uterine contractions. The described symptoms fit this condition, as they can cause mild pain and be
managed by ambulation, showers, and rest.
Choice C rationale
Chorioamnionitis is an infection of the fetal membranes and amniotic fluid, leading to fever, uterine tenderness, and foul-smelling amniotic fluid, not mild contractions and moderate
variability in FHR.
Choice D rationale
Iron deficiency anemia in pregnancy can cause fatigue, pallor, and shortness of breath but does not affect uterine contractions or fetal heart rate.
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Correct Answer is D
Explanation
Choice A rationale
GBS can be transmitted to the baby during both vaginal and cesarean deliveries if the mother is colonized with the bacteria. It is not limited to cesarean sections, hence why appropriate screening and treatment are essential.
Choice B rationale
GBS, although often harmless in the general population, can cause severe infections in newborns. This bacterium can be a source of severe neonatal infections like sepsis, pneumonia, and meningitis, necessitating preventive measures during pregnancy and delivery.
Choice C rationale
Screening for GBS is typically performed between 35 and 37 weeks of gestation, not at the first prenatal visit. This timing ensures accurate detection of the bacteria closer to the time of delivery.
Choice D rationale
Intravenous antibiotics during labor are recommended for mothers who test positive for GBS to prevent transmission to the baby. This intervention significantly reduces the risk of neonatal GBS infection.
Correct Answer is C
Explanation
Choice A rationale
Accelerations are increases in the fetal heart rate (FHR) above the baseline, typically in response to fetal movement or uterine contractions. They indicate a healthy, well-oxygenated
fetus and are not consistent with the described pattern of decelerations.
Choice B rationale
Late decelerations are characterized by a gradual decrease in FHR that begins after the contraction has started, with the lowest point of the deceleration (nadir) occurring after the
peak of the contraction. They are associated with uteroplacental insufficiency and fetal hypoxia, which is not described in the scenario.
Choice C rationale
Early decelerations are a gradual decrease in FHR that mirrors the contraction, starting with the contraction and returning to baseline as the contraction ends. The nadir of the
deceleration occurs at the peak of the contraction, which fits the pattern described.
Choice D rationale
Variable decelerations are abrupt decreases in FHR that can occur at any time during the contraction cycle, usually due to umbilical cord compression. They are not uniform in
relation to contractions and can vary in duration, depth, and timing, unlike the described pattern.