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The labor and delivery nurse is caring for a client in active labor.

The nurse notes the fetal heart rate baseline is 175 bpm, moderate variability.

Accelerations are absent and no decelerations noted.

 

How should the nurse describe this tracing to the medical provider?

A.

Category I.

B.

Category II.

C.

Category III.

D.

Category IV.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Category I tracings are considered normal and are associated with a well-oxygenated, non-acidotic fetus with a normal fetal heart rate baseline, moderate variability, and no late or variable decelerations. However, a baseline heart rate of 175 bpm is considered tachycardia, which does not fit the criteria for Category I.

 

Choice B rationale

 

Category II tracings are indeterminate and include any fetal heart rate pattern that does not fit into Category I or III. A baseline heart rate of 175 bpm with moderate variability and no accelerations or decelerations fits into this category. This indicates that the fetus may be experiencing some stress but is not in immediate danger.

 

Choice C rationale

 

Category III tracings are abnormal and are associated with an increased risk of fetal acidemia. These tracings include absent baseline variability with recurrent late or variable decelerations, bradycardia, or a sinusoidal pattern. The given tracing does not meet these criteria as it shows moderate variability and no decelerations.

 

Choice D rationale

 

There is no Category IV in the classification of fetal heart rate tracings. The standard classification includes only Categories I, II, and III.


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

A pulse of 88 bpm is within the normal range for an adult and does not indicate any immediate concern that needs to be reported to the anesthesia provider.

Choice B rationale

A pain level of 1 on a 0 to 10 scale indicates that the epidural is effectively managing the client’s pain. This is a positive outcome and does not require reporting.

Choice C rationale

Blood pressure of 88/52 mmHg indicates hypotension, which is a common and potentially serious side effect of epidural anesthesia. Hypotension can lead to decreased placental perfusion and fetal distress, so it requires immediate attention and reporting to the anesthesia provider.

Choice D rationale

Dizziness can be a side effect of epidural anesthesia, but it is not as critical as hypotension. It should be monitored, but it does not require immediate reporting unless it is severe or accompanied by other symptoms.

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.

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