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?
Category I.
Category II.
Category III.
Category IV.
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 A
Explanation
Choice A rationale
A reactive non-stress test (NST) indicates that the fetal heart rate increases appropriately with fetal movements, suggesting good fetal oxygenation and neurological function. This is the desired outcome for an NST4.
Choice B rationale
A non-reactive NST means the fetal heart rate did not increase with movements, which could indicate fetal hypoxia or other issues. Further testing would be needed to assess fetal well-being.
Choice C rationale
An inconclusive NST means the test did not provide enough information to determine fetal well-being, possibly due to fetal sleep cycles or maternal factors. Additional testing would be required.
Choice D rationale
A positive NST is not a standard term used in fetal monitoring. The correct terms are reactive or non-reactive.
Correct Answer is B
Explanation
Choice A rationale
Early decelerations are characterized by a gradual decrease and return to baseline of the fetal heart rate that coincides with the peak of a contraction. They are typically benign and related to fetal head compression.
Choice B rationale
Late decelerations are characterized by a gradual decrease and return to baseline of the fetal heart rate that occurs after the peak of a contraction. They are associated with uteroplacental insufficiency and require prompt intervention to improve fetal oxygenation.
Choice C rationale
Variable decelerations are characterized by an abrupt decrease in fetal heart rate that varies in duration, intensity, and timing relative to contractions. They are often caused by umbilical cord compression and may require interventions to relieve the compression.
Choice D rationale
Prolonged decelerations are characterized by a decrease in fetal heart rate that lasts longer than 2 minutes but less than 10 minutes. They indicate a more severe and sustained disruption in fetal oxygenation and require immediate intervention.