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The nurse observes variable decelerations on the fetal monitor tracing.

 

Which of the following is a correct interpretation of this finding?

A.

Variable decelerations are related to the use of narcotic analgesics.

B.

Variable decelerations are due to umbilical cord compression.

C.

Variable decelerations are caused by maternal hypotension.

D.

Variable decelerations are indicative of fetal hypoxia.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Variable decelerations are not related to the use of narcotic analgesics. Narcotic analgesics can cause other fetal heart rate changes, such as decreased variability, but they do not cause variable decelerations.

 

Choice B rationale

 

Variable decelerations are due to umbilical cord compression. This is the correct interpretation. Umbilical cord compression can lead to transient decreases in fetal blood flow and oxygenation, resulting in variable decelerations on the fetal monitor tracing.

 

Choice C rationale

 

Variable decelerations are not caused by maternal hypotension. Maternal hypotension can lead to late decelerations due to uteroplacental insufficiency, but it does not cause variable decelerations.

 

Choice D rationale

 

Variable decelerations are not indicative of fetal hypoxia. While severe and persistent variable decelerations can lead to fetal hypoxia, the primary cause of variable decelerations is umbilical cord compression.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Terbutaline is a beta-adrenergic agonist that works by relaxing the smooth muscles of the uterus, thereby reducing uterine contractions. It is commonly used in cases of tachysystole and recurrent late decelerations to decrease uterine activity and improve fetal oxygenation. Terbutaline’s mechanism of action involves stimulating beta-2 adrenergic receptors, which leads to an increase in cyclic AMP and subsequent relaxation of uterine smooth muscle.

Choice B rationale

Oxytocin is a hormone that stimulates uterine contractions and is typically used to induce or augment labor. Administering oxytocin in a situation where there is already tachysystole and recurrent late decelerations would exacerbate the problem by increasing uterine contractions, potentially leading to further fetal distress.

Choice C rationale

Misoprostol is a prostaglandin analog used to ripen the cervix and induce labor. Similar to oxytocin, it would not be appropriate in this scenario as it would increase uterine contractions, worsening the tachysystole and late decelerations.

Choice D rationale

Magnesium sulfate is primarily used as a tocolytic to prevent preterm labor and as a neuroprotective agent for the fetus in cases of preeclampsia. While it has some uterine relaxation properties, it is not the first-line treatment for reducing uterine activity in the context of tachysystole and late decelerations.

Correct Answer is B

Explanation

Choice A 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.

Choice B 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 C 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 D 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.

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