When interpreting a fetal monitoring tracing, which of the following findings would require the nurse to intervene?
Presence of late decelerations.
Variability in fetal heart rate of 12 bpm.
Accelerations in fetal heart rate.
Baseline fetal heart rate of 140 bpm.
The Correct Answer is A
Choice A rationale
Late decelerations are a sign of uteroplacental insufficiency and fetal hypoxia. They occur after the peak of a contraction and indicate that the fetus is not receiving enough oxygen. This requires immediate intervention to improve fetal oxygenation and prevent fetal distress.
Choice B rationale
Variability in fetal heart rate of 12 bpm is considered moderate variability, which is a reassuring sign of fetal well-being. It indicates that the fetus has a healthy autonomic nervous system and is not in distress.
Choice C rationale
Accelerations in fetal heart rate are also a reassuring sign. They indicate that the fetus is well-oxygenated and responding appropriately to stimuli. No intervention is needed for accelerations.
Choice D rationale
A baseline fetal heart rate of 140 bpm is within the normal range (110-160 bpm) and does not indicate any immediate concern. It is a sign of a healthy, well-oxygenated fetus.
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View Related questions
Correct Answer is B
Explanation
Choice A rationale
Magnetic Resonance Imaging (MRI) is a non-invasive imaging technique that provides detailed images of the fetus and placenta. However, it is not typically used as the first-line test for assessing placental perfusion and IUGR. Doppler flow studies are more specific for evaluating blood flow and detecting issues related to placental insufficiency.
Choice B rationale
Doppler flow studies are non-invasive tests that assess blood flow in the umbilical artery and other fetal vessels. These studies are particularly useful in evaluating placental perfusion and identifying intrauterine growth restriction (IUGR). Abnormal Doppler flow patterns can indicate compromised blood flow to the fetus, which is a concern in cases of minimal fetal growth.
Choice C rationale
Amniocentesis is an invasive procedure that involves extracting a sample of amniotic fluid for genetic testing and assessment of fetal lung maturity. It is not used for evaluating placental perfusion or IUGR7.
Choice D rationale
Chorionic villus sampling (CVS) is an invasive procedure used for early genetic testing by sampling placental tissue. It is not used for assessing placental perfusion or IUGR7.
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.