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When interpreting a fetal monitoring tracing, which of the following findings would require the nurse to intervene?

A nurse is caring for a 29-year-old female client who is 35 weeks gestation in the triage area of the maternity ward. The client presents with complaints of decreased fetal movement. Below are the exhibits relevant to the case:

History and Physical

The client is a 29-year-old female, gravida 2 para 1, at 35 weeks gestation. She has a history of an uncomplicated spontaneous vaginal birth three years ago of a 7 lb 4 oz infant. The client has no significant medical, social, or surgical history.

Nurses Notes

The client arrived at triage with complaints of decreased fetal movement over the past 24 hours. She reports feeling anxious and concerned about the well-being of her baby. The client denies any contractions, vaginal bleeding, or fluid leakage. She states that she has been feeling generally well otherwise. The client’s partner is present and supportive. The nurse notes that the client appears visibly worried but is cooperative and responsive to questions.

Vital Signs

• Temperature: 98.6°F (37°C)
• Pulse: 82 beats per minute
• Respiratory Rate: 18 breaths per minute
• Blood Pressure: 120/80 mmHg
• Oxygen Saturation: 98% on room air

Physical Examination Results

Upon physical examination, the client’s abdomen is soft and non-tender. Fundal height measures consistent with 35 weeks gestation. Fetal heart tones are auscultated at 140 beats per minute with a Doppler. No signs of uterine contractions are noted. There is no evidence of vaginal bleeding or fluid leakage. The client’s extremities are without edema, and deep tendon reflexes are normal.

Provider’s Prescriptions

1. Non-stress test (NST) to assess fetal well-being.
2. Ultrasound to evaluate fetal movement and amniotic fluid index.
3. Continuous fetal heart rate monitoring.
4. Encourage the client to rest and monitor fetal movements.
5. Follow-up appointment in 1 week or sooner if symptoms persist or worsen.

Diagnostic Results

• Non-stress test (NST): Reactive, indicating normal fetal heart rate patterns with adequate accelerations.
• Ultrasound: Normal amniotic fluid index, fetal movements observed, no abnormalities detected.

Medical History

The client has no significant medical history. She had an uncomplicated spontaneous vaginal birth three years ago. There are no known allergies, and she is not on any medications.

What is the most appropriate next step in the management of this client?

The nursing preceptor asks the nursing student how to determine the intensity of contractions before placing the client on the electronic fetal monitor. What is the best explanation?

A nurse is creating the plan of care for a client in active labor. Which of the following actions should the nurse include in the plan of care?

A nurse is caring for a client who is 39 weeks gestation and having contractions.

Which of the following should the nurse recognize as a sign of true labor?

A nurse is caring for a client at 38 weeks gestation who arrived to the triage with complaints of decreased fetal movement. The nurse contacts the provider and reports the findings. The nurse anticipates an order for which of the following?

The nurse preceptor is teaching about the physiology of the fetal heart rate (FHR) pattern. Which statement by the student indicates a lack of understanding?

The nurse is caring for a client. Which of the following findings would the nurse report to the anesthesia provider?

A nurse is caring for a client in active labor.

The nurse identifies tachysystole and late decelerations with each contraction.

The nurse performs intrauterine resuscitation interventions, including repositioning the client, initiating an IV fluid bolus, and applying oxygen.

After the stated interventions, the nurse continues to observe tachysystole and recurrent late decelerations.

Which medication does the nurse anticipate administering to reduce uterine activity?

A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client’s umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as -2 station. Which of the following interpretations of this finding should the nurse make?