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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Correct Answer is A
Explanation
Choice A rationale
The occiput anterior (OA) position is considered the optimal fetal position for vaginal birth. In this position, the baby’s head is down, and the back of the head (occiput) is facing the mother’s front. This position allows for the most efficient passage through the birth canal.
Choice B rationale
The occiput posterior (OP) position, where the baby’s head is down but facing the mother’s back, can lead to a longer and more painful labor. It is not considered optimal for vaginal birth.
Choice C rationale
Breech positions, where the baby’s buttocks or feet are positioned to come out first, are not optimal for vaginal birth and often require a cesarean section due to the increased risk of complications.
Choice D rationale
The transverse position, where the baby is lying sideways across the uterus, is not suitable for vaginal birth. This position typically requires a cesarean section to safely deliver the baby.
Correct Answer is A
Explanation
Choice A rationale
Breech presentation means the fetus’s buttocks or feet are positioned to be delivered first. Fetal heart tones are often heard above the umbilicus in this position.
Choice B rationale
Transverse lie means the fetus is lying horizontally in the uterus. Fetal heart tones would typically be heard at the sides of the abdomen.
Choice C rationale
Cephalic presentation means the fetus’s head is positioned to be delivered first. Fetal heart tones are usually heard below the umbilicus in this position.
Choice D rationale
Oblique lie means the fetus is positioned diagonally in the uterus. Fetal heart tones can be variable depending on the exact position.