Exam 18: Fetal Assessment During Labor

The client has delivered by urgent caesarean birth for fetal compromise.Umbilical cord gases were obtained for acid-base determination.The pH is 6.9,partial pressure of carbon dioxide (PCO₂)is elevated,and the base deficit is 11 mmol/L.What type of acidemia is displayed by the infant?

Which FHR decelerations would require the nurse to change the maternal position? (Select all that apply).

Which client would not be a suitable candidate for internal EFM?

In which situation would the nurse be called on to stimulate the fetal scalp?

Which nursing intervention would result in an increase in maternal cardiac output?

A tiered system of categorizing FHR has been recommended by professional organizations.Nurses,midwives,and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and understand the significance of each category.What is the correct nomenclature for these categories? (Select all that apply).

Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion?

During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period.Which statement best describes the status of this fetus?

The nurse is evaluating the EFM tracing of the client who is in active labor.Suddenly,the FHR drops from its baseline of 125 down to 80 beats per minute.The mother is repositioned,and the nurse provides oxygen,increased IV fluids,and performs a vaginal examination.The cervix has not changed.Five minutes have passed,and the FHR remains in the 80s.What additional nursing measures should the nurse take next?

Which characteristic correctly matches the type of deceleration with its likely cause?

Which information related to a prolonged deceleration is important for the labor nurse to understand?

Part of the nurse's role is assisting with pushing and positioning.Which guidance should the nurse provide to her client in active labor?

Which definition of an acceleration in the fetal heart rate (FHR)is accurate?

The nurse providing care for a high-risk laboring woman is alert for late FHR decelerations.Which clinical finding might be the cause for these late decelerations?

Which FHR finding is the most concerning to the nurse who is providing care to a laboring client?

According to the National Institute of Child Health and Human Development (NICHD)Three-Tier System of FHR Classification,category III tracings include all FHR tracings not categorized as category I or II.Which characteristics of the FHR belong in category III? (Select all that apply).

In assessing the immediate condition of the newborn after birth,a sample of cord blood may be a useful adjunct to the Apgar score.Cord blood is then tested for pH,carbon dioxide,oxygen,and base deficit or excess.Which clinical situation warrants this additional testing? (Select all that apply).

While evaluating an external monitor tracing of a woman in active labor,the nurse notes that the FHR for five sequential contractions begins to decelerate late in the contraction,with the nadir of the decelerations occurring after the peak of the contraction.What is the nurse's first priority?

A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate.Which condition related to decreased variability is considered benign?

Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur?