The nurse evaluates a pattern on the fetal monitor that appears similar to early decelerations. The deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. The deceleration pattern described, beginning near the acme of the contraction and extending beyond, is associated with uteroplacental insufficiency. 2. Uteroplacental insufficiency indicates a potential problem with oxygen and nutrient delivery to the fetus. 3. This situation requires immediate intervention to improve oxygenation to the fetus. 4. Monitoring alone is not sufficient; action is needed to address the underlying issue. 5. Therefore, the correct nursing action in this situation is to recognize the potential uteroplacental insufficiency and take appropriate measures to address it. Summary of why other choices are incorrect: A: This pattern reflects variable decelerations - Incorrect because the described pattern is not characteristic of variable decelerations. B: Document this Category I fetal heart rate pattern and decrease the rate of the - Incorrect because immediate action is needed in the presence of potential uteroplacental insufficiency.

Correct Answer: C

Rationale: Rationale for correct answer (C): Recording the normal pattern is indicated because the deceleration pattern mirroring uterine contractions is a reassuring sign of fetal well-being. It indicates a physiologic response to labor. Repositioning the patient (A) is unnecessary as the pattern is normal. Applying a fetal scalp electrode (B) is invasive and unnecessary in this scenario. Administering oxygen (D) is not indicated as the fetal heart rate pattern is normal.

Correct Answer: B

Rationale: The correct answer is B because it aligns with the nurse's responsibility to educate and provide information to the patient and their support person. Teaching about the monitoring equipment and addressing any questions ensures that the patient and their support person are informed and empowered. This promotes patient understanding and involvement in their care, leading to better outcomes. Choice A is incorrect because the nurse should initiate corrective actions promptly for abnormal findings without waiting for physician input. Choice C is incorrect as it focuses solely on documentation rather than patient education. Choice D is incorrect as it neglects the importance of involving the support person in the care process.

Correct Answer: B

Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn. A: Presenting part not engaged is not a direct indication for amnioinfusion. C: Breech position of the fetus does not specifically warrant amnioinfusion. D: Twin gestation alone is not a direct indication for amnioinfusion.

Correct Answer: A

Rationale: The correct answer is A: Administer O at 8 to 10 L/minut. In a left side-lying position, this deceleration indicates possible umbilical cord compression, reducing oxygen supply to the fetus. Administering oxygen at 8 to 10 L/min can help improve fetal oxygenation. Decreasing the IV rate (B) wouldn't directly address the fetal distress. Repositioning the ultrasound transducer (C) is irrelevant to the situation. Performing a vaginal exam (D) could worsen the cord compression if the cord is prolapsed.