The nurse in labor and delivery notices an increase in the number of women requesting cesarean births. Which are the parameters and criteria used when making the decision to perform a cesarean delivery on maternal request (CDMR)? Select all that apply.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: C

Rationale: The tocotransducer is a device used for electronic fetal monitoring to measure uterine contractions. Proper placement of the tocotransducer is over the uterine fundus, which is the upper part of the uterus where contractions are most accurately detected. Placing the tocotransducer there allows for optimal monitoring of uterine activity during labor, ensuring accurate readings and appropriate interventions if necessary. Placing the tocotransducer inside the uterus, on the fetal scalp, or over the mother's lower abdomen would not provide accurate readings of uterine contractions.

Correct Answer: C

Rationale: When the fetus is in a right occiput anterior position, the back of the fetus is on the mother's right side, and the fetal heart is also located on the right side of the mother's abdomen. It is typically heard in the lower right quadrant due to the location of the fetal back and heart. The nurse should assess the fetal heart rate in the right lower quadrant of the maternal abdomen to accurately assess the well-being of the fetus in this position.

Correct Answer: C

Rationale: When a Category II pattern of fetal heart rate is noted, placing a wedge under the left hip of the pregnant patient is indicated. This position helps to improve blood flow to the placenta and can sometimes help to improve the fetal heart rate pattern. Placing the patient in a left lateral tilt can also be effective in improving circulation and oxygenation to the fetus. It is important to act promptly in response to abnormal fetal heart rate patterns to optimize the well-being of the baby. Lowering the head of the bed, changing the position to the right side, or placing the mother in Trendelenburg position are not appropriate actions in this situation.

Correct Answer: B

Rationale: The fetal heart rate pattern described in the question, which likely includes decelerations, is indicative of cord compression. Cord compression occurs when there is pressure on the umbilical cord, leading to temporary reduction or blockage of blood flow and oxygen supply to the fetus. This can result in variable decelerations in the fetal heart rate pattern. Common scenarios that can cause cord compression include changes in fetal position, cord prolapse, or excessive uterine contractions. It is important to promptly address cord compression to prevent fetal distress and potential complications during labor and delivery. The other options listed may also influence fetal heart rate, but in this scenario, cord compression is the most likely cause based on the described heart rate pattern.