What causes decreased FHR baseline variability?

Correct Answer: C

Rationale: Decreased FHR baseline variability is a concerning finding during fetal monitoring as it can indicate fetal distress. Magnesium sulfate is the correct answer because it is a known cause of decreased FHR baseline variability. Magnesium sulfate is commonly used to prevent seizures in preeclampsia, but it can also have the side effect of depressing the fetal central nervous system, leading to decreased variability in the fetal heart rate pattern. Incorrect choices: A: Ampicillin is an antibiotic commonly used in pregnancy to treat infections. While it can cross the placenta, it is not known to directly affect fetal heart rate variability. B: Cocaine is a vasoconstrictor and can lead to fetal distress, but it is not specifically associated with decreased FHR baseline variability. D: Terbutaline is a medication used to stop preterm labor by relaxing the uterus. While it can have side effects such as tachycardia in the mother, it is not known to directly impact fetal heart rate variability.

Correct Answer: D

Rationale: During intrauterine resuscitation, terbutaline is appropriate when dealing with tachysystole, which is defined as excessive uterine contractions occurring more frequently than every 2-3 minutes. Terbutaline is a beta-agonist that works by relaxing the smooth muscles of the uterus, which can help decrease the frequency and intensity of contractions in cases of tachysystole. This can be crucial in preventing fetal distress and ensuring adequate oxygenation to the fetus during labor. Choice A, absent accelerations, refers to a non-reassuring fetal heart rate pattern on the electronic fetal monitoring strip. Terbutaline is not indicated for this situation as it does not address the underlying cause of absent accelerations, which could be due to fetal hypoxia or other factors. In this case, other interventions such as changing the mother's position or administering oxygen would be more appropriate. Choice B, hypotension, is not a situation where terbutaline would be indicated during intrauterine resuscitation. Terbutaline can actually cause a decrease in blood pressure as a side effect, so administering it to a patient with hypotension could worsen their condition. Hypotension during labor would be managed with fluids, positioning, and possibly medications to increase blood pressure. Choice C, dehydration, is also not a situation where terbutaline would be appropriate. Dehydration during labor can lead to decreased blood volume and potential complications for both the mother and the baby. Rehydration with intravenous fluids would be the appropriate intervention for a patient experiencing dehydration during labor, rather than administering terbutaline. In conclusion, terbutaline is appropriate during intrauterine resuscitation when dealing with tachysystole to help relax the uterine muscles and prevent fetal distress. It is not indicated for absent accelerations, hypotension, or dehydration, as these situations require different interventions to address the underlying issues.

Correct Answer: D

Rationale: Cleansing breath is the correct answer because it specifically refers to a slow, deep inhalation through the nose and exhalation through the mouth. This type of breathing technique is often used in practices like yoga and meditation to help release tension, calm the mind, and improve focus. By taking in a deep breath through the nose, you are able to fully oxygenate your body and then release any built-up stress or negativity as you exhale through the mouth. Pursed-lip breathing (choice A) involves inhaling through the nose and exhaling through pursed lips, which can help improve breathing efficiency and decrease shortness of breath. However, this technique does not specifically involve a deep inhalation through the nose and exhalation through the mouth as described in the question. Panting (choice B) is a rapid, shallow form of breathing often associated with dogs or individuals experiencing panic or anxiety. This type of breathing is not conducive to relaxation or stress relief, as it can actually increase feelings of anxiety and hyperventilation. Chanting (choice C) involves repeating a word or phrase rhythmically while breathing normally. This practice is often used in meditation or spiritual practices to focus the mind and create a sense of calm, but it does not specifically involve the slow, deep inhalation through the nose and exhalation through the mouth as described in the question.

Correct Answer: B

Rationale: Encouraging frequent position changes is the correct answer because it is a helpful way for the nurse to assist the laboring person during labor. Changing positions frequently can help alleviate discomfort, promote better blood flow, and potentially help progress labor. This can also help the laboring person feel more in control and involved in their own labor process. Option A, offering an epidural, is incorrect because it is not within the nurse's scope of practice to suggest or administer medication. The decision to have an epidural should be made by the laboring person in consultation with their healthcare provider. Option C, explaining that the laboring person has to care for two other persons, is incorrect because it is not the nurse's role to add additional stress or responsibilities to the laboring person. The focus should be on supporting and caring for the laboring person during this important time. Option D, telling them to call someone to come sit with them, is incorrect because the nurse should be present to provide support and care for the laboring person. It is important for the nurse to actively participate in the labor process and provide any necessary assistance or support.

Correct Answer: C

Rationale: Nitrous oxide is a commonly used analgesic during labor and delivery. The correct answer is C because nitrous oxide does not affect respiration as an opiate would. This is because nitrous oxide is a gas that is inhaled through a mask, and it works quickly to provide pain relief without affecting the respiratory system. Choice A is incorrect because nitrous oxide does not cause respiratory depression in the newborn. In fact, nitrous oxide is quickly eliminated from the body, so it does not accumulate in the newborn's system to cause respiratory depression. Choice B is incorrect because nitrous oxide does not cause the laboring person to have decreased respirations. Nitrous oxide is a self-administered analgesic, which means that the laboring person controls when and how much they inhale. This allows them to maintain normal breathing patterns throughout labor. Choice D is incorrect because the mask used to administer nitrous oxide is typically held by the laboring person themselves, not by their partner. This allows the laboring person to have control over when and how much nitrous oxide they inhale, which is an important aspect of its effectiveness as an analgesic during labor.