What do the birthing person's vital signs most likely show during the second stage?

Correct Answer: A

Rationale: During the second stage of labor, the birthing person's vital signs are likely to show an increased heart rate during contractions and a baseline heart rate between contractions, which is why option A is correct. Option B, which states increased heart rate during contractions and decreased heart rate between contractions, is incorrect because the heart rate typically remains elevated during contractions due to the increased demand for oxygen and blood flow to the uterus. The heart rate should not decrease between contractions as the body is still working to support the birthing process. Option C, which suggests a decreased heart rate during contractions and an increased heart rate between contractions, is also incorrect. A decreased heart rate during contractions could indicate fetal distress or other complications, which is not typical during the second stage of labor. Additionally, an increased heart rate between contractions is not expected as the body should be recovering and preparing for the next contraction. Option D, stating a decreased heart rate during contractions and a baseline heart rate between contractions, is incorrect because a decreased heart rate during contractions is concerning and could indicate fetal distress or other complications. The baseline heart rate should remain relatively stable between contractions. In summary, the correct choice A accurately reflects the expected changes in the birthing person's vital signs during the second stage of labor, while the other options inaccurately describe potential deviations from the normal physiological response.

Correct Answer: D

Rationale: During the COVID-19 pandemic, restrictions were put in place in hospitals to limit the number of support persons allowed in the labor and delivery room. This meant that many laboring patients were unable to have their usual support person present. As a result, patients who were not able to have support during labor experienced increased levels of stress, anxiety, and depression. This lack of support can have a negative impact on the overall birth experience and mental health outcomes for the patient. Choice A is incorrect because labor support can come from a variety of sources, not just the significant other. While the significant other is a common source of support, other options include doulas, midwives, family members, or friends. Choice B is incorrect because laboring patients do benefit from support from outside sources. Research has shown that having a support person present during labor can lead to better outcomes for both the patient and the baby. Choice C is incorrect because the pandemic did have an impact on birth outcomes. The restrictions put in place during the pandemic changed the way care was delivered and limited the support available to patients, which could have affected the overall birth experience. Overall, choice D is the correct answer because patients who experienced a lack of support during the pandemic's restrictions were more likely to experience depression and other negative mental health outcomes. Labor support is crucial during the birthing process, and the pandemic highlighted the importance of ensuring patients have access to the support they need during labor and delivery.

Correct Answer: A

Rationale: Accelerations on a fetal heart rate (FHR) tracing are indicative of a reassuring pattern. Accelerations are temporary increases in the FHR above the baseline, typically in response to fetal movement or stimulation. This is a positive sign of fetal well-being as it shows a healthy autonomic nervous system response. Marked variability, while it may seem like a good sign, is actually associated with fetal distress. Variability refers to the fluctuations in the FHR and a marked variability indicates an exaggerated response which can be a sign of hypoxia or other issues. Prolonged decelerations are concerning as they indicate a decrease in the FHR that lasts longer than 2 minutes but less than 10 minutes. This could be a sign of fetal distress and requires immediate intervention. Absent variability is also a worrisome finding on an FHR tracing. Variability is a sign of the fetal autonomic nervous system function, so the absence of variability can indicate fetal distress or a compromised nervous system. In summary, accelerations are a reassuring pattern on an FHR tracing as they indicate a healthy autonomic nervous system response, while marked variability, prolonged decelerations, and absent variability are all concerning findings that may indicate fetal distress.

Correct Answer: A

Rationale: Applying a fetal scalp electrode is the most accurate way to monitor the FHR because it provides a direct measurement of the fetal heart rate. The electrode is placed on the baby's scalp during labor, allowing for continuous and real-time monitoring of the FHR. This method is considered more accurate than external methods because it eliminates potential interference from maternal movements or body tissues. Monitoring with an external ultrasound, while commonly used, may not always provide the most accurate measurement of the FHR. The external ultrasound relies on sound waves to detect the fetal heartbeat through the mother's abdomen, which can sometimes be affected by maternal factors such as obesity or fetal position. Using the Doppler monitor for intermittent auscultation involves listening to the fetal heart rate at specific intervals during labor. While this method can be effective in certain situations, it is not as continuous or accurate as using a fetal scalp electrode. Auscultating with a fetoscope is another method of listening to the fetal heart rate intermittently. However, like the Doppler monitor, this method does not provide continuous monitoring and may not be as accurate as using a fetal scalp electrode. In summary, applying a fetal scalp electrode is the most accurate way to monitor the FHR because it allows for continuous and direct measurement of the fetal heart rate without interference from maternal factors.

Correct Answer: B

Rationale: Loss of fetal reserve is the probable cause of the FHR change because it indicates a decrease in the ability of the fetus to tolerate stress during labor. This can be due to various factors such as placental insufficiency, maternal hypotension, or uteroplacental insufficiency. When there is a loss of fetal reserve, the FHR may show signs of distress such as decelerations or tachycardia, indicating that the fetus is not getting enough oxygen. Fetal scalp stimulation (Choice A) is a technique used to assess the fetal response to external stimuli by applying pressure to the fetal scalp. While this can sometimes cause a temporary change in FHR, it is not likely the cause of a sustained FHR change indicating loss of fetal reserve. Fetal heart block (Choice C) is a rare condition where there is interference with the electrical signals between the atria and ventricles of the fetal heart. This is usually not associated with changes in FHR that indicate loss of fetal reserve. Fetal arrhythmia (Choice D) is an irregular heartbeat in the fetus, which can sometimes cause changes in FHR. However, fetal arrhythmias are not typically associated with loss of fetal reserve unless they are severe and causing significant stress on the fetus.