What is the most accurate way to monitor the FHR?

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: Late decelerations in fetal heart rate (FHR) patterns are associated with uteroplacental insufficiency, which means that there is a decrease in oxygen supply to the fetus. This can occur due to conditions such as maternal hypertension, placental abruption, or umbilical cord compression. Late decelerations typically begin after the peak of a contraction and recover after the contraction ends. This pattern indicates that the fetus is experiencing stress and is not getting enough oxygen, making it the correct answer. Early decelerations (choice A) are a benign finding and are usually associated with head compression during contractions. They mirror the contraction pattern and are not typically concerning for fetal well-being. Variable decelerations (choice C) are usually caused by umbilical cord compression. They have a rapid onset and recovery and can vary in depth, duration, and timing in relation to contractions. While they can be concerning, they are not the expected periodic change in FHR. A sinusoidal pattern (choice D) is a rare FHR pattern characterized by smooth, undulating waves with a consistent frequency of 3-5 cycles per minute. This pattern is associated with severe fetal anemia or hypoxia, but it is not the expected periodic change in FHR. In summary, late decelerations are the expected periodic change in FHR when there is uteroplacental insufficiency, which reduces the oxygen supply to the fetus. Early decelerations are benign, variable decelerations are typically caused by umbilical cord compression, and a sinusoidal pattern is rare and associated with severe fetal distress.

Correct Answer: B

Rationale: Management of a category III fetal monitor tracing involves expediting birth because it indicates fetal distress and potential hypoxia. In this situation, immediate delivery is necessary to prevent adverse outcomes for the baby. Decreasing oxytocin by half (choice A) may be considered if the tracing is concerning due to uterine hyperstimulation, but it is not the primary management for category III tracings. Readjusting the fetal monitor (choice C) may be helpful to ensure accurate readings, but it does not address the underlying fetal distress. Increasing magnesium sulfate (choice D) is typically used for neuroprotection in preterm labor or preeclampsia and is not the appropriate management for category III tracings. In summary, expediting birth is the correct answer because it is the most effective way to address fetal distress indicated by a category III fetal monitor tracing.

Correct Answer: D

Rationale: Intrauterine resuscitation is a medical intervention designed to treat fetal hypoxia, which is a condition where the fetus is not receiving enough oxygen. This can occur due to various reasons such as compression of the umbilical cord, placental insufficiency, or maternal conditions like preeclampsia. Choice A, hypertension, is high blood pressure in the mother and does not directly relate to fetal oxygenation. While hypertension can have negative effects on the fetus, it is not the primary focus of intrauterine resuscitation. Choice B, hypoglycemia, is low blood sugar levels and does not directly impact fetal oxygen levels. While maternal hypoglycemia can affect the fetus, it is not the target of intrauterine resuscitation. Choice C, hyperthyroid, is an overactive thyroid gland in the mother and does not directly affect fetal oxygenation. While maternal hyperthyroidism can have implications for the fetus, it is not the main concern in intrauterine resuscitation. Therefore, the correct answer is D, fetal hypoxia, as intrauterine resuscitation aims to improve oxygen delivery to the fetus in order to prevent potential complications such as brain damage or even fetal death.

Correct Answer: D

Rationale: Hydrotherapy, the correct answer, has been shown to decrease pain, encourage movement, and improve labor satisfaction. Hydrotherapy involves the use of water immersion during labor, which has several benefits. Firstly, the buoyancy of water helps reduce the pressure on the body, making it easier for the laboring person to move and change positions. This movement can help progress labor and reduce discomfort. Additionally, the warmth of the water can help relax muscles and decrease pain sensations, providing natural pain relief. On the other hand, controlled breathing (choice A) is a common technique used during labor to help manage pain, but it may not necessarily encourage movement or improve labor satisfaction to the same extent as hydrotherapy. Aromatherapy (choice B) involves the use of essential oils to create a relaxing environment, but it may not have the same physical benefits as hydrotherapy in terms of pain management and movement encouragement. Massage (choice C) can also be helpful for pain relief and relaxation during labor, but it may not provide the same overall benefits as hydrotherapy in terms of movement and labor satisfaction. In conclusion, while controlled breathing, aromatherapy, and massage can all be beneficial during labor, hydrotherapy has been specifically shown to decrease pain, encourage movement, and improve labor satisfaction, making it the most effective technique among the choices provided.