What is the probable cause of this FHR change?

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.

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.

Correct Answer: C

Rationale: Supporting hypnosis for comfort measures involves creating an environment conducive to relaxation and focus. Choice A is incorrect because talking through contractions can be distracting and disrupt the hypnotic state. Choice B is also incorrect because keeping the lights on can be stimulating and prevent the individual from fully relaxing and entering a hypnotic state. Choice D is incorrect because asking the individual to rate pain during a contraction can shift their focus away from the hypnotic suggestions and increase their awareness of discomfort. On the other hand, choice C is correct because keeping the room quiet and dimly lit can help create a calm and soothing environment that is ideal for hypnosis. Dim lighting can help reduce visual distractions and promote relaxation, while a quiet environment can help the individual focus on the hypnotic suggestions and their breathing. This type of environment can enhance the effectiveness of hypnosis for pain management and comfort during labor.