What type of FHR decelerations are a sign of possible fetal descent?

Correct Answer: A

Rationale: Early decelerations are a type of FHR deceleration that are considered benign and are actually a sign of possible fetal descent. These decelerations typically mirror the contractions during labor, meaning they start and end at the same time as the contraction. This is because early decelerations are caused by head compression during contractions, which stimulates the vagus nerve and leads to a reflex slowing of the fetal heart rate. Late decelerations, on the other hand, are a concerning type of FHR deceleration that occur after the peak of the contraction. They are often associated with uteroplacental insufficiency and are not a sign of fetal descent, but rather a sign of fetal distress. Variable decelerations are another type of FHR deceleration that are caused by cord compression. They are characterized by an abrupt and sharp decrease in the fetal heart rate, followed by a rapid return to baseline. Variable decelerations are typically not associated with fetal descent. Prolonged decelerations are FHR decelerations that last longer than 2 minutes but less than 10 minutes. They are often caused by various factors such as cord compression, maternal hypotension, or uterine hyperstimulation. Prolonged decelerations are not specifically indicative of fetal descent.

Correct Answer: A

Rationale: Cardiac arrhythmia is the correct answer because it refers to abnormal heart rhythms that can affect the fetal heart rate tracing. This can manifest as irregular, fast, or slow heartbeats, leading to abnormal patterns in the tracing. Cardiac arrhythmias can be caused by various factors such as maternal medications, maternal medical conditions, or fetal factors. Monitoring and identifying cardiac arrhythmias are crucial to ensure the well-being of the fetus during labor and delivery. Fetal hypoxia, on the other hand, refers to a condition where the fetus is not receiving enough oxygen. While fetal hypoxia can lead to abnormal heart rate tracings, it is not the cause of the abnormal tracing in this scenario. Fetal hypoxia can be caused by factors such as placental insufficiency, umbilical cord compression, or maternal hypotension. Uterine rupture is a rare but serious complication that can occur during labor. It involves a tear in the wall of the uterus, leading to severe pain, fetal distress, and abnormal heart rate tracings. However, uterine rupture typically presents with a sudden and dramatic change in the fetal heart rate tracing, which is not described in the scenario provided. Labor dystocia refers to difficult or abnormal labor progression. This can result in prolonged labor, maternal exhaustion, and fetal distress. While labor dystocia can lead to abnormal heart rate tracings due to the stress placed on the fetus during prolonged labor, it is not the primary cause of the abnormal tracing described in the scenario. In conclusion, the correct answer is cardiac arrhythmia because it directly affects the fetal heart rate tracing, leading to abnormal patterns. Fetal hypoxia, uterine rupture, and labor dystocia can also result in abnormal heart rate tracings, but they are not the primary cause in this specific scenario.

Correct Answer: B

Rationale: A Category II tracing is indicative of an indeterminate fetal heart rate pattern, meaning it does not fit clearly into either Category I (reassuring) or Category III (abnormal). Variable decelerations with moderate variability is a characteristic of Category II tracings. Variable decelerations are abrupt decreases in the fetal heart rate that vary in duration, depth, and timing with contractions. These are considered concerning but not necessarily indicative of immediate fetal distress. Moderate variability refers to fluctuations in the fetal heart rate pattern of 6-25 beats per minute, which is considered normal and reassuring. Persistent late decelerations (Choice A) are a characteristic of Category III tracings, indicating fetal distress. Late decelerations are gradual decreases in the fetal heart rate that occur after the peak of a contraction and may be indicative of uteroplacental insufficiency. Moderate variability with accelerations (Choice C) is a characteristic of Category I tracings, which are considered reassuring. Moderate variability is normal fluctuation in the fetal heart rate, while accelerations are brief increases in the fetal heart rate above baseline. This pattern suggests a healthy, oxygenated fetus. A baseline fetal heart rate of 80 bpm (Choice D) is extremely low and would be indicative of fetal distress or other issues. A baseline fetal heart rate below 110 bpm is considered bradycardia and would require immediate intervention.

Correct Answer: D

Rationale: Early decelerations are a common finding during labor and are typically benign, caused by head compression during contractions. Decreasing oxytocin by half (Choice A) is not necessary for early decelerations as they are not typically associated with uteroplacental insufficiency. Expedited delivery (Choice B) is not indicated for early decelerations as they are not typically a sign of fetal distress. Early decelerations are considered reassuring patterns as long as they are symmetrical and coincide with contractions. Performing a vaginal exam (Choice C) is not necessary for early decelerations unless there are other concerning signs or symptoms present. Vaginal exams should be performed judiciously to avoid introducing infection or causing discomfort to the patient. The correct answer, readjusting the fetal monitor (Choice D), is the appropriate nursing intervention for FHR tracing with early decelerations. This involves ensuring the fetal monitor is correctly placed on the mother's abdomen, checking for any maternal movement or fetal position changes that could affect the tracing, and making any necessary adjustments to optimize the monitoring of the fetal heart rate. This intervention allows for accurate assessment of the fetal well-being and helps ensure appropriate management of labor.

Correct Answer: B

Rationale: The nurse turns the laboring person to a side-lying position primarily to resolve supine hypotension. When the person lies flat on their back (the supine position), the weight of the uterus can compress the vena cava, reducing blood return to the heart and causing a decrease in blood pressure. This can lead to dizziness, lightheadedness, and a decrease in oxygen supply to both the person and the baby. Therefore, turning the person to a side-lying position can alleviate this pressure on the vena cava, allowing for improved blood flow and blood pressure regulation. Choice A, to increase contractions, is incorrect because the position of the laboring person does not directly impact the strength or frequency of contractions. Contractions are primarily controlled by hormones and the natural progression of labor. Choice C, to reverse uterine tachysystole, is also incorrect. Uterine tachysystole refers to excessively frequent contractions, which can be caused by factors such as medications or maternal conditions. Changing the person's position may help alleviate pressure on the uterus, but it is not a direct treatment for uterine tachysystole. Choice D, to decrease placental perfusion, is incorrect as well. Placental perfusion refers to the blood flow to the placenta, which is essential for providing oxygen and nutrients to the developing baby. Turning the person to a side-lying position actually helps improve blood flow and oxygenation to both the person and the baby, rather than decreasing placental perfusion. In conclusion, the correct answer is B because turning the laboring person to a side-lying position helps resolve supine hypotension by relieving pressure on the vena cava and improving blood flow and blood pressure regulation.