CH8 N266 Intrapartum Assessment and Interventions exam study guide explanation fall 2023 rated 5 stars

CH8 N266 Intrapartum Assessment and Interventions exam study guide explanation fall 2023 rated 5 stars Maternal Factors - 1. UTERINE muscles STRETCHED to the threshold point ---> release of PROSTAGLANDINS = contractions. 2. PRESSURE of CERVIX stimulates the nerveplexus, ---> surges OXYTOCIN (A pituitary gland) = myometrial contractions. 3. Oxytocin and prostaglandin ---> inhibit calcium binding in muscle = increased intracellular calcium levels --->contractions. 4. Progesterone, decrease ---> estrogen increase = contractions . 5. Estrogen increases, ---> uterine response. 1. A nurse is providing care for a client who is in active labor. Her cervix is dilated to 5 cm, and her membranes are intact. Based on the use of external electronic fetal monitoring, the nurse notes a FHR of 115 to 125/min with occasional increases up to 150 to 155/min that last for 25 seconds, and have beat-to-beat variability of 20/min. There is no slowing of FHR from the baseline. The nurse should recognize that this client is exhibiting signs of which of the following? (Select all that apply.) A. Moderate variability B. FHR accelerations C. FHR decelerations D. Normal baseline FHR E. Fetal tachycardia - 1. A. CORRECT: There is moderate variability of 20/ min (6 to 25/min is expected reference range). B. CORRECT: FHR accelerations are present with increases up to 150 to 155/min lasting for 25 seconds. C. There are no FHR decelerations because the FHR does not slow down. D. CORRECT: There is a normal baseline FHR of 115 to 125/min falls within the expected reference range of 110 to 160/min. E. There is no evidence of fetal tachycardia because the FHR is within the expected reference range of 115 to 125/min. 3. A nurse is reviewing the electronic monitor tracing of a client who is in active labor. The nurse should know that a fetus receives more oxygen when which of the following appears on the tracing? A. Peak of the uterine contraction B. Moderate variability C. FHR acceleration D. Relaxation between uterine contractions - 3. A. Compression of the arteries to the uteroplacental intervillous spaces is most acute at the peak (acme) of the uterine contraction, resulting in a decrease in fetal circulation and oxygenation. B. Moderate variability indicates fluctuations in the fetal heart and is not an indication the fetus is receiving more oxygen. C. FHR accelerations indicate an intact fetal CNS and is not an indication the fetus is receiving more oxygen. D. CORRECT: A fetus is most oxygenated during the relaxation period between contractions. During contractions, the arteries to the uteroplacental intervillous spaces are compressed, resulting in a decrease in fetal circulation and oxygenation. 2. A nurse is teaching a client about the benefits of internal fetal heart monitoring. Which of the following should statements the nurse include in the teaching? (Select all that apply.) A. "It is considered a noninvas