Chapter 15: Fetal Assessment during Labor NCLEX

B (Initiation of epidural anesthesia that resulted in maternal hypotension. Hyperthyroidism would result in baseline tachycardia. Fetal bradycardia is the pattern described and results from the hypoxia that would occur when uteroplacental perfusion is reduced by maternal hypotension. The woman receiving epidural anesthesia needs to be well hydrated before and during induction of the anesthesia to maintain an adequate cardiac output and blood pressure. A maternal fever could cause fetal tachycardia. Assumption of a lateral position enhances placental perfusion and should result in a reassuring FHR pattern.) - Answer - When assessing a fetal heart rate (FHR) tracing, the nurse notes a decrease in the baseline rate from 155 to 110. The rate of 110 persists for more than 10 minutes. The nurse could attribute this decrease in baseline to: A. Maternal hyperthyroidism. B. Initiation of epidural anesthesia that resulted in maternal hypotension. C. Maternal infection accompanied by fever. D. Alteration in maternal position from semirecumbent to lateral. A (Describe the finding in the nurse's notes. An early deceleration pattern from head compression is described. No action other than documentation of the finding is required since this is an expected reaction to compression of the fetal head as it passes through the cervix. These actions would be implemented when non-reassuring or ominous changes are noted. These actions would be implemented when non-reassuring or ominous changes are noted. These actions would be implemented when non-reassuring or ominous changes are noted.) - Answer - On review of a fetal monitor tracing, the nurse notes that for several contractions, the fetal heart rate decelerates as a contraction begins and returns to baseline just before it ends. The nurse should: A. Describe the finding in the nurse's notes. B. Reposition the woman onto her side. C. Call the physician for instructions. D. Administer oxygen at 8 to 10 L/min with a tight face mask. D (Variability averages between 6 to 10 beats/min.