RN Nursing · Fetal Heart Rate Monitoring · Practice question
A nurse is assessing fetal heart tones for a client who is pregnant. The nurse has determined the fetal position as left occiput anterior. To which of the following areas of the client's abdomen should the nurse apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?
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Left upper quadrant
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Right upper quadrant
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✓
Left lower quadrant
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Right lower quadrant
Answer & explanation
Correct: Left lower quadrant
In a left occiput anterior (LOA) position, the fetal occiput is in the left anterior quadrant of the maternal pelvis, meaning the fetal back is on the maternal left side and the head is down (vertex presentation). The point of maximum intensity (PMI) of fetal heart tones is best heard through the fetal back. Therefore, the transducer is placed in the LEFT LOWER QUADRANT of the maternal abdomen. For right occiput anterior (ROA), PMI would be in the right lower quadrant. Breech positions produce heart tones in the upper quadrants because the fetal back is higher in the uterus (Lowdermilk, 2020).
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