RN Nursing · Fetal Heart Rate Monitoring · Practice question
A nurse is reviewing the electronic fetal monitor strip for a client who is at 38 weeks gestation and is in labor. Which of the following findings indicates to the nurse that the fetus is experiencing recurrent late decelerations?
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As the contractions peak, the FHR begins to gradually decrease from the baseline and returns gradually to the baseline after the contraction has ended.
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In between contractions, the FHR repeatedly decreases below the baseline to create a tracing that looks like the letter "V".
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The FHR occasionally drops abruptly from the baseline and returns to the baseline gradually.
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The FHR increases above the baseline by 15 beats/min and lasts 20 seconds before decreasing back to the baseline.
Answer & explanation
Correct: As the contractions peak, the FHR begins to gradually decrease from the baseline and returns gradually to the baseline after the contraction has ended.
Late decelerations are gradual decreases in FHR (≥30 seconds from onset to nadir) that begin after the contraction peak and return to baseline after the contraction ends. They reflect uteroplacental insufficiency. V-shaped decelerations are variable decelerations caused by cord compression. Abrupt drops with gradual return don't match standard categories well; variables are abrupt with abrupt return. An increase of 15 bpm lasting 15+ seconds is an acceleration, a reassuring sign. Recognizing late decelerations is critical to initiate intrauterine resuscitation. (AWHONN Fetal Heart Monitoring, 2021).
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- A nurse is monitoring a laboring client with an external electronic fetal monitor and notes the fetal heart rate decelerates after the contraction begins, with the lowest point of the deceleration occurring after the peak of the contraction. What is the nurse's priority action?
- A nurse is assisting with the care of a client who is pregnant and in the labor and delivery unit. The nurse is contacting the provider regarding the client's status. (Based on the provided Medical History, Vital Signs, and Nurses' Notes) Which of the following findings should the nurse include in the report? (Select 4)
- A nurse is assisting with caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should identify that the registered nurse should take?
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