Practice Quiz

CNM Certified Nurse Midwife

Category - Intrapartum

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A client at 39 weeks’ gestation is admitted to the labor and delivery unit. An external fetal heart rate monitor is attached to the client. Physical examination and laboratory test results reveal that the fetus is in breech position, and a cesarean delivery is recommended. Physical examination is conducted and laboratory tests are ordered. Before the pregnancy, the client’s average heart rate was 80 beats per minute. Which of the following assessment findings necessitates immediate physician notification?
  1. Hematrocrit = 38%
  2. WBC = 18,000 cells/mm3
  3. Maternal heart rate = 95 beats per minute
  4. Fetal heart rate = 180 beats per minute
Explanation
Answer: D - A fetal heart rate of 180 beats per minute requires immediate notification of the physician. The normal fetal heart rate is between 120 and 160 beats per minute. A fetal heart rate of 180 beats per minute suggests that the fetus is in respiratory distress. The client’s hematocrit concentration is within the normal limits. The WBC increases above the normal range during the third trimester, and it may increase to 18,000 cells/mm3 during labor. The maternal heart rate may increase by 10 to 15 beats per minute during pregnancy.
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