CNM Certified Nurse Midwife

Category - Intrapartum

A nurse midwife is assessing a client at 34 weeks’ gestation. An external fetal heart monitor is attached. Which of the following assessment findings suggest fetal distress?

I. Fetal heart rate decreases at the onset of contractions and returns to baseline after the contraction
II. Fetal heart rate of 130 beats per minute
III. Greenish amniotic fluid
IV. Continuous decrease in baseline variability

  1. I and II
  2. I and III
  3. III and IV
  4. I, III, and IV
Explanation

Answer: C - Greenish or meconium-stained amniotic fluid and continuous decrease in baseline variability are signs of fetal distress. Early deceleration, which describes a decrease in the fetal heart rate at the onset of contraction and its return to baseline after the contraction, and a fetal heart rate between 120 and 160 beats per minute are not signs of fetal distress. Early deceleration is caused by vagal stimulation from head compression. It is a reassuring pattern. Other signs and symptoms of fetal distress include fetal hyperactivity, severe variable decelerations and late decelerations.

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