Obstetric & Maternity Nursing Flashcards

What is a normal fetal heart rate during labor?

Answer: 110–160 beats per minute

Normal fetal heart rate baseline is 110–160 bpm. Bradycardia is 160 bpm for ≥10 minutes. Accelerations (15 bpm above baseline for 15 seconds) are reassuring signs of fetal well-being.

A patient at 28 weeks gestation is at risk for preterm labor. Which medication is used to accelerate fetal lung maturity?

Answer: Betamethasone (antenatal corticosteroid)

Antenatal corticosteroids (betamethasone or dexamethasone) administered at 24–34 weeks gestation accelerate surfactant production and lung maturation, significantly reducing the risk of RDS, IVH, and necrotizing enterocolitis in premature newborns.

What is the correct action when a variable deceleration pattern is seen on the fetal monitor during labor?

Answer: Reposition the mother, administer oxygen, and increase IV fluid rate

Variable decelerations result from umbilical cord compression. Initial interventions are: change maternal position (left lateral or hands-and-knees), increase IV fluids to improve placental perfusion, apply oxygen 8–10 L/min via face mask, and notify the physician if decelerations persist.

A G4P3 mother is delivering her fourth baby rapidly. The nurse notes the umbilical cord prolapsed ahead of the baby's head. What is the immediate action?

Answer: Manually hold the presenting part off the cord with a gloved hand and call for emergency cesarean

Umbilical cord prolapse is an obstetric emergency. The presenting part must be manually elevated off the cord to relieve compression and preserve fetal oxygenation while preparing for emergency cesarean. The cord should be kept warm and moist. Every second counts.

Which nursing assessment is most important in a patient receiving magnesium sulfate for preeclampsia?

Answer: Respiratory rate, deep tendon reflexes, and urine output

Magnesium sulfate toxicity progresses: first, loss of DTRs (patella reflex) at ~7–10 mEq/L, then respiratory depression at ~10–13 mEq/L, then cardiac arrest. Respiratory rate <12/min, absent DTRs, or urine output <25 mL/hr require stopping the infusion. Calcium gluconate is the antidote.

What does a positive non-stress test (NST) indicate?

Answer: A reactive NST with at least 2 accelerations in 20 minutes indicates fetal well-being

In NST terminology, a 'reactive' (not 'positive') NST is reassuring, showing at least 2 FHR accelerations (≥15 bpm for ≥15 seconds) in 20 minutes. A non-reactive NST requires further evaluation (biophysical profile, contraction stress test). The term 'positive' is used for CST.