A client at 37 weeks gestation is being admitted for a scheduled external cephalic version (ECV). Which of the following actions should the nurse anticipate being completed prior to the provider performing this elective procedure? (Select four options).
Initiate IV access for fluids and/or emergency medications.
Witness client sign informed consent form.
Verify fetal presentation by ultrasound.
Administer oxytocin.
Non-stress test (NST) that is reactive.
Correct Answer : A,B,C,E
E.
Choice A rationale
Initiating IV access is crucial to provide fluids and/or emergency medications if needed. External cephalic version (ECV) involves manipulating the fetus externally, which could lead to complications such as cord prolapse or fetal distress, requiring rapid intervention. IV access ensures that the healthcare team can respond promptly with necessary treatments.
Choice B rationale
The informed consent process is vital as it ensures that the client understands the procedure, its risks, benefits, and alternatives. The nurse's role includes witnessing the client's signature to confirm that the discussion and consent have occurred, ensuring ethical and legal standards are met.
Choice C rationale
Verifying fetal presentation by ultrasound is essential before performing ECV. Ultrasound helps determine the exact position of the fetus and the placenta, ensuring the procedure's safety and effectiveness. Accurate assessment helps avoid complications like placental abruption or cord entanglement.
Choice E rationale
A non-stress test (NST) that is reactive indicates good fetal well-being before the ECV procedure. It ensures that the fetus can tolerate the manipulation without undue stress. The NST helps identify any pre-existing fetal distress, guiding the decision to proceed or delay the procedure.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
D.
Choice A rationale
Initiating an IV fluid bolus is a common intervention in labor, particularly if there are signs of maternal hypotension or fetal distress. However, it may not be the priority action in every situation, and the decision should be based on the specific clinical context.
Choice B rationale
Discontinuing oxytocin infusion is crucial if there are signs of fetal distress, uterine hyperstimulation, or tachysystole. Oxytocin, while useful for inducing and augmenting labor, can sometimes lead to excessive uterine contractions that compromise fetal oxygenation.
Choice C rationale
Notifying the provider is essential when any complication or unexpected situation arises during labor. The provider needs to be informed to make timely decisions regarding the management of labor and ensure the safety of both mother and baby.
Choice D rationale
Repositioning the client to a lateral position can improve uteroplacental blood flow and enhance fetal oxygenation. This simple intervention can be particularly beneficial if there are concerns about fetal heart rate patterns.
Choice E rationale
Titrating oxytocin infusion to 8 mu/min per order is an appropriate intervention if the goal is to maintain adequate uterine contractions. However, if there are signs of fetal or maternal distress, this action should be reconsidered.
Correct Answer is A
Explanation
Choice A rationale
Terbutaline is a medication used to relax the uterus and reduce excessive uterine activity. It is a beta-2 adrenergic agonist that decreases the frequency and intensity of contractions. Administering terbutaline can help alleviate uterine hyperstimulation, improving fetal oxygenation and preventing further complications.
Choice B rationale
Hemabate is used to treat postpartum hemorrhage by inducing uterine contractions. It is not used to reduce excessive uterine activity during labor. Its primary function is to manage bleeding after childbirth, making it inappropriate for this situation.
Choice C rationale
Magnesium sulfate is used for neuroprotection in preterm labor and to prevent seizures in preeclampsia. While it can have some tocolytic effects, it is not the first-line treatment for reducing uterine activity. Its main role is in preventing eclamptic seizures and protecting fetal brain development in preterm labor.
Choice D rationale
Methergine is used to prevent or treat postpartum hemorrhage by causing uterine contractions. Similar to Hemabate, it is not suitable for reducing uterine activity during labor. Its primary purpose is to control bleeding after delivery, not to manage labor contractions.
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