A nurse is caring for a client who is at 20 weeks of gestation and has trichomoniasis.
Which of the following findings should the nurse expect?

Rationale:

A. Administering oxygen via a nonrebreather mask may be indicated for fetal distress, but the priority in this situation is to protect the umbilical cord from compression and minimize fetal compromise.

B. Cover the umbilical cord with a sterile saline-saturated towel is an appropriate action to prevent the cord from drying out and to reduce infection butimmediate focus should be on relieving pressure on the umbilical cord to ensure adequate fetal perfusion.

C. Initiate an infusion of IV fluids for the client can help stabilize maternal hemodynamics, but it does not directly address the umbilical cord compression. Relieving the pressure on the cord is the immediate intervention to prevent fetal hypoxia.

D. Perform a vaginal examination by applying upward pressure on the presenting part is the priority intervention. In cases of umbilical cord prolapse, the nurse must perform a vaginal examination and apply upward manual pressure on the presenting part (usually the fetal head) to lift it off the umbilical cord. This action relieves compression on the cord and restores blood flow and oxygen delivery to the fetus until an emergency delivery can be performed.

Rationale:

A. Polycythemia, an elevated red blood cell count, is not typically associated with forceps- assisted birth.

B. Facial palsy, or facial nerve injury, can occur as a complication of forceps-assisted birth due to pressure on the facial nerves during delivery.

C. Bronchopulmonary dysplasia is a lung condition primarily associated with premature birth and prolonged mechanical ventilation, not forceps-assisted birth.

D. Hypoglycemia may occur in newborns for various reasons but is not specifically associated with forceps-assisted birth unless there are other complicating factors such as maternal diabetes.