A nurse is positioning a client for a cesarean birth. To prevent a compromise in placental blood flow during the intraoperative period, which of the following actions should the nurse take?

Insert a pillow under the client's knees.

Assist the client into the lithotomy position,

Place a wedge under one of the client's hips.

Position the client in reverse Trendelenburg.

Answer and Explanation

The Correct Answer is C

A) Insert a pillow under the client's knees: While placing a pillow under the knees may promote comfort, it can lead to increased pressure on the lower back and may not effectively address potential compression of the vena cava, which is crucial in maintaining optimal placental blood flow during surgery.

B) Assist the client into the lithotomy position: The lithotomy position can increase pressure on the abdominal vessels, potentially compromising blood flow to the placenta. This position should be used cautiously, especially in clients with concerns regarding blood flow.

C) Place a wedge under one of the client's hips: This action is appropriate as it helps to displace the uterus laterally, reducing pressure on the inferior vena cava. This maneuver improves venous return and maintains placental perfusion, which is critical during cesarean delivery.

D) Position the client in reverse Trendelenburg: Although this position elevates the upper body, it does not specifically address the potential for vena cava compression caused by the weight of the uterus. It is less effective than placing a wedge under the hips in terms of preserving placental blood flow.

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Correct Answer is C

Explanation

A) A client who has orthostatic hypotension and 4+ pitting edema in the lower extremities: While this client requires assessment, their condition is not immediately life-threatening. Orthostatic hypotension and edema need to be evaluated, but they are not acute emergencies.

B) A client who has Clostridium difficile and a temperature of 38.6° C (101.5° F): This client needs attention due to the infection and fever, but it is not as critical as the potential cardiac event presented in option C.

C) A client who has left shoulder pain and S-T elevation on a 12-lead ECG: This client is exhibiting signs that may indicate an acute myocardial infarction (heart attack). S-T elevation on an ECG is a significant finding and suggests that this client could be experiencing a serious cardiac event, making it the priority for assessment.

D) A client who has a complete femur fracture and reports a pain level of 7 on a scale from 0 to 10: While this client is in pain and requires care, the priority in emergency situations is often given to conditions that are life-threatening, such as those related to cardiac function. Therefore, this client can be assessed after addressing the potential cardiac emergency.

A. Noting changes in the treatment plan in the client's medical record B. Recording the client's progress in the nurses' notes C. Posting swallowing precautions at the head of the client's bed D. Having interdisciplinary team meetings for the client on a regular basis

Correct Answer is D

Explanation

A) Noting changes in the treatment plan in the client's medical record: While this is important for continuity of care, it may not directly facilitate communication among staff in real-time or promote a collaborative approach.

B) Recording the client's progress in the nurses' notes: Documenting progress is essential, but it serves more as a record of care rather than an active communication tool among the team members.

C) Posting swallowing precautions at the head of the client's bed: This helps ensure that all staff are aware of the precautions, but it does not promote a broader dialogue about the client's overall care and communication needs.

D) Having interdisciplinary team meetings for the client on a regular basis: This is the correct answer. Regular interdisciplinary meetings encourage collaborative communication, allowing various healthcare professionals to discuss the client’s needs, share observations, and develop a cohesive care plan, which is especially important for clients with communication barriers like expressive aphasia.

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A nurse is positioning a client for a cesarean birth. To prevent a compromise in placental blood flow during the intraoperative period, which of the following actions should the nurse take?

Nursing Test Bank

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