A nurse is providing education to a group of parents of toddlers about household items that can be swallowed and block the airway of their child.
The nurse should include which of the following items as a risk for aspiration?

Choice A rationale

Calling in additional staff from home involves complex decision-making regarding staffing needs, skill mix, and regulatory requirements, which falls outside the scope of practice for unlicensed assistive personnel. This task requires a registered nurse's clinical judgment and professional accountability to ensure appropriate patient care staffing levels.

Choice B rationale

Assisting medics with inter-facility transport involves patient assessment, monitoring, and potentially administering medications or interventions during transit. These activities require specialized training, licensure, and clinical judgment possessed by paramedics or registered nurses, not within the UAP's scope of practice.

Choice C rationale

Updating vital signs is a fundamental skill within the UAP's scope of practice, as it involves routine data collection and documentation. Recognizing and reporting changes in vital signs to the charge nurse aligns with the UAP's role in assisting with patient monitoring and contributing to the nursing assessment process.

Choice D rationale

Disclosing patient information to family members, even in an emergency, requires adherence to patient confidentiality regulations (e.g., HIPAA) and the nurse's clinical judgment to accurately convey complex medical information. This is a responsibility of a licensed nurse, not a UAP, to ensure ethical and legal compliance.

Choice A rationale

Episiotomy involves an incision in the perineum to enlarge the vaginal opening. While it can facilitate delivery, it does not directly address the mechanical obstruction caused by the shoulder impacting against the maternal symphysis pubis, which is the hallmark of shoulder dystocia.

Choice B rationale

The McRoberts maneuver is most commonly used first to relieve shoulder dystocia. It involves hyperflexing the maternal hips onto the abdomen, which flattens the sacrum, rotates the symphysis pubis cephalad, and often allows the impacted anterior shoulder to clear underneath the symphysis pubis, facilitating delivery.

Choice C rationale

The Zavanelli maneuver involves pushing the fetal head back into the birth canal and performing a Cesarean section. This is a highly invasive and often last-resort maneuver, employed only after less invasive methods like McRoberts and suprapubic pressure have failed due to its significant risks.

Choice D rationale

Fundal pressure involves applying downward pressure on the top of the uterus. This maneuver is contraindicated in shoulder dystocia because it can worsen the impaction of the fetal shoulder against the maternal symphysis pubis, potentially leading to more severe injury to the fetus or mother.