A nurse is teaching a group of pregnant clients about the risk factors for umbilical cord prolapse.
Which of the following factors should the nurse include? (Select all that apply.)
Polyhydramnios
Breech presentation
Premature rupture of membranes
Post-term pregnancy
Multiple gestation
Correct Answer : A,B,C,E
The correct answer is choices A, B, C and E. These are all risk factors for umbilical cord prolapse, which is a complication that occurs when the umbilical cord drops through the cervix and into the vagina ahead of the baby during delivery. This can cause fetal hypoxia and distress by compressing the cord and reducing blood flow to the baby.
Choice A is correct because polyhydramnios, or excessive amniotic fluid around the fetus, can cause the cord to slip out when the membranes rupture.
Choice B is correct because breech presentation, or abnormal positioning of the baby, can make it easier for the cord to slip between and past the fetal feet and into the pelvis.
Choice C is correct because premature rupture of membranes, or breaking of the water before labor begins, can cause the cord to prolapse if the baby’s head is not well engaged in the pelvis.
Choice D is wrong because post-term pregnancy, or pregnancy that lasts longer than 42 weeks, is not a risk factor for umbilical cord prolapse. However, it can increase the risk of other complications such as fetal macrosomia, placental insufficiency and meconium aspiration.
Choice E is correct because multiple gestation, or having more than one baby in the uterus, can cause unstable lie, or frequent changes in the position of the baby. This can increase the risk of cord prolapse if the membranes rupture when the baby is not in a cephalic (head-down) position.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. FHR of 80/min with severe variable decelerations.This indicates that the umbilical cord is prolapsed and compressed by the baby’s body, causing a decrease in blood and oxygen supply to the baby.A normal fetal heart rate is between 120 and 160 beats per minute.Severe variable decelerations are abrupt drops in the fetal heart rate that do not correspond to contractions.
Choice A is wrong because FHR of 160/min with accelerations is a normal finding that indicates a healthy baby.Accelerations are temporary increases in the fetal heart rate that usually occur with fetal movement or contractions.
Choice B is wrong because FHR of 120/min with early decelerations is also a normal finding that indicates a well-oxygenated baby.Early decelerations are gradual decreases in the fetal heart rate that mirror contractions and are caused by head compression.
Choice D is wrong because FHR of 140/min with late decelerations is an abnormal finding that indicates uteroplacental insufficiency, not cord prolapse.Late decelerations are gradual decreases in the fetal heart rate that occur after contractions and are caused by reduced blood flow to the placenta.
Correct Answer is B
Explanation
Terbutaline is a medication that can relax the uterine muscles and reduce contractions.This can help relieve pressure on the prolapsed umbilical cord and restore blood flow to the baby while preparing for an emergency cesarean delivery.
Choice A is wrong because magnesium sulfate is used to prevent seizures in women with preeclampsia or eclampsia, not to treat umbilical cord prolapse.
Choice C is wrong because oxytocin is used to induce or augment labor, not to stop it.Oxytocin can increase contractions and worsen cord compression.
Choice D is wrong because methylergonovine is used to prevent or treat postpartum hemorrhage, not to treat umbilical cord prolapse.Methylergonovine can also increase contractions and worsen cord compression.
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