A patient’s umbilical cord prolapses during labor.
The nurse should place her in which position? (Select all that apply.).
Knee-chest
Trendelenburg
Supine with a rolled towel under one hip
Lithotomy
Sims
Correct Answer : A,B
The correct answer is choice A and B. The nurse should place the patient in knee-chest or Trendelenburg position to relieve the pressure of the fetal presenting part on the prolapsed cord and improve fetal oxygenation. These positions also allow gravity to help keep the cord in the uterus and prevent further descent.
Choice C is wrong because supine position can worsen cord compression and compromise fetal blood flow. Choice D is wrong because lithotomy position can also increase cord descent and reduce fetal perfusion. Choice E is wrong because Sims position can cause cord prolapse if the membranes are intact or rupture spontaneously.
Normal ranges for fetal heart rate are 110 to 160 beats per minute. Cord prolapse can cause fetal bradycardia with decelerations during contractions due to cord compression.
This is a sign of fetal distress and requires immediate intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. The cord is hidden, often next to but not in front of the fetal head.This is called anoccult cord prolapseand it occurs when the umbilical cord descends alongside–but not past–the presenting part of the baby.Occult cords can occur with ruptured or intact membranes.They can cause hypoxia, brain injury, and permanent disability in a baby, so medical personnel must address them rapidly and appropriately.
Choice A is wrong because it describes anovert cord prolapse, which means that the cord slips down into your cervix and vagina ahead of your baby during delivery.This is a medical emergency that can cut off your baby’s blood and oxygen supply during delivery.
Choice C is wrong because it describes avisible cord prolapse, which is a type of overt cord prolapse where the cord is visible or palpable outside of the vagina.This is also a medical emergency that requires immediate delivery.
Choice D is wrong because it describes anuchal cord, which means that the cord is wrapped around the fetal neck or body.This is not a prolapse, but it can cause complications such as reduced blood flow, fetal distress, or umbilical cord strangulation.
Correct Answer is D
Explanation
The correct answer is choice D. A patient who is 34 weeks pregnant with a breech presentation and ruptured membranes.This is because breech presentation and ruptured membranes are both risk factors for umbilical cord prolapse, which is where the umbilical cord descends through the cervix and is alongside or below the presenting part of the fetus.This can cause fetal hypoxia and distress.
Choice A is wrong because a cephalic presentation and intact membranes are not risk factors for umbilical cord prolapse.
Choice B is wrong because although twins and ruptured membranes are risk factors for umbilical cord prolapse, the risk is lower than in choice D. Choice C is wrong because although a transverse lie is a risk factor for umbilical cord prolapse, the risk is lower than in choice D if the membranes are intact.
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