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. Umbilical cord compression.Variable decelerations are the most common type of fetal deceleration and they are caused by compression of the umbilical cord.They vary in shape, duration, and intensity and may not have a constant relationship with uterine contractions.
Choice A is wrong because uteroplacental insufficiency is the cause of late decelerations, not variable decelerations.Uteroplacental insufficiency is a decrease in the blood flow to the placenta that reduces the amount of oxygen and nutrients transferred to the fetus.
Choice C is wrong because maternal hypotension is one of the possible causes of late decelerations, not variable decelerations.Maternal hypotension can reduce the uteroplacental blood flow and cause fetal hypoxia.
Choice D is wrong because fetal head compression is the cause of early decelerations, not variable decelerations.Early decelerations are benign and uniform in shape and they occur when the fetal head is pressed against the cervix during a uterine contraction.
Correct Answer is A
Explanation
The correct answer is choice A. Uterine atony.
Uterine atony is the failure of the uterus to contract and retract after delivery, which can lead to excessive bleeding and hemorrhage.A boggy uterus on palpation is a sign of uterine atony.
Choice B. Uterine inversion is wrong because it is a rare complication in which the uterus turns inside out and protrudes through the cervix.It usually causes severe pain, shock, and hemorrhage.
Choice C. Uterine rupture is wrong because it is a life-threatening emergency in which the uterus tears open along the scar line of a previous cesarean delivery or other uterine surgery.It usually causes severe abdominal pain, fetal distress, and maternal hypovolemic shock.
Choice D. Uterine infection is wrong because it is an inflammation of the endometrium (the lining of the uterus) caused by bacteria.It usually causes fever, foul-smelling lochia, and lower abdominal tenderness.
Normal ranges for postpartum bleeding are about 500 ml for vaginal delivery and 1000 ml for cesarean delivery.The uterus should feel firm and midline at or below the umbilicus after delivery.
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