A pregnant woman's amniotic membranes rupture and a prolapsed umbilical cord is found. What intervention would be the first priority?
Placing the woman in the knee-chest position.
Starting oxygen by facemask.
Preparing the woman for a vaginal birth.
Covering the cord in sterile gauze soaked in saline.
The Correct Answer is A
In the case of a prolapsed umbilical cord, the first priority intervention is to relieve pressure on the cord. Placing the woman in the knee-chest position or Trendelenburg position with the hips elevated is the best way to achieve this. This position helps to reduce the compression of the cord and improve fetal oxygenation.
Option B is incorrect because while oxygen may be necessary, relieving pressure on the cord is the priority.
Option C is incorrect because a vaginal birth should not proceed with a prolapsed umbilical cord, as it can cause cord compression and fetal distress.
Option D is incorrect because covering the cord in sterile gauze soaked in saline is not a priority intervention and may not be effective in relieving pressure on the cord.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Fetal well-being during labor is assessed by the response of the fetal heart rate (FHR) to uterine contractions (UCs). During labor, the fetal heart rate is monitored to assess the well-being of the fetus. The fetal heart rate should increase in response to fetal movement and contractions, which indicates that the fetus is receiving adequate oxygenation and blood flow. This response is called an "acceleration" in the FHR. However, accelerations alone are not enough to assess fetal well-being during labor. It is the combination of the FHR pattern with the uterine contractions pattern that provides the most information.
In addition to the FHR response to UCs, other factors that may be used to assess fetal well-being during labor include fetal scalp blood sampling, fetal pulse oximetry, and fetal ultrasound. Maternal pain control may help to decrease maternal stress and anxiety during labor, but it is not directly related to fetal well-being. An FHR above 110 beats/min is within the normal range for a fetal baseline heart rate, but it is not enough to assess fetal well-being during labor.
Correct Answer is B
Explanation
Bedrest is no longer recommended as it does not improve outcomes and may increase the risk of complications such as thromboembolism and pneumonia. Instead, patients with a placenta previa should be advised to avoid activities that may increase pelvic pressure, such as sexual intercourse, heavy lifting, and strenuous exercise. The other options are appropriate instructions to include in the patient's discharge plan.
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