The baby's head is delivered at 0900. The shoulders are not delivered and you notice a turtle sign. Interventions to relieve a dystocia include (Select all that apply):

Enter maneuvers (wood screw or rubin) by physician

Put mother on all fours (gaskin)

Suprapubic pressure by the nurse

McRoberts by the nurse

Delivery of the anterior arm by the physician

Fundal pressure by the nurse

Answer and Explanation

Correct Answer : A,B,C,D,E

Choice A: Enter maneuvers (wood screw or rubin) by physician are interventions to relieve a dystocia, as they involve rotating the fetal shoulders to align them with the maternal pelvis and facilitate the delivery. The physician can perform these maneuvers by applying pressure on the fetal clavicles or scapulas through the vaginA.

Choice B: Put mother on all fours (gaskin) is an intervention to relieve a dystocia, as it involves changing the maternal position to widen the pelvic outlet and reduce the pressure on the fetal shoulders. The mother can assume this position by kneeling on the bed and resting on her elbows or hands.

Choice C: Suprapubic pressure by the nurse is an intervention to relieve a dystocia, as it involves applying firm and downward pressure on the mother's lower abdomen to dislodge the anterior fetal shoulder from behind the pubic symphysis and assist the delivery. The nurse can perform this intervention by using the heel of the hand or a fist.

Choice D: McRoberts by the nurse is an intervention to relieve a dystocia, as it involves flexing and abducting the mother's legs to her chest to increase the pelvic diameter and relax the pelvic floor muscles. The nurse can perform this intervention by holding the mother's legs or using stirrups.

Choice E: Delivery of the anterior arm by the physician is an intervention to relieve a dystocia, as it involves reaching into the vagina and sweeping the fetal arm across the chest and out of the birth canal to reduce the shoulder-to-shoulder diameter and assist the delivery. The physician can perform this intervention by using a finger or a forceps.

Choice F: Fundal pressure by the nurse is not an intervention to relieve a dystocia, as it involves pushing on the upper part of the uterus to expel the fetus. This intervention is contraindicated in shoulder dystocia, as it can worsen the impaction of the fetal shoulders and cause fetal injury or maternal traumA.

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Correct Answer is ["A","B","E","F"]

Explanation

A. Call the lactation consultant to visit the patient

Rationale: A lactation consultant is a specialized professional who can provide expert guidance on breastfeeding techniques and troubleshooting latching issues. They can offer personalized assistance and support to ensure proper latch and feeding.

B. Encourage and support the mother's desire/intention and include the partner in the conversation

Rationale: Providing emotional support and encouragement is crucial. Including the partner helps create a supportive environment for the mother and ensures that everyone is on the same page regarding breastfeeding goals and practices.

E. Check for audible swallowing and a comfortable (non-painful) suck

Rationale: Ensuring that the baby is swallowing and that the mother is not experiencing pain during feeding indicates that the latch may be correct. This helps confirm that the baby is feeding effectively and that the mother is comfortable.

Not Recommended:

C. Give the mother a bottle of formula to supplement

Rationale: Introducing formula supplementation is not necessary if the goal is exclusive breastfeeding. This step might undermine the mother's confidence or interfere with the baby's ability to latch properly.

D. Help the mother shove her nipple in the baby's mouth

Rationale: This approach can cause discomfort and may not address the underlying issue of improper latching. It is better to use techniques that encourage a natural and comfortable latch.

Note:

F. Assist with proper positioning and latch techniques"

Rationale:Proper positioning ensures the baby is comfortably aligned with their head in line with their body, and the baby is brought to the breast, not vice versa.

A good latch involves the baby opening their mouth wide to take in the nipple and a portion of the areola, which helps with milk transfer and reduces discomfort. Proper latch prevents pain and supports milk production.

A. Increase the rate of the IV fluids. B. Assist the client to ambulate. C. Check for blood under the client's buttock. D. Perform fundal massage.

Correct Answer is C

Explanation

View Question and Answer

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The baby's head is delivered at 0900. The shoulders are not delivered and you notice a turtle sign. Interventions to relieve a dystocia include (Select all that apply):

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your patient who wants to exclusively breastfeed is afraid her baby isn't latching properly. To assist the mother you would (Select all that apply)

Correct Answer is ["A","B","E","F"]

Explanation

A nurse is caring for a client who is 4 hr postpartum. The nurse finds a small amount of lochia rubra on the client's perineal pad. The fundus is midline and firm at one fingerbreadth above the umbilicus. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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