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 C

Explanation

A. Apply warm, moist soaks to the client's lower legs. B. Have the client ambulate frequently in the hallway. C. Keep the client on bed rest. D. Place pillows under the client's knees while she is resting in beD.

Correct Answer is B

Explanation

Choice A: Applying warm, moist soaks to the client's lower legs is not an effective intervention, as it can increase the swelling and the discomfort of the legs and interfere with the healing of the incision. The nurse should avoid applying heat to the legs and use compression stockings or pneumatic devices insteaD.

Choice B: Having the client ambulate frequently in the hallway is an effective intervention, as it can improve the blood circulation and prevent the formation of blood clots in the legs. The nurse should encourage the client to ambulate as soon as possible after the surgery and assist the client with the first ambulation.

Choice C: Keeping the client on bed rest is not an appropriate intervention, as it can increase the stasis and the coagulation of the blood and increase the risk of thrombophlebitis. The nurse should avoid prolonged bed rest and promote early mobilization of the client.

Choice D: Placing pillows under the client's knees while she is resting in bed is not an appropriate intervention, as it can impair the venous return and increase the pressure and the inflammation of the legs. The nurse should avoid placing anything under the client's knees and keep the legs slightly elevated and in a straight position.

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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

A nurse is assisting in the care of a client who is in labor. The doctor documents the vaginal examination as: 3 cm, 30%, and -1. The nurse evaluates this documentation to mean which of the following?

Correct Answer is C

Explanation

A nurse is caring for a client who is 1 day postpartum following a cesarean birtH. To prevent thrombophlebitis, the nurse should include which of the following interventions in the client's plan of care? (Select onE.:

Correct Answer is B

Explanation

A nurse is assisting in the care of a client who had a vaginal birth 2 hours ago. Which of the following actions should the nurse take? (Select all that apply):

A nurse is caring for a client who is at 38 weeks of gestation and has a score of 10 on her biophysical profile. Which of the following actions should the nurse take?

A nurse is assisting in the care of a client who is in active labor. The nurse notes late decelerations on the fetal monitor tracing. Which of the following actions should the nurse take FIRST?

A nurse is assisting a nurse midwife in examining a client who is a primigravida at 40 weeks of gestation and states that she thinks she is in labor.Which of the following findings confirm that the client is in labor? (Select all that apply):

Your patient is receiving magnesium sulfate for neuroprotection and preterm labor at 1 gram/hour. The most concerning vital sign below is:

A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rulE. The first day of her last menstrual period was May 4. Which of the following dates should the nurse tell the client is her estimated date of delivery?

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