The provider orders a Heparin infusion to run 950 units/hr. The medication is supplied as 25,000 units/250 mL NSS.

At what rate would the infusion pump be set at?

Choice A rationale

Applying a fetal scalp electrode is an invasive procedure that provides a more accurate assessment of fetal heart rate. However, late decelerations indicate uteroplacental insufficiency requiring immediate interventions to improve fetal oxygenation before considering invasive monitoring.

Choice B rationale

Performing a vaginal exam can assess labor progress and rule out cord prolapse or other issues. While important, it is not the immediate priority when late decelerations indicate acute fetal hypoxemia; improving oxygenation to the fetus is paramount.

Choice C rationale

Inserting an intravenous catheter is essential for administering fluids or medications. However, the most immediate intervention for late decelerations is to improve uterine blood flow and fetal oxygenation, which is achieved through maternal repositioning as the first step.

Choice D rationale

Late decelerations indicate uteroplacental insufficiency, meaning reduced blood flow and oxygen to the fetus. Repositioning the client to the left-lateral position relieves pressure on the vena cava, improving venous return to the heart, thus increasing uterine blood flow and fetal oxygenation by optimizing placental perfusion.

Choice A rationale

Local funeral home morgues would be quickly overwhelmed and inadequate for mass casualties resulting from a nuclear detonation. The sheer volume of bodies would exceed their capacity, and they may lack the specialized facilities required for handling contaminated remains, posing significant public health and safety risks. Normal morgue capacity is designed for typical mortality rates.

Choice B rationale

Refrigerated trucks provide a temporary, scalable solution for storing a large number of bodies, helping to prevent decomposition and the spread of pathogens in a mass casualty event. This method allows for organized collection and identification processes to be established while awaiting more permanent arrangements, crucial in disaster response. Proper refrigeration maintains body integrity.

Choice C rationale

Hospital morgues, like local funeral home morgues, have limited capacity and are primarily designed for routine patient deaths. In a large-scale disaster, they would be rapidly overfilled, compromising their ability to manage current hospital fatalities and posing logistical challenges for body management and identification. Normal hospital morgues are equipped for standard operations.

Choice D rationale

Mass graves are a last resort in extreme mass casualty events when conventional methods of body disposal are overwhelmed or impractical due to scale, contamination, or resource limitations. While a somber decision, they can be a necessary measure to manage large numbers of deceased individuals safely and efficiently, preventing widespread public health crises. Proper procedures minimize environmental impact.