Which condition increases the risk of occult umbilical cord prolapse?
Transverse lie
Macrosomia
Oligohydramnios
Placenta previa
The Correct Answer is C
This is a condition where there is too little amniotic fluid around the fetus. This increases the risk of umbilical cord prolapse because the cord can easily slip past the presenting part of the fetus and into the cervix or vagina.
This can cause fetal hypoxia and distress due to compression or occlusion of the cord.
Choice A. Transverse lie is wrong because this is a condition where the fetus lies horizontally across the uterus. This can increase the risk of cord prolapse if the membranes rupture and the cord descends alongside or before the fetus.
Choice B. Macrosomia is wrong because this is a condition where the fetus is larger than average. This can decrease the risk of cord prolapse because the presenting part of the fetus is more likely to fill the pelvis and prevent the cord from slipping past.
Choice D. Placenta previa is wrong because this is a condition where the placenta covers part or all of the cervix. This can increase the risk of bleeding during labor, but not necessarily cord prolapse.
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Correct Answer is C
Explanation
The correct answer is choice C.“I will come to the hospital as soon as my water breaks.” This statement indicates understanding of measures to prevent umbilical cord prolapse, which is a complication that occurs when the umbilical cord drops out of the cervix before the baby during labor.This can cut off the baby’s blood and oxygen supply and cause permanent brain damage.Immediate delivery by C-section is usually necessary.
Choice A is wrong because squatting or sitting on hard surfaces does not increase the risk of umbilical cord prolapse.
Choice B is wrong because decreased fetal movement is not a sign of umbilical cord prolapse, but rather a sign of fetal distress that may have other causes.
Choice D is wrong because drinking plenty of fluids and resting on the left side are general measures to promote maternal and fetal well-being, but they do not prevent umbilical cord prolapse.
Some of the risk factors for umbilical cord prolapse include premature rupture of membranes, multiple pregnancy, breech presentation, excessive amniotic fluid, abnormal length of the umbilical cord and premature delivery.Some of the symptoms of umbilical cord prolapse include visible or palpable cord after water breaks, fetal heart rate abnormalities and maternal feeling of something coming out of the vagina.Umbilical cord prolapse can be diagnosed by physical examination, ultrasound or fetal heart rate monitoring.
Correct Answer is ["A","B"]
Explanation
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.
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