Which interventions are appropriate when managing a prolapsed umbilical cord during labor? (Select all that apply)

1. Jittery Extremities
   • Hypoglycemia: Jittery extremities are a common sign of low blood glucose levels.
   • Neonatal Abstinence Syndrome: Jitteriness can occur due to withdrawal symptoms in newborns exposed to opioids.
2. Poor Sucking Reflex
   • Hypoglycemia: Newborns with low blood glucose levels may have difficulty feeding and a poor sucking reflex.
   • Neonatal Abstinence Syndrome: Poor feeding and sucking reflex can be part of withdrawal symptoms in newborns.
3. Excessive Sweating
   • Hypoglycemia: Excessive sweating can be a symptom of low blood glucose levels.
   • Neonatal Abstinence Syndrome: Sweating is one of the possible signs of withdrawal in newborns.
4. Irritability
   • Hypoglycemia: Irritability can result from low blood glucose levels.
   • Neonatal Abstinence Syndrome: Irritability is a common symptom of withdrawal in newborns exposed to opioids.
5. Weak Cry
   • Hypoglycemia: A weak cry can be a symptom of low blood glucose levels.
   • Neonatal Abstinence Syndrome: Weak cry can also be part of withdrawal symptoms in newborns.
6. Mild Tremors
   • Hypoglycemia: Tremors or shaking can be a sign of low blood glucose levels.
   • Neonatal Abstinence Syndrome: Tremors are common withdrawal symptoms in newborns exposed to opioids.
7. Low Blood Glucose Level
   • Hypoglycemia: A blood glucose level of 40 mg/dL is considered low and indicates hypoglycemia.
   • Neonatal Abstinence Syndrome: Low blood glucose level is not a direct indicator of NAS but may occur due to poor feeding.
8. Positive Urine Toxicology
   • Hypoglycemia: Not relevant.
   • Neonatal Abstinence Syndrome: Positive urine toxicology for opioids indicates in utero exposure to opioids, which can lead to NAS.

Choice A rationale

Decreased fetal heart rate can occur due to uteroplacental insufficiency but is not specific to hypertonic contractions.

Choice B rationale

The uterus may not relax between contractions, leading to a lack of rest periods for the fetus and compromised blood flow.

Choice C rationale

Easily indentable contractions are characteristic of hypotonic contractions, not hypertonic ones.

Choice D rationale

Weak and ineffective contractions indicate hypotonic labor, contrasting the excessive strength of hypertonic contractions.

NGN QUESTIONS