Which of the following is a key difference between Hodgkin's lymphoma (HL) and Non-Hodgkin's lymphoma (NHL) in children?

A. Administering oxygen via a nonrebreather mask is incorrect as the priority action. Although oxygen can improve fetal oxygenation, it does not directly relieve compression of the umbilical cord, which is the immediate, life-threatening issue in a prolapsed cord. Oxygen may be used after cord compression is relieved, but it is not the first intervention.

B. Placing a rolled towel beneath one of the client’s hips is incorrect because this action alone is insufficient to relieve pressure on the umbilical cord. While positioning such as Trendelenburg or knee-chest may help reduce cord compression, the most immediate and effective intervention is manual elevation of the presenting part.

C. Applying internal upward pressure to the presenting part using two gloved fingers is correct because this action immediately relieves pressure on the prolapsed umbilical cord, restoring fetal blood flow and oxygenation. The nurse must maintain this pressure continuously until the patient is taken for emergency delivery, usually by cesarean section. This is the highest priority life-saving intervention.

D. Increasing the IV infusion rate to provide a fluid bolus is incorrect because fluids do not address the mechanical compression of the umbilical cord. Although IV fluids may be part of overall management, they do not correct the acute cause of fetal hypoxia in cord prolapse.

A. Administering a high-protein diet is incorrect because oral or enteral feeding is not the immediate priority after birth in an infant with myelomeningocele. The initial focus is on protecting the exposed neural tissue and preventing infection, not nutritional supplementation.

B. Covering the sac with a sterile, moist dressing and positioning the infant prone is correct because a myelomeningocele involves exposed spinal cord and meninges, placing the infant at high risk for infection and trauma. A sterile, nonadherent, moist dressing (often saline-soaked) prevents drying and rupture of the sac, while the prone position minimizes pressure on the defect until surgical repair can be performed.

C. Placing the infant in a supine position is incorrect because this position increases pressure on the spinal defect, raising the risk of rupture and infection. While monitoring vital signs is important, positioning must prioritize protection of the lesion.

D. Beginning oral feeding immediately is incorrect because feeding is not the immediate concern and may be delayed until the infant is stabilized and evaluated. Additionally, the risk of aspiration and the need for surgical intervention take precedence.