Which of these clients is at greatest risk for umbilical cord prolapse?
A client who is pregnant with twins
A client who has gestational hypertension
A client who has oligohydramnios
A client who has placenta previa.
The Correct Answer is C
The correct answer is choice C. A client who has oligohydramnios.
Oligohydramnios is a condition where there is too little amniotic fluid around the fetus. This can cause the umbilical cord to slip down into the cervix or vagina before the baby, resulting in cord prolapse.
Cord prolapse can cut off the blood and oxygen supply to the baby and cause fetal distress or death.
Choice A is wrong because a client who is pregnant with twins is not at greater risk for cord prolapse unless there is also malpresentation of the fetuses, such as breech or transverse lie.
Choice B is wrong because a client who has gestational hypertension is not at greater risk for cord prolapse unless there is also polyhydramnios, which is excessive amniotic fluid around the fetus.
Choice D is wrong because a client who has placenta previa is not at greater risk for cord prolapse unless there is also artificial rupture of membranes by doctors.
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Correct Answer is D
Explanation
The correct answer is choice D. A patient who is 34 weeks pregnant with a breech presentation and ruptured membranes.This is because breech presentation and ruptured membranes are both risk factors for umbilical cord prolapse, which is where the umbilical cord descends through the cervix and is alongside or below the presenting part of the fetus.This can cause fetal hypoxia and distress.
Choice A is wrong because a cephalic presentation and intact membranes are not risk factors for umbilical cord prolapse.
Choice B is wrong because although twins and ruptured membranes are risk factors for umbilical cord prolapse, the risk is lower than in choice D. Choice C is wrong because although a transverse lie is a risk factor for umbilical cord prolapse, the risk is lower than in choice D if the membranes are intact.
Correct Answer is C
Explanation
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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