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Administering oxygen via face mask is a supportive measure for potential fetal hypoxia, but it is secondary to relieving cord compression. While oxygen can improve maternal oxygen saturation and fetal oxygenation, it will not resolve the underlying issue of cord compression. Addressing the mechanical compression of the cord must be the immediate priority to restore adequate blood flow.

Applying an external fetal monitor is important for assessing fetal well-being after a cord prolapse. However, it is not the first action. The immediate priority is to relieve pressure on the cord to prevent further fetal compromise. Fetal monitoring provides diagnostic information but does not directly intervene to alleviate the life-threatening compression.

Loosely wrapping the cord with a saline-saturated towel is an important step to prevent drying and maintain viability of the exposed cord, but it is not the immediate priority. The primary goal is to relieve pressure on the cord to ensure blood flow to the fetus. Protecting the cord from drying is a subsequent action after addressing the compression.

While breastfeeding can delay the return of ovulation, it is not a reliable method of contraception on its own, especially as the frequency of feedings decreases or if supplements are introduced. Lactational amenorrhea is only highly effective under strict conditions, and relying solely on it for birth control carries a significant risk of unintended pregnancy.

Birth control pills are not absolutely contraindicated for breastfeeding clients. Certain types, specifically progestin-only pills, are safe and recommended. Estrogen-containing pills are generally avoided due to their potential to reduce milk supply. Therefore, stating all birth control pills are contraindicated is an inaccurate and overly broad statement.

There is no scientific evidence to suggest that taking birth control pills while breastfeeding increases the risk for breast cancer. The impact of hormonal contraception on breast cancer risk is complex and generally linked to combined oral contraceptives, with no clear association for progestin-only pills. This statement is a misinformation that can cause undue alarm.

Inserting the suppository 5 cm (2 inches) is not deep enough for optimal absorption and retention of the medication. Vaginal suppositories should be inserted as far as possible into the vagina, typically reaching the posterior fornix, to ensure maximum therapeutic effect and prevent expulsion. Inadequate insertion depth can reduce drug efficacy.

Applying petroleum jelly to the suppository is contraindicated because petroleum-based products can degrade the suppository's active ingredients or alter its dissolution properties. Water-based lubricants are appropriate if lubrication is needed to facilitate insertion, but petroleum jelly should be avoided to ensure the medication's integrity and effectiveness.

Assisting the client into a prone position is incorrect for vaginal suppository insertion. The dorsal recumbent position with knees flexed, or a side-lying position, allows for optimal access to the vaginal canal and facilitates comfortable and effective suppository placement, promoting proper drug distribution and retention within the vaginal vault.

Administering aspirin is generally contraindicated in the immediate postpartum period, especially if there is any risk of bleeding or if the client is breastfeeding. Aspirin can inhibit platelet aggregation, increasing the risk of postpartum hemorrhage. Safer analgesics, such as NSAIDs like ibuprofen, or acetaminophen, are preferred for pain relief.

Having the client use a warm pack is generally not recommended for immediate episiotomy discomfort. While warmth can be soothing, a warm pack can increase blood flow to the area, potentially increasing swelling and discomfort or exacerbating any bleeding in the immediate postpartum period. Cold applications are typically preferred initially.

Instructing the client to sit on a soft pillow may provide some comfort by distributing pressure, but it does not directly address the underlying pain and inflammation from the episiotomy. While it can be a supportive measure, it is not as therapeutically effective as direct interventions like cold packs, witch hazel, or appropriate analgesia. .

Maternal serum alpha-fetoprotein (MSAFP) screening is a blood test typically performed between 15 and 20 weeks of gestation, with optimal timing around 16 to 18 weeks. It is used to screen for potential chromosomal abnormalities and neural tube defects. Performing this screening at 6 weeks of gestation would be too early, as the levels of alpha-fetoprotein would not be sufficiently elevated or stable enough to provide accurate and reliable diagnostic or screening information for fetal anomalies.

Screening for gestational diabetes mellitus (GDM) is generally performed between 24 and 28 weeks of gestation using an oral glucose tolerance test (OGTT). This period allows for the detection of glucose intolerance that develops during pregnancy, often due to increasing insulin resistance caused by placental hormones. Screening at 12 weeks of gestation would be too early, as the physiological changes leading to GDM typically manifest later in pregnancy.

While regular urine specimens are important throughout pregnancy to screen for conditions like urinary tract infections (UTIs), pre-eclampsia, and gestational diabetes, the frequency of "every 2 months" for a clean-catch urine specimen is not a standard routine. Typically, a urine specimen is collected at each prenatal visit, which is often more frequent than every 2 months, especially as pregnancy progresses. This allows for ongoing monitoring of various parameters.

Fever is an elevated body temperature and is not a direct adverse effect typically associated with nalbuphine hydrochloride. Fever is more commonly indicative of an infectious process, inflammatory response, or certain drug reactions (e.g., drug fever), but it is not a direct pharmacological action or common side effect of opioid analgesics like nalbuphine. Opioids generally do not affect thermoregulation in a way that causes a fever.

Diarrhea is characterized by loose, watery stools and is not a common adverse effect of nalbuphine hydrochloride. Opioids, in general, are more known for causing constipation due to their effects on decreasing gastrointestinal motility and increasing fluid absorption in the intestines, by acting on opioid receptors in the enteric nervous system. Therefore, diarrhea would be an atypical and unexpected response to nalbuphine.

Diuresis refers to increased urine production and is not a typical adverse effect of nalbuphine hydrochloride. Opioids can sometimes affect antidiuretic hormone (ADH) secretion, potentially leading to fluid retention or oliguria rather than diuresis. Diuresis is usually associated with diuretic medications or certain physiological conditions that promote increased urine output, which is contrary to the expected effects of opioids on renal function.

Phenylketonuria (PKU) is an inherited metabolic disorder characterized by the inability to metabolize the amino acid phenylalanine. This condition is diagnosed through newborn screening tests that measure phenylalanine levels in the blood, not by maternal serum alpha-fetoprotein screening. MSAFP is not a marker for metabolic disorders like PKU, as it is primarily indicative of fetal structural anomalies, particularly neural tube defects.

Trisomy 21, also known as Down syndrome, is a chromosomal disorder caused by the presence of an extra copy of chromosome 21. While MSAFP is part of the "triple screen" or "quad screen" used for aneuploidy screening, an elevated MSAFP level alone is typically associated with neural tube defects. In cases of Trisomy 21, MSAFP levels are usually *lower* than normal, in conjunction with altered levels of other markers like human chorionic gonadotropin (hCG) and unconjugated estriol.

Hemophilia is a genetic bleeding disorder caused by a deficiency in specific clotting factors, primarily factors VIII or IX. This condition is inherited in an X-linked recessive pattern and is diagnosed through specialized blood tests that measure clotting factor activity. Maternal serum alpha-fetoprotein screening is not used to detect hemophilia, as it is a marker for fetal structural integrity, particularly concerning neural tube and abdominal wall defects.

Wearing the lap belt high across the abdomen is incorrect and potentially dangerous. The lap belt should be positioned low, across the pelvic bones (hips) and under the pregnant abdomen. This ensures that the force of a collision is distributed across the strong pelvic bones, minimizing direct pressure on the uterus and fetus, thereby reducing the risk of placental abruption or direct fetal trauma.

Disabling the vehicle's driver-side airbags is strongly discouraged and unsafe. Airbags are designed to provide crucial protection in a collision by deploying rapidly to cushion the occupant. While pregnant individuals should maintain a safe distance from the steering wheel to mitigate airbag impact on the uterus, disabling the airbag removes a vital safety feature and significantly increases the risk of severe injury to both the mother and the fetus in an accident.

Placing the shoulder harness across the gravid uterus is incorrect. The shoulder harness should be positioned snugly between the breasts and across the collarbone. It should never be placed directly over the abdomen or the uterus. Proper placement ensures that the upper body is restrained effectively, preventing forward motion and distributing impact forces across the chest and shoulder, thus protecting the gravid uterus from direct trauma.

A blood pressure (BP) of 105/62 mm Hg, while slightly on the lower side of what might be considered a typical adult range (e.g., 120/80 mm Hg), is often within acceptable limits for a postoperative adolescent, especially considering potential mild vasodilation from opioid use. A normal range for adolescent blood pressure can vary, but generally, hypotension is defined as a systolic BP less than 90 mm Hg or symptomatic drop. This finding, while noted, is not immediately life-threatening compared to compromised respiratory function.

Urinary retention is a common adverse effect of opioid analgesics due to their anticholinergic-like effects on bladder detrusor muscle contractility and increased sphincter tone. While uncomfortable and requiring intervention (e.g., straight catheterization), it is not an immediate life-threatening concern compared to respiratory depression. A normal bladder capacity is approximately 300-500 mL, and the urge to void typically occurs at 150-200 mL. Persistent urinary retention can lead to bladder distention, pain, and increased risk of urinary tract infection, but it doesn't pose the same acute physiological threat as respiratory depression.

Blurred vision can be an adverse effect of opioid medications, often related to miosis (pupil constriction) or effects on accommodation. While it can impair the patient's comfort and ability to ambulate safely, it is not a life-threatening priority in the immediate postoperative period compared to respiratory compromise. This visual disturbance typically resolves as the medication is metabolized and excreted. Normal visual acuity is typically 20/20. .