A nurse is assisting with an artificial rupture of membranes (AROM) for a client who is in active labor.
The nurse should report which of the following findings to the provider immediately?
Clear amniotic fluid
Fetal heart rate of 140 bpm
Cervical dilation of 6 cm
Recession of the fetal head.
The Correct Answer is D
This is a sign of umbilical cord prolapse, which is a medical emergency that requires immediate delivery of the baby. The umbilical cord can become compressed and cut off oxygen and blood supply to the baby.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A prolonged deceleration of the fetal heart rate to 90/min indicates acute fetal hypoxia/acidosis, which is a decrease in the blood flow to the placenta that reduces the amount of oxygen and nutrients transferred to the fetus.Fetal pH drops at a rate of 0.01/min during the deceleration.Causes of acute hypoxia include low maternal blood pressure, dehydration, anemia, rapid uterine contractions, placental abruption, and fetal hypoxia.
Correct Answer is B
Explanation
The client with any prior history of uterine surgery is at increased risk for a uterine rupture.A falling blood pressure and increasing pulse is a sign of hemorrhage, and in this client a uterine rupture needs to be a first consideration.
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