A nurse is caring for a client who is in the active phase of labor. The nurse palpates the umbilical cord during a vaginal examination. Which of the following actions should the nurse take?
Decrease the rate of the IV infusion.
Place the client in a knee-chest position.
Instruct the client to push with the next contraction.
Replace the umbilical cord into the cervix
The Correct Answer is B
A. Decreasing IV infusion rate does not relieve umbilical cord prolapse.
B. Placing the client in a knee-chest position helps relieve pressure on the prolapsed umbilical cord, improving fetal oxygenation until delivery.
C. Instructing the client to push can worsen cord compression and is contraindicated.
D. The nurse should not attempt to replace the umbilical cord into the cervix; this is a sterile procedure typically performed by the provider.
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Related Questions
Correct Answer is D
Explanation
A. Fentanyl citrate is a potent opioid, typically reserved for severe pain and usually administered in controlled settings, not first-line postpartum analgesia.
B. Meperidine is less commonly used due to side effects and safety concerns.
C. Aspirin is generally avoided postpartum due to bleeding risks.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used postpartum for pain relief and inflammation control with a safer profile for breastfeeding mothers.
Correct Answer is A
Explanation
A. A jittery newborn at 4 hours old may be experiencing hypoglycemia, which is a potentially serious condition requiring immediate assessment and intervention.
B. Universal newborn screening is important but can be delayed until the newborn is more stable.
C. The New Ballard Score is an assessment of gestational age and can be done after stabilization.
D. Checking temperature prior to the first bath is important but less urgent than evaluating possible hypoglycemia.
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