A nurse is performing a vaginal examination on a client who is in labor and has a prolapsed umbilical cord.
Which of the following actions should the nurse take to relieve cord compression?
Push the presenting part upward with gloved fingers
Pull the cord gently to reduce tension
Clamp the cord with sterile forceps
Cut the cord and tie it with sterile string
The Correct Answer is A
The correct answer is choice A. Push the presenting part upward with gloved fingers. This action can relieve cord compression and improve fetal oxygenation until an emergency cesarean section can be performed.
Choice B is wrong because pulling the cord gently to reduce tension can cause more damage to the umbilical vessels and increase the risk of fetal hemorrhage.
Choice C is wrong because clamping the cord with sterile forceps can cut off the blood supply to the fetus and cause fetal death.
Choice D is wrong because cutting the cord and tying it with sterile string can also cut off the blood supply to the fetus and cause fetal death.
Some additional information:
• A prolapsed umbilical cord is a rare but life-threatening obstetric emergency that occurs when the umbilical cord is abnormally positioned between the fetal presenting part and the cervix.
• The normal range of umbilical cord length is 40 to 60 cm. A longer cord can increase the risk of prolapse.
• The normal range of fetal heart rate is 110 to 160 beats per minute. A prolapsed cord can cause fetal bradycardia (slow heart rate) due to hypoxia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. FHR of 80/min with severe variable decelerations.This indicates that the umbilical cord is prolapsed and compressed by the baby’s body, causing a decrease in blood and oxygen supply to the baby.A normal fetal heart rate is between 120 and 160 beats per minute.Severe variable decelerations are abrupt drops in the fetal heart rate that do not correspond to contractions.
Choice A is wrong because FHR of 160/min with accelerations is a normal finding that indicates a healthy baby.Accelerations are temporary increases in the fetal heart rate that usually occur with fetal movement or contractions.
Choice B is wrong because FHR of 120/min with early decelerations is also a normal finding that indicates a well-oxygenated baby.Early decelerations are gradual decreases in the fetal heart rate that mirror contractions and are caused by head compression.
Choice D is wrong because FHR of 140/min with late decelerations is an abnormal finding that indicates uteroplacental insufficiency, not cord prolapse.Late decelerations are gradual decreases in the fetal heart rate that occur after contractions and are caused by reduced blood flow to the placenta.
Correct Answer is B
Explanation
Terbutaline is a medication that can relax the uterine muscles and reduce contractions.This can help relieve pressure on the prolapsed umbilical cord and restore blood flow to the baby while preparing for an emergency cesarean delivery.
Choice A is wrong because magnesium sulfate is used to prevent seizures in women with preeclampsia or eclampsia, not to treat umbilical cord prolapse.
Choice C is wrong because oxytocin is used to induce or augment labor, not to stop it.Oxytocin can increase contractions and worsen cord compression.
Choice D is wrong because methylergonovine is used to prevent or treat postpartum hemorrhage, not to treat umbilical cord prolapse.Methylergonovine can also increase contractions and worsen cord compression.
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