A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching?
Any vaginal discharge should be immediately reported to her health care provider.
The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported.
The client will be scheduled for a cesarean birth.
The client will need to arrange for care at home because her activity level will be restricted.
The Correct Answer is B
The information that the nurse should emphasize in the discharge teaching for a pregnant woman who has undergone a cervical cerclage due to an incompetent cervix is that the presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported to her healthcare provider immediately. This is because these symptoms could indicate cervical dilation or premature labor, which can lead to pregnancy loss or other complications.
Reporting any vaginal discharge is important, but it is not the most critical symptom to monitor for after cervical cerclage placement. Vaginal discharge is common after cervical cerclage and can occur for several weeks without posing a significant risk to the pregnancy.
A cesarean birth may or may not be necessary depending on the patient's individual circumstances and the course of the pregnancy. It is not a given that all women with cervical cerclage require a cesarean delivery.
While some activity restrictions may be necessary after cervical cerclage placement, it is not necessary for the patient to arrange for care at home. Many women are able to manage their daily activities with appropriate precautions and guidance from their healthcare provider.
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Related Questions
Correct Answer is B
Explanation
Placenta previa is a condition where the placenta implants low in the uterus, covering part or all of the cervix. This can cause bleeding and can be dangerous for both the mother and the baby. In cases of placenta previa, a cesarean delivery is necessary to avoid complications. Therefore, it is not safe for the patient to deliver vaginally.
Betamethasone is indicated in delivery anticipated before 34 weeks gestation. Vaginal exams may cause more bleeding in the event of placenta previa.
Correct Answer is A
Explanation
In the case of a prolapsed umbilical cord, the first priority intervention is to relieve pressure on the cord. Placing the woman in the knee-chest position or Trendelenburg position with the hips elevated is the best way to achieve this. This position helps to reduce the compression of the cord and improve fetal oxygenation.
Option B is incorrect because while oxygen may be necessary, relieving pressure on the cord is the priority.
Option C is incorrect because a vaginal birth should not proceed with a prolapsed umbilical cord, as it can cause cord compression and fetal distress.
Option D is incorrect because covering the cord in sterile gauze soaked in saline is not a priority intervention and may not be effective in relieving pressure on the cord.
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