A woman who is 34 weeks pregnant is informed by the nurse that a danger sign of pregnancy and fetal well being could be
Select one:
Constipation for 2 days.
Absent of fetal movement in one full day
Edema at the end of the day, resolving during the night.
Anxiety during the night
The Correct Answer is B
a. This is not typically considered a danger sign of pregnancy.
b. This is a potential danger sign of pregnancy and should be reported to the healthcare provider.
c. This is not typically considered a danger sign of pregnancy.
d. This is not typically considered a danger sign of pregnancy.
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Correct Answer is D
Explanation
a. This is not the correct action for this situation.
b. This is not the correct action for this situation.
c. This is not the correct action for this situation.
d. The patient is experiencing uterine tachysystole, which is defined as more than five contractions in 10 minutes, lasting longer than 90 seconds, or with less than 30 seconds of interval between contractions. This can cause fetal hypoxia and distress, as evidenced by late decelerations in the fetal heart rate tracing. The nurse should stop the oxytocin, increase the IV fluid rate, position the patient on her left side, administer oxygen, and notify the provider.
Correct Answer is C
Explanation
a. The client should also be placed in Trendelenburg or knee-chest position to reduce cord compression.
b. This is not the first action to take when the umbilical cord is prolapsed.
c. This is a medical emergency that requires immediate intervention to prevent fetal hypoxia and death. The nurse should insert a gloved hand into the vagina and apply upward pressure on the presenting part to lift it off the cord until delivery.
d. This may be necessary if the cord compression cannot be relieved, but the first priority is to relieve the cord compression.
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