The baby's head is delivered at 0900. The shoulders are not delivered and you notice a turtle sign. Interventions to relieve a dystocia include (Select all that apply):
Enter maneuvers (wood screw or rubin) by physician
Put mother on all fours (gaskin)
Suprapubic pressure by the nurse
McRoberts by the nurse
Delivery of the anterior arm by the physician
Fundal pressure by the nurse
Correct Answer : A,B,C,D,E
Choice A: Enter maneuvers (wood screw or rubin) by physician are interventions to relieve a dystocia, as they involve rotating the fetal shoulders to align them with the maternal pelvis and facilitate the delivery. The physician can perform these maneuvers by applying pressure on the fetal clavicles or scapulas through the vaginA.
Choice B: Put mother on all fours (gaskin) is an intervention to relieve a dystocia, as it involves changing the maternal position to widen the pelvic outlet and reduce the pressure on the fetal shoulders. The mother can assume this position by kneeling on the bed and resting on her elbows or hands.
Choice C: Suprapubic pressure by the nurse is an intervention to relieve a dystocia, as it involves applying firm and downward pressure on the mother's lower abdomen to dislodge the anterior fetal shoulder from behind the pubic symphysis and assist the delivery. The nurse can perform this intervention by using the heel of the hand or a fist.
Choice D: McRoberts by the nurse is an intervention to relieve a dystocia, as it involves flexing and abducting the mother's legs to her chest to increase the pelvic diameter and relax the pelvic floor muscles. The nurse can perform this intervention by holding the mother's legs or using stirrups.
Choice E: Delivery of the anterior arm by the physician is an intervention to relieve a dystocia, as it involves reaching into the vagina and sweeping the fetal arm across the chest and out of the birth canal to reduce the shoulder-to-shoulder diameter and assist the delivery. The physician can perform this intervention by using a finger or a forceps.
Choice F: Fundal pressure by the nurse is not an intervention to relieve a dystocia, as it involves pushing on the upper part of the uterus to expel the fetus. This intervention is contraindicated in shoulder dystocia, as it can worsen the impaction of the fetal shoulders and cause fetal injury or maternal traumA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: I am a terrible mother and should give my child up for adoption. This is a false and harmful statement that reflects low self-esteem, guilt, and hopelessness. These are common symptoms of perinatal mood and anxiety disorder, but they do not reflect the reality or the potential of the patient. The patient needs support, counseling, and possibly medication to overcome these negative thoughts.
Choice B: This is just normal baby blues and I will be fine in a few days. This is a false and minimizing statement that denies the severity and duration of perinatal mood and anxiety disorder. Baby blues are mild and transient mood changes that occur in the first two weeks after delivery. Perinatal mood and anxiety disorder is a more serious and persistent condition that can affect the mother's mental health, bonding with the baby, and daily functioninG. The patient needs to recognize the signs and symptoms of perinatal mood and anxiety disorder and seek professional help.
Choice C: I will have to be on medications the rest of my lifE. This is a false and pessimistic statement that assumes that perinatal mood and anxiety disorder is a chronic and incurable condition. Medications are one of the treatment options for perinatal mood and anxiety disorder, but they are not the only onE. Psychotherapy, peer support, lifestyle changes, and alternative therapies are also effective ways to manage perinatal mood and anxiety disorder. The patient needs to have a realistic and hopeful outlook on the recovery process and the possibility of remission.
Choice D: I am not alone, I am not to blame, I will get better with help. This is a true and empowering statement that reflects the key messages of perinatal mood and anxiety disorder education and awareness. The patient needs to know that perinatal mood and anxiety disorder is a common and treatable condition that affects many women around the worlD. The patient needs to understand that perinatal mood and anxiety disorder is not caused by personal weakness, failure, or fault. The patient needs to believe that perinatal mood and anxiety disorder can be overcome with the help of health care providers, family, friends, and support groups.
Correct Answer is D
Explanation
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