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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. "You are far enough along that your baby will be just finE." This is not a good response because it is dismissive of the client's concerns and does not provide any factual information or reassurancE. The nurse should not make false promises or minimize the client's feelings.

B. "Everyone worries about their baby while they are in labor." This is not a good response because it is generalizing and does not address the client's specific situation. The nurse should not compare the client to others or imply that their worries are normal or insignificant.

D. "We have a neonatal unit here equipped to handle emergencies." This is not a good response because it implies that there is a high risk of complications and may increase the client's anxiety. The nurse should not focus on negative outcomes or scare the client with unnecessary information.

A. Heart rate of 99 B. Respiratory rate of 9 C. BP of 99/69 D. Temperature of 99.9

Correct Answer is B

Explanation

Choice A reason: This is not the most concerning vital sign because a heart rate of 99 is within the normal range for an adult. The nurse should monitor the patient's heart rate and rhythm, but it is not a sign of magnesium toxicity or adverse effects.

Choice B reason: This is the most concerning vital sign because a respiratory rate of 9 is below the normal range for an adult and indicates respiratory depression, which is a sign of magnesium toxicity. The nurse should stop the infusion, notify the provider, and prepare to administer calcium gluconate as an antidotE.

Choice C reason: This is not the most concerning vital sign because a BP of 99/69 is within the normal range for an adult. The nurse should monitor the patient's blood pressure and fluid status, but it is not a sign of magnesium toxicity or adverse effects.

Choice D reason: This is not the most concerning vital sign because a temperature of 99.9 is within the normal range for an adult. The nurse should monitor the patient's temperature and infection signs, but it is not a sign of magnesium toxicity or adverse effects.

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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):

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is at 32 weeks of gestation and in labor. The client asks the nurse, "Will my baby be okay?" Which of the following responses should the nurse make?

Correct Answer is C

Explanation

Your patient is receiving magnesium sulfate for neuroprotection and preterm labor at 1 gram/hour. The most concerning vital sign below is:

Correct Answer is B

Explanation

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