What is an occult cord prolapse?
The cord is in front of the fetal head, but not visible or palpable
The cord is hidden, often next to but not in front of the fetal head.
The cord is visible or palpable outside of the vagina
The cord is wrapped around the fetal neck or body
The Correct Answer is B
The correct answer is choice B. The cord is hidden, often next to but not in front of the fetal head. This is called an occult cord prolapse and it occurs when the umbilical cord descends alongside–but not past–the presenting part of the baby. Occult cords can occur with ruptured or intact membranes. They can cause hypoxia, brain injury, and permanent disability in a baby, so medical personnel must address them rapidly and appropriately.
Choice A is wrong because it describes an overt cord prolapse, which means that the cord slips down into your cervix and vagina ahead of your baby during delivery. This is a medical emergency that can cut off your baby’s blood and oxygen supply during delivery.
Choice C is wrong because it describes a visible cord prolapse, which is a type of overt cord prolapse where the cord is visible or palpable outside of the vagina. This is also a medical emergency that requires immediate delivery.
Choice D is wrong because it describes a nuchal cord, which means that the cord is wrapped around the fetal neck or body. This is not a prolapse, but it can cause complications such as reduced blood flow, fetal distress, or umbilical cord strangulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. A loop of umbilical cord protruding from her vagina.This is a sign of umbilical cord prolapse, which is a medical emergency that occurs when the cord slips past the fetal presenting part and becomes compressed, reducing blood flow and oxygen to the fetus.The nurse should immediately call for help, place the woman in a knee-chest or Trendelenburg position, insert two fingers into the vagina and lift the presenting part off the cord, cover the cord with sterile saline-soaked gauze, administer oxygen, and prepare for an emergency cesarean delivery.
Choice A is wrong because a sudden increase in fetal heart rate variability is not a specific sign of cord prolapse.It may indicate fetal well-being or distress depending on the pattern and duration of the variability.
Choice B is wrong because a large amount of clear amniotic fluid is not a sign of cord prolapse.It may indicate rupture of membranes, which is a risk factor for cord prolapse if the presenting part is not engaged.
Choice C is wrong because a change in fetal heart rate from 140 to 90 bpm is not a sign of cord prolapse.It may indicate fetal bradycardia, which can have many causes such as hypoxia, acidosis, medication effects, or fetal sleep cycle.
Correct Answer is A
Explanation
The correct answer is choice A. Uterine atony.
Uterine atony is the failure of the uterus to contract and retract after delivery, which can lead to excessive bleeding and hemorrhage.A boggy uterus on palpation is a sign of uterine atony.
Choice B. Uterine inversion is wrong because it is a rare complication in which the uterus turns inside out and protrudes through the cervix.It usually causes severe pain, shock, and hemorrhage.
Choice C. Uterine rupture is wrong because it is a life-threatening emergency in which the uterus tears open along the scar line of a previous cesarean delivery or other uterine surgery.It usually causes severe abdominal pain, fetal distress, and maternal hypovolemic shock.
Choice D. Uterine infection is wrong because it is an inflammation of the endometrium (the lining of the uterus) caused by bacteria.It usually causes fever, foul-smelling lochia, and lower abdominal tenderness.
Normal ranges for postpartum bleeding are about 500 ml for vaginal delivery and 1000 ml for cesarean delivery.The uterus should feel firm and midline at or below the umbilicus after delivery.
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