Which of the following statements by a patient indicates understanding of how to prevent umbilical cord prolapse?
“I will avoid squatting or sitting on the toilet after my water breaks.”
“I will drink plenty of fluids to keep my amniotic fluid level normal.”
“I will monitor my baby’s movements and report any decrease.”
“I will sleep on my left side to improve blood flow to my baby.”.
The Correct Answer is A
The correct answer is choice A. “I will avoid squatting or sitting on the toilet after my water breaks.” This statement indicates that the patient understands how to prevent umbilical cord prolapse, which is a rare but serious complication that occurs when the umbilical cord slips out of the cervix before the baby during labor. This can cut off the baby’s blood and oxygen supply and require immediate delivery.
Choice B is wrong because drinking plenty of fluids does not affect the amniotic fluid level, which is determined by the placenta and the baby’s kidneys. Excessive amniotic fluid (polyhydramnios) can actually increase the risk of umbilical cord prolapse.
Choice C is wrong because monitoring the baby’s movements does not prevent umbilical cord prolapse, although it can help detect fetal distress if the cord is compressed. Decreased fetal movements can have other causes besides cord prolapse, such as fetal sleep cycle, maternal medication, or placental insufficiency.
Choice D is wrong because sleeping on the left side does not prevent umbilical cord prolapse, although it can improve blood flow to the baby and reduce the risk of supine hypotension syndrome. Umbilical cord prolapse can occur regardless of the maternal position.
Normal ranges for amniotic fluid index (AFI) are 5 to 25 cm. Normal ranges for fetal heart rate (FHR) are 110 to 160 beats per minute (bpm).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
The correct answer is choice A and B. The nurse should place the patient in knee-chest or Trendelenburg position to relieve the pressure of the fetal presenting part on the prolapsed cord and improve fetal oxygenation.These positions also allow gravity to help keep the cord in the uterus and prevent further descent.
Choice C is wrong because supine position can worsen cord compression and compromise fetal blood flow.Choice D is wrong because lithotomy position can also increase cord descent and reduce fetal perfusion.Choice E is wrong because Sims position can cause cord prolapse if the membranes are intact or rupture spontaneously.
Normal ranges for fetal heart rate are 110 to 160 beats per minute.Cord prolapse can cause fetal bradycardia with decelerations during contractions due to cord compression.
This is a sign of fetal distress and requires immediate intervention.
Correct Answer is C
Explanation
The correct answer is choice C. Apply pressure to presenting part with hand.
This is because cord prolapse is an emergency situation that requires immediate delivery to save the fetus.Applying pressure to the presenting part with hand can help relieve the compression of the cord and maintain fetal oxygenation until delivery.
Choice A is wrong because stopping oxytocin infusion will not prevent cord compression or fetal hypoxia.Oxytocin may be stopped after applying pressure to the presenting part and notifying the physician.
Choice B is wrong because placing the patient in knee-chest position may not be effective in relieving cord compression.
It may also be uncomfortable and difficult for the patient to maintain.A better position would be Trendelenburg or modified Sims.
Choice D is wrong because administering oxygen via non-rebreather mask is not a priority action.Oxygen may be given after applying pressure to the presenting part and notifying the physician, but it will not improve fetal oxygenation if the cord is compressed.
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