Review Risk factors and causes

Umbilical cord prolapse > Maternal & Newborn

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Risk factors and causes

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Total Questions : 4

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Question 1:

A nurse is reviewing the risk factors for cord prolapse with a group of nursing students.

Which of the following statements by a student indicates an understanding of the teaching?

A. “Cord prolapse is more likely to occur in clients who have a low-lying placenta.” B. “Cord prolapse is more likely to occur in clients who have a vertex presentation.” C. “Cord prolapse is more likely to occur in clients who have oligohydramnios.” D. “Cord prolapse is more likely to occur in clients who have a singleton pregnancy.”.

Answer and Explanation

Choice A:

Cord prolapse is more likely to occur in clients who have aplacenta previa, not a low-lying placenta.

Placenta previa is a condition where the placenta covers the cervix partially or completely.This can prevent the baby from descending into the pelvis and leave more space for the cord to prolapse.

Choice B:

Cord prolapse is more likely to occur in clients who have anon-vertex presentation, such as breech or transverse lie, not a vertex presentation.

A non-vertex presentation means that the baby’s head is not pointing down towards the birth canal.This can result in a smaller or irregularly shaped presenting part that does not fit snugly into the pelvis and allows the cord to slip past it.

Choice C:

Oligohydramnios is a condition where there is too little amniotic fluid around the fetus.This can cause the umbilical cord to slip down into the cervix and vagina ahead of the baby during delivery.This can cut off the blood and oxygen supply to the baby and cause fetal distress.

Choice D:

Cord prolapse is more likely to occur in clients who have amultiple pregnancy, not a singleton

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Question 2:

A nurse is assisting with the delivery of a client who has a breech presentation.

The nurse notices that the umbilical cord is protruding from the vagina.

Which of the following actions should the nurse take first?

A. Apply pressure to the presenting part with gloved fingers. B. Place the client in Trendelenburg position C. Administer oxygen via face mask at 10 L/min. D. Clamp and cut the umbilical cord

Answer and Explanation

Choice A:

This is because applying pressure can prevent further compression of the umbilical cord and reduce the risk of fetal hypoxia (lack of oxygen).The umbilical cord can be flattened or twisted during delivery, which can cause nerve or brain damage.

Choice B:

Placing the client in Trendelenburg position (head down and feet up) may not be enough to relieve the cord compression and may cause discomfort or respiratory distress for the client.

Choice C:

Administering oxygen may not improve the fetal oxygenation if the cord is severely compressed.

Oxygen administration may also delay the urgent delivery of the baby

Choice D:

Clamping and cutting the umbilical cord will cut off the fetal blood supply and oxygenation.

This can lead to fetal death or severe brain injury.

Normal ranges for umbilical cord pH are 7.18 to 7.38 for arterial blood and 7.28 to 7.45 for venous blood.

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Question 3:

A nurse is monitoring the fetal heart rate of a client who has a suspected occult cord prolapse.

Which of the following findings should the nurse expect?

A. Episodic accelerations B. Fibrillation C. Moderate tachycardia D. Severe variable decelerations

Answer and Explanation

Choice A:

Episodic accelerations are normal and indicate fetal well-being.They are not associated with cord prolapse.

Choice B:

Fibrillation is a cardiac arrhythmia that affects the atria or ventricles of the heart.It is not a term used to describe fetal heart rate patterns.

Choice C:

Moderate tachycardia is a fetal heart rate above 160 beats per minute for more than 10 minutes.

Choice D:

This is because occult cord prolapse occurs when the cord is compressed by the fetal presenting part, causing fetal hypoxemia.The fetal heart rate pattern may show severe bradycardia or severe variable decelerations, which indicate cord compression and fetal distress.

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Question 4:

A nurse is preparing to perform an amnioinfusion for a client who has oligohydramnios and a cord compression.

Which of the following are appropriate steps for this procedure? (Select all that apply.)

A. Obtain informed consent from the client B. Insert an intrauterine pressure catheter into the uterus C. Infuse warmed sterile normal saline into the amniotic cavity D. Monitor the client’s temperature every 4 hours E. Assess the fetal heart rate and uterine activity continuously

Answer and Explanation

Choice A:

Informed consent is required before performing any invasive procedure, such as amnioinfusion.

Choice B:

An intrauterine pressure catheter (IUPC) is needed to infuse fluid into the amniotic cavity and to monitor the uterine contractions.

Choice C:

Warmed sterile normal saline is the fluid of choice for amnioinfusion, as it mimics the natural amniotic fluid and reduces the risk of infection.

Choice D:

The client’s temperature should be monitored every 15 to 30 minutes, not every 4 hours, to detect any signs of infection or chorioamnionitis.

Choice E:

The fetal heart rate and uterine activity should be assessed continuously to evaluate the fetal well-being and the effectiveness of amnioinfusion.

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Risk factors and causes

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