Signs and symptoms
Signs and symptoms ( 5 Questions)
A nurse is performing a vaginal examination on a client who is in labor and has a prolapsed umbilical cord.
Which of the following actions should the nurse take to relieve cord compression?
This action can relieve cord compression and improve fetal oxygenation until an emergency cesarean section can be performed.
Pulling the cord gently to reduce tension can cause more damage to the umbilical vessels and increase the risk of fetal hemorrhage.
Clamping the cord with sterile forceps can cut off the blood supply to the fetus and cause fetal death.
Cutting the cord and tying it with sterile string can also cut off the blood supply to the fetus and cause fetal death
The correct answer is choice A. Push the presenting part upward with gloved fingers. This action can relieve cord compression and improve fetal oxygenation until an emergency cesarean section can be performed.
Choice B is wrong because pulling the cord gently to reduce tension can cause more damage to the umbilical vessels and increase the risk of fetal hemorrhage.
Choice C is wrong because clamping the cord with sterile forceps can cut off the blood supply to the fetus and cause fetal death.
Choice D is wrong because cutting the cord and tying it with sterile string can also cut off the blood supply to the fetus and cause fetal death.
Some additional information:
• A prolapsed umbilical cord is a rare but life-threatening obstetric emergency that occurs when the umbilical cord is abnormally positioned between the fetal presenting part and the cervix.
• The normal range of umbilical cord length is 40 to 60 cm. A longer cord can increase the risk of prolapse.
• The normal range of fetal heart rate is 110 to 160 beats per minute. A prolapsed cord can cause fetal bradycardia (slow heart rate) due to hypoxia.