The nurse is concerned that a patient in the second stage of ...

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The nurse is concerned that a patient in the second stage of labor will experience a drop in blood pressure. What should the nurse do to prevent this from occurring?
 
  A) Position the patient supine.
  B) Encourage oral fluid intake.
  C) Administer intravenous fluids.
  D) Position the patient side-lying.

Question 2

During the active stage of labor, a patient's membranes spontaneously rupture. Which action should the nurse do first after this occurs?
 
  A) Turn the patient onto the left side.
  B) Assess fetal heart rate for fetal safety.
  C) Test a sample of amniotic fluid for protein.
  D) Instruct to bear down with the next contraction.

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Answer to Question 1

D
Feedback:
If a patient lies in a supine position and pushes during the second stage of labor, pressure of the uterus on the vena cava causes the blood pressure to drop, leading to hypotension. A side-lying position during the second stage of labor can help avoid such a problem. Fluids would be indicated if the patient is having epidural anesthesia.

Answer to Question 2

B
Feedback:
If membranes rupture during labor, the fetal heart rate should be assessed immediately to be certain that the umbilical cord hasn't prolapsed and is now being compressed against the cervix by the fetal head. The patient does not need to be turned onto the left side. The amniotic fluid is tested for pH and not protein. Bearing down at this time could be dangerous, considering there is no way of knowing how much the cervix has dilated at the time of membrane rupture.

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Excellent

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Gracias!