Author Question: When caring for a laboring patient, the nurse notes the onset of sudden vaginal bleeding at the ... (Read 71 times)

NguyenJ · **on:** Jun 28, 2018

When caring for a laboring patient, the nurse notes the onset of sudden vaginal bleeding at the beginning of cervical dilation. The patient denies any pain. What action by the nurse is best?

A.
Document the findings in the woman's chart.
B.
Place the woman in a knee-chest position.
C.
Prepare the woman for an immediate cesarean birth.
D.
Perform a careful vaginal exam to assess for exposed umbilical cord vessels.

Question 2

A nurse assisting in a birth observes the patient suddenly fall back against the bed and become unresponsive. What action by the nurse takes priority?

A.
Assess airway, breathing, and circulation.
B.
Begin immediate cardiopulmonary resuscitation.
C.
Insert an indwelling urinary catheter.
D.
Prepare for an emergency cesarean delivery.

SamMuagrove · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: D
This woman has the classic sign of vasa previa, in which the unprotected fetal vessels cover the cervical os and precede the fetus. This condition is usually seen with a velamentous insertion of the umbilical cord. The nurse should conduct a careful vaginal exam, assessing for exposed fetal blood vessels. The patient may need an emergent cesarean delivery. This assessment should come prior to interventions such as positioning.

Answer to Question 2

ANS: A
In any emergency situation, such as an unresponsive patient, the nurse needs to assess airway, breathing, and circulation and begin providing CPR if needed. The patient may or may not need an emergency cesarean delivery. Inserting a urinary catheter is not the priority.