A patient in labor has reached 8 cm dilation, but the fetal heart ...

[segrsyd]

A patient in labor has reached 8 cm dilation, but the fetal heart rate suddenly slows. Perineal inspection reveals a prolapsed fetal cord. What should the nurse do first?
 
  A) Turn the patient onto the left side.
  B) Replace the cord with gentle pressure.
  C) Place the patient in a kneechest position.
  D) Cover the exposed cord with a dry, sterile wrap.

Question 2

A new mother who is breast-feeding her newborn asks the nurse, How will I know if my baby is drinking enough? Which response by the nurse would be most appropriate?
 
  A) If he seems content after feeding, that should be a sign..
  B) Make sure he drinks at least 5 minutes on each breast..
  C) He should wet between 6 to 12 diapers each day..
  D) If his lips are moist, then he's okay..

[FergA]

Answer to Question 1

C
Feedback:
Prolapsed cord is always an emergency situation because the pressure of the fetal head against the cord at the pelvic brim leads to cord compression and decreased oxygenation to the fetus. Pressure on the cord must be relieved, which is done by placing the patient in a kneechest or Trendelenburg position to cause the fetal head to fall back from the cord. Turning the patient onto the left side will not relieve pressure on the fetal cord. Any amount of prolapsed cord should not be reinserted into the patient. Exposed cord should be covered with sterile saline compresses to prevent drying.

Answer to Question 2

C
Feedback:
Soaking 6 to 12 diapers a day indicates adequate hydration. Contentedness after feeding is not an indicator for adequate hydration. Typically a newborn wakes up 8 to 12 times per day for feeding. As the infant gets older, the time on the breast increases. Moist mucous membranes help to suggest adequate hydration but this is not the best indicator.