The first action that should be taken when the umbilical cord ...

[sammy]

The first action that should be taken when the umbilical cord prolapses is to:
 
  a. Administer oxygen by face mask at 8 to 10 L/minute.
  b. Have the woman get on her hands and knees.
  c. Prepare for a rapid vaginal delivery or cesarean.
  d. Position the woman so that her hips are higher than her head.

Question 2

A woman admitted through the emergency department delivered only 30 minutes after arriving at the hospital. She stated that her contractions had begun about 2 hours earlier and rapidly became more frequent and intense.
 
  Which statement best defines this brief labor?
  a. Because this was a precipitate labor, it could have resulted in fetal hypoxia or intracranial hemorrhage and maternal trauma.
  b. This was probably a postterm labor, which typically progresses very rapidly with little fetal or maternal risk.
  c. Hydramnios is a common cause of very rapid labor as a result of overdistention of the uterus.
  d. Women who have had previous cesarean births are at risk of uterine rupture following rapid labor.

[kaylee05]

Answer to Question 1

ANS: D
When the cord prolapses, the fetus is deprived of oxygen. Positioning the woman in a knee-chest or Trendelenburg position, or side-lying with hips elevated, is intended to shift the fetus off of the cord, which relieves some pressure and restores circulation to the fetus. Oxygen may then be administered, and preparations for a rapid vaginal delivery or cesarean birth may be done.

Answer to Question 2

ANS: A
A completed labor of less than 3 hours is called a precipitate labor, and it can cause harm to the fetus and the mother. Postterm labor is usually dysfunctional and may require forceps-assisted or cesarean delivery with a risk of vaginal lacerations. Hydramnios tends to cause decreased uterine tone, which can cause dysfunctional labor and postpartum hemorrhage. Prolonged labor or aggressive induction can result in uterine rupture, especially in women who have had past cesarean births.