A client with polyhydramnios was admitted to a ...

[jon_i]

A client with polyhydramnios was admitted to a labor-birth-recovery-postpartum (LDRP) suite. Her membranes rupture and the fluid is clear and odorless, but the fetal heart monitor indicates bradycardia and variable decelerations.
 
  Which action should be taken next?
 
  a. Perform Leopold maneuvers.
  b. Perform a vaginal examination.
  c. Apply warm saline soaks to the vagina.
  d. Place the client in a high Fowler position.

Question 2

Which technique is least effective for the client with persistent occiput posterior position?
 
  a. Squatting
  b. Lying supine and relaxing
  c. Sitting or kneeling, leaning forward with support
  d. Rocking the pelvis back and forth while on hands and knees

[meganlapinski]

Answer to Question 1

ANS: B
A prolapsed cord may not be visible but may be palpated on vaginal examination. The priority is to relieve pressure on the umbilical cord. Leopold maneuvers are not an appropriate action at this time. Moist towels retard cooling and drying of the prolapsed cord, but it is hoped the fetus will be delivered before this occurs. The high Fowler position will increase cord compression and decrease fetal oxygenation.

Answer to Question 2

ANS: B
Lying supine increases the discomfort of back labor. Squatting aids rotation and fetal descent. A sitting or kneeling position may help the fetal head to rotate to occiput anterior. Rocking the pelvis encourages rotation from occiput posterior to occiput anterior.

[jon_i]

Excellent

[Sarahjh]

TYSM