The health care provider has asked the nurse to prepare for an ...

[mynx]

The health care provider has asked the nurse to prepare for an amniotomy. What is the nurse's priority action with this procedure?
 
  a. Perform Leopold's maneuvers.
  b. Determine the color of the amniotic fluid.
  c. Assess the fetal heart rate immediately after the procedure.
  d. Prepare the patient for a change in her pain level after the procedure.

Question 2

The gynecologist performs an amniotomy. What will the nurse's role include immediately following the procedure?
 
  a. Assessing for ballottement
  b. Conducting a pH and/or fern test
  c. Labeling of specimens for chromosomal analysis
  d. Recording the character and amount of amniotic fluid

[joshraies]

Answer to Question 1

ANS: C
An amniotomy is the artificial rupture of the membranes performed with an AmniHook inserted through the cervix. The FHR is assessed for at least 1 minute when the membranes rupture. The umbilical cord could be displaced in a large fluid gush, resulting in compression and interruption of blood flow through the cord. Leopold's maneuvers should be performed before the amniotomy, which will give an indication of fetal position and station. Color of the fluid can indicate fetal status; however, circulatory assessment is the priority. If the patient is in active labor, a decrease in the amount of amniotic fluid will result in increased intensity of contractions. There is no information in the stem to indicate that the patient is in labor.

Answer to Question 2

ANS: D
An amniotomy is a procedure in which the amniotic sac is deliberately ruptured. It is important to note and record the character and amount of amniotic fluid following this procedure. Assessing for ballottement is not indicated. Conducting a pH or fern test is not needed because an amniotomy releases amniotic fluid. An amniocentesis, not an amniotomy, is used to collect a specimen for chromosomal analysis.

[mynx]

TYSM

[ktidd]

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