The nurse manager on the high-risk OB unit has been told by an OB ...

[wrbasek0]

The nurse manager on the high-risk OB unit has been told by an OB office nurse to prepare for a woman with a spinal cord injury (SCI) to deliver there. The woman wants to try a vaginal birth. What response by the nurse manager is best?
 
  A.
  Assess the level of the woman's spinal cord injury.
  B.
  Assure the office nurse that vaginal birth is possible.
  C.
  Explain that women with SCI do well with a water birth.
  D.
  Tell the office nurse that vaginal birth is impossible.

Question 2

A pregnant woman calls the OB clinic nurse to complain of sharp abdominal pain with coughing or sneezing. What action by the nurse is best?
 
  A.
  Explain that the pain is from stretching of the ligaments.
  B.
  Have the woman count her contractions each hour while awake.
  C.
  Place the woman on bedrest until her next clinic visit.
  D.
  Tell the woman to come to the clinic today.

[firehawk60]

Answer to Question 1

ANS: A
Women with SCI above the level of T6 may be able to deliver vaginally because the uterus may retain enough intrinsic motility to create effective contractions. The nurse manager should ask about the level of the SCI. The nurse should not assure the office nurse that vaginal delivery is possible without this information. A woman with an SCI probably would not do well in a water birth due to impaired mobility. The nurse should also not tell the office nurse that vaginal birth is impossible without further information.

Answer to Question 2

ANS: A
The uterus is supported by several ligaments. The round ligaments expand in diameter and length during pregnancy and may be associated with sharp pain if they are stretched tight during sudden movement, such as with sneezing, coughing, or position changes. The nurse should reassure the woman that this is not concerning and explain the phenomenon. There is no need for the woman to count contractions, be placed on bedrest, or come in to the clinic that day.

[wrbasek0]

Excellent

[elyse44]

TYSM