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A patient who is at 39 weeks' gestation is scheduled for amniotomy.
The nurse is aware that which criteria must be met before the procedure?

A.

Prior amniotic fluid leakage must be validated before the procedure.

B.

The fetal head is currently engaged in the maternal pelvis.

C.

The nurse must have certification to perform the procedure.

D.

Ultrasound indicates the umbilical cord is away from the cervix.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Prior amniotic fluid leakage is not a required criterion for amniotomy. The main concern is cervical readiness and fetal head position, not previous leakage.

 

Choice B rationale

The fetal head engaged in the maternal pelvis ensures proper pressure and position for safe amniotomy. Engagement reduces the risk of umbilical cord prolapse and injury.

 

Choice C rationale

Certification of the nurse for amniotomy is not a standard criterion. The procedure is performed by qualified professionals, but certification isn't a prerequisite for the procedure to be scheduled.

 

Choice D rationale

Ultrasound to check the umbilical cord's position isn't a standard pre-amniotomy criterion. While it can be useful, the primary concern is the fetal head engagement and cervical readiness.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Massaging the fundus can help contract the uterus and reduce bleeding. Ensuring IV access is crucial for administering medications rapidly. Methylergonovine (Methergine) and oxytocin help stimulate uterine contractions and reduce postpartum hemorrhage, which can be life-threatening.

Choice B rationale

Administering pain medication might be necessary, but it doesn't address the immediate issue of uterine atony and hemorrhage. Surgical intervention is a last resort and should be prepared for only if medical management fails.

Choice C rationale

Reassessing vital signs and monitoring is important, but it doesn't provide an immediate solution to the bleeding and uterine atony. Immediate action to contract the uterus is crucial.

Choice D rationale

Contacting the attending physician is important, but immediate intervention to stop the bleeding and address uterine atony is critical to prevent further complications.

Correct Answer is ["A","B","C"]

Explanation

Choice A rationale

Massaging the fundus helps to stimulate uterine contractions, reducing bleeding and promoting firmness in the uterus. Ensuring IV access is critical for administering medications and

fluids quickly.

Choice B rationale

Methylergonovine (Methergine) is used to prevent and control postpartum hemorrhage by promoting uterine contractions. Oxytocin bolus also helps stimulate contractions, preventing

further blood loss.

Choice C rationale

Carboprost tromethamine (Hemabate) is another uterotonic agent used to control severe postpartum hemorrhage by causing uterine contractions. Its use depends on the patient's

response to other treatments.

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