UWORLD NCLEX REVIEW MATERNAL & CHILD NURSING Batch 14

UWORLD NCLEX REVIEW MATERNAL & CHILD NURSING Batch 14 Supine hypotensive syndrome occurs when the weight of the abdominal contents compresses the vena cava causing decreased venous return to the heart. This results in low cardiac output (maternal hypotension) and reflex tachycardia. Manifestations include dizziness, pallor, and cold and clammy skin. The client should be immediately repositioned onto the right or left side until the symptoms subside. Prevention of this condition includes using a wedge under the client's hip while in a supine position. (Option 1) Decreased maternal cardiac output can result in decreased placental blood flow and fetal heart rate (FHR) abnormalities. FHR assessment also follows after the client is placed in the right or left lateral position. (Option 2) When supine hypotension is suspected, the client should first be placed in a lateral position. Blood pressure and pulse are checked to confirm the diagnosis. Assessing lung and heart sounds is not a priority. (Option 3) The HCP is notified after placing the client in a lateral position and completing the assessment. Fetal occiput posterior (OP) position is a common fetal malposition that occurs when the fetal occiput rotates and faces the mother's posterior or sacrum. OP fetal position can cause increased back pain or "back labor." Many fetuses in OP position during early labor spontaneously rotate to occiput anterior position (occiput facing the mother's anterior or pubis). The nurse or labor support person can apply counterpressure to the client's sacrum during contractions to help alleviate back pain associated with OP fetal positioning. Firm, continuous pressure is applied with a closed fist, heel of the hand, or other firm object (eg, tennis ball, back massager) (Option 1). ......................................................continued..........................................................