ATI Maternal Newborn Practice B 2019 With Rationale
Maternal Newborn Practice B 2019 With Rationale Vaginal Examination, umbilical cord protruding from vagina, action to take: Apply internal upward pressure to the presenting part using 2 gloved fingers Rational: Prolapse of the umbilical cord during labor can result in decreased perfusion to the fetus, which can lead to hypoxia. After calling for assistance, the nurse should relieve the compression on the umbilical cord by applying upward internal pressure on the presenting part with two gloved fingers. The nurse should not move their hand. 2hr postpartum, interventions during taking-hold phases of behavior adjustment: Demonstrate to the client how to perform a newborn bath. 36 wk gestation, nonstress test: "You will be offered orange juice to drink during the test." Nutritional intake, 8 wk gestation, inc daily intake of: Iron (Fe) 35 wk placenta previa, action to take: Initiate continuous external fetal monitoring. Rational: client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. The nurse should initiate interventions such as bed rest, pelvic rest, and continuous fetal heart monitoring, which assesses fetal well-being and the presence of contractions. The nurse should obtain IV access and monitor laboratory values. Also, the nurse should implement interventions to prepare for an emergency birth. FHR, fetal position left occipital anterior, area to apply ultrasound transducer to assess point of maximu
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