Practice Quiz

Certified Midwife Exam Prep

Category - Midwifery

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A client at 30 weeks’ gestation complains of shortness of breath and an unusually rapid enlargement of the uterus. A tense uterus is noted by the midwife during assessment. Palpation of the small parts of the fetus and auscultating the fetal heart rate are difficult. The midwife suspects severe hydramnios. Which of the following interventions are appropriately included in the care plan?

I. Encourage ambulation.
II. Increase intake of foods high in fiber.
III. Perform amniocentesis.
IV. Administer indomethacin.
  1. I and II
  2. II and III
  3. II, III and IV
  4. All of the above
Explanation
Answer: C - The midwife may increase the client’s intake of foods high in fiber, perform amniocentesis and administer indomethacin. Hydramnios may cause fetal malpresentation, premature rupture of the membranes and pre-term labor. The client should increase her fiber intake to prevent constipation because straining to defecate could increase the uterine pressure and cause rupture of the membranes. Amniocentesis may be performed to remove some of the excess amniotic fluid, but this intervention is a temporary measure, as amniotic fluid is replaced rapidly. Indomethacin may reduce the total volume.
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