CPM Certified Professional Midwife

Category - Labor, Birth, and Immediate Postpartum

A client in labor begins to complain of severe abdominal pain and chest pain. On assessment, the midwife notes that uterine contractions have stopped and that the abdomen is rigid. Fetal heart tone is not noted. The client’s blood pressure decreases, and her heart rate increases to over 100 beats per minute. Which of the following is the next action of the midwife?
  1. Maintain bed rest in a side - lying position.
  2. Prepare the client for cesarean delivery.
  3. Administer oxytocin.
  4. Initiate intubation and mechanical ventilation.
Explanation
Answer: B - The next action of the midwife is to prepare the client for cesarean delivery. Based on the history and assessment findings, the client has uterine rupture, and this is mainly managed by cesarean delivery. Hysterotomy with hysterectomy may be performed. Intubation and mechanical ventilation may be necessary for clients with amniotic fluid embolism.
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