A midwife is about to perform amniotomy on a client who is in her 39th week of gestation. Which of the following actions of the midwife is the least appropriate before starting the procedure?
  1. Examine the cervix and measure cervical dilatation.
  2. Assess the fetal heart tone.
  3. Maintain aseptic technique.
  4. Position the client in lithotomy position.
Explanation
Answer: D - The least appropriate action of the midwife is to place the client in the lithotomy position. The client must be positioned in the dorsal recumbent position. The midwife should examine the cervix and measure cervical dilatation. In most cases, a cervical dilatation of 3 cm is needed before amniotomy. The fetal heart tone is assessed before and after the procedure. Aseptic technique is maintained throughout the procedure.
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