CNM Certified Nurse Midwife

Category - Antepartum

A nurse midwife is assessing a client in her third trimester. The client is complaining of sharp, stabbing uterine pain. The nurse midwife suspects abruptio placenta. Which of the following interventions is the least effective for the client?
  1. Administer oxygen by face mask.
  2. Insert a large gauge intravenous catheter.
  3. Order bed rest in the supine position.
  4. Vaginal examination is not performed.
Explanation
Answer: C - The client should be on bed rest in a lateral position, not the supine position, to alleviate the pressure on the vena cava and to improve fetal circulation. The nurse midwife should administer oxygen by face mask to limit the effects of the absence of oxygen supply to the fetus. A large gauge intravenous catheter is inserted for fluid replacement. In order to prevent further trauma, the nurse midwife should not perform a vaginal or pelvic examination.
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