CNM Certified Nurse Midwife

Answer: D - The registered nurse is correctly and safely positioning the client in lithotomy position only when the nurse midwife is scrubbing. Lying longer for more than an hour in the lithotomy position may cause pelvic congestion and hemorrhage, so it is important that the client is placed in this position only when the procedure is about start. To prevent constriction, the strap holding the leg should not be secured too tightly . Once the client is in lithotomy, the top portion of the table is raised to 30 to 60 degrees for more effective pushing. The legs must be raised at the same time to prevent straining the client’s back and abdominals.