Certified Midwife Exam Prep

Category - Midwifery

A client with a multiple pregnancy is scheduled for cesarean delivery and is transported to the delivery operating room. The midwife reminds the staff nurse to position the client in which of the following positions in the operating room?
  1. Left side-lying position
  2. Semi-Fowler position
  3. Supine position, with a wedge placed under the right hip.
  4. Supine position, with a wedge placed under the left hip.
Explanation
Answer: C - The midwife reminds the staff nurse to position the client in supine position, with a wedge placed under the right hip, in the operating room. The enlarging uterus compresses the vena cava and the descending aorta of the client, which impedes blood flow to the lower extremities and uterus. The side-lying position is the most ideal position during pregnancy, as it displaces the uterus off the compressed structures. In an abdominal surgery, the client should be positioned in supine position. To displace the uterus and to prevent decreased blood flow to the uterus, a wedge should be placed under the right hip.
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