When caring for a laboring patient, the nurse notes the onset of sudden vaginal bleeding at the beginning of cervical dilation. The patient denies any pain. What action by the nurse is best?
A.
Document the findings in the woman's chart.
B.
Place the woman in a knee-chest position.
C.
Prepare the woman for an immediate cesarean birth.
D.
Perform a careful vaginal exam to assess for exposed umbilical cord vessels.
ANS: D
This woman has the classic sign of vasa previa, in which the unprotected fetal vessels cover the cervical os and precede the fetus. This condition is usually seen with a velamentous insertion of the umbilical cord. The nurse should conduct a careful vaginal exam, assessing for exposed fetal blood vessels. The patient may need an emergent cesarean delivery. This assessment should come prior to interventions such as positioning.
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Fill in the blank(s) with the appropriate word(s).
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A drug-drug Interaction with a P450 inducer or inhibitor may be of particular concern with:
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