After an amniotomy, which action by the nurse takes priority?
A.
Change the patient’s gown.
B.
Assess the fetal heart rate.
C.
Estimate the amount of amniotic fluid.
D.
Assess the color of the amniotic fluid.
The Correct answer and Explanation is:
The correct answer is B. Assess the fetal heart rate.
Explanation:
An amniotomy, or artificial rupture of membranes (AROM), is a procedure in which the amniotic sac is intentionally ruptured by the healthcare provider to expedite labor. Following this procedure, several immediate and important actions are required to ensure the safety and well-being of both the mother and the fetus. The priority action after an amniotomy is to assess the fetal heart rate. Here’s why:
- Monitoring Fetal Well-being: One of the primary concerns after an amniotomy is the potential for umbilical cord compression. When the membranes are ruptured, there is less cushioning around the umbilical cord, which can lead to cord compression and reduced blood flow to the fetus. This can result in variable fetal heart rate decelerations. By immediately assessing the fetal heart rate, the nurse can detect any changes or abnormal patterns that may indicate fetal distress.
- Detecting Complications Early: Prompt assessment of the fetal heart rate allows for early detection of any complications that might arise from the amniotomy. If any abnormalities are observed, such as decreased fetal heart rate or significant changes in the pattern, timely interventions can be taken to address potential issues, such as repositioning the mother, administering oxygen, or considering a cesarean delivery if necessary.
- Ensuring Ongoing Safety: Continuous fetal heart rate monitoring after an amniotomy helps ensure that the fetus remains stable and that labor is progressing normally. This ongoing assessment is crucial in determining if the labor is progressing as expected and if any additional interventions are required to safeguard the health of the mother and baby.
While other actions such as changing the patient’s gown, estimating the amount of amniotic fluid, and assessing the color of the amniotic fluid are important, they do not have the immediate impact on fetal well-being that monitoring the fetal heart rate does. Therefore, the priority is to assess the fetal heart rate to ensure the fetus is tolerating the procedure well and to quickly identify and address any potential issues.