Studying for NCLEX, WHATS THE ANSWER?!

[studyingnurse]

Hi everyone,

I am studying to writen the NCLEX RN in Canada and I have used the NCSBN and uworld resources to study. I came across the question of, "what do you do in priority sequence when a the fetal heart monitor is showing late decels?". Both resources have given different orders for intervention and I want to know what the right answer is haha HELP

NCSBN says the order should be:

1) turn client to left side

2) administer IV bolus

3) give oxygen

4) discontinue oxytocin

5) notify HCP

uWorld says the order should be:

1) discontinue oxytocin

2) turn client to left side

3) administer oxygen via nonrebreather mask

4) administer prescribed IV bolus of Ringers or NS

5) notify HCP

To me I think that uWorld makes the most sense but definitely want to hear some opinions so I don't get the answer wrong. Thanks :)

[klone, MSN, RN]

I agree with you. Shutting off Pit is the FIRST thing you would do, then you would do the other things in order of how quickly it can be done. Changing position can be accomplished faster than putting on O2, and has a more immediate result.

[TheCommuter, BSN, RN]

We moved this thread to the NCLEX forum.

[Jareen]

I'm going with the Ncsbn answer ;as Klone said it would have the most immediate effect

[studyingnurse]

So you think the proper order is what uworld says?

[studyingnurse]

Thanks!

[Jareen]

No! Ncsbn, I'm sorry I didn't complete my comment , I'm at work; but I was basically saying that I agreed with his statement that positioning would give a more immediate effect.

[LadyFree28, BSN, LPN, RN]

Go with the NCSBN-it is closer to the NCLEX (and a lot of the questions are similar to the NCLEX because they are the makers of the NCLEX).

Also, think about it...when performing interventions, one should be doing SOMETHING immediately...think about late decels and what would be the BEST first intervention...if you get stumped, look up late decel intervention from a book source, and you should get a definitive answer.

[gracehope26, ASN, BSN, RN]

I would go with the uworld answer because when dealing with any situation with a patient, you always want to do the least invasive procedures first.

[Jareen]

Ok turning of the oxytocin and positioning the client are equally less invasive: my main reason for choosing to position the client on the left side first is, that in itself may alleviate some symptoms; whereas stopping the oxytocin first when you could've positioned the client and started seeing improvement in the FHR therefore having no need to stop the oxytocin and having to start all over again... If you catch my drift

[studyingnurse]

Oh sorry! Yes I see what you're saying :) so I should just stick with ncsbn's answer then?

I just hate how in ncsbn's answer, they put discontinuing oxytocin basically last ...

[LadyFree28, BSN, LPN, RN]

Oh sorry! Yes I see what you're saying :) so I should just stick with ncsbn's answer then?

I just hate how in ncsbn's answer, they put discontinuing oxytocin basically last ...

Why would you what to turn off the oxytocin first?

What are the effects of turning it off?

Look up oxytocin, the effects of turning it off, and decels.