A client at 32 weeks gestation goes into cardiac arrest. What is the nurse's best action while performing cardiopulmonary resuscitation for this client?

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11ecbb05_cb04_74da_b433_85f5266fb83e_MD0009_00 Common causes of sudden cardiac arrest in pregnant clients include embolism, eclampsia, magnesium overdoses, and uterine rupture. If cardiopulmonary resuscitation (CPR) is required, several modifications must be made to ensure efficacy of the rescue efforts. During pregnancy, the heart is displaced toward the left because the growing uterus pushes upward on the diaphragm, particularly in the third trimester. To accommodate this displacement, the hands should be placed on the sternum slightly higher than usual for chest compressions during CPR (Option B). In addition, a gravid uterus can significantly compress the client's vena cava and aorta, thereby hindering effective blood flow during CPR. The uterus should be manually displaced to the client's left to reduce this pressure. The nurse can also place a rolled blanket or wedge under the right hip to displace the uterus. If return of spontaneous circulation (ROSC) does not occur after 4 minutes of CPR, emergency cesarean section is usually initiated. Delivery should occur within 5 minutes of initiating CPR. (Option A) Compressions to the right sternal border will lack effectiveness as the heart is displaced to the left side during pregnancy. (Option C) Chest compressions given below the diaphragm are not effective for ROSC and greatly increase the risk of injury to the client's uterus, spleen, or liver. (Option D) In the supine position, the vena cava and aorta are compressed by the uterus, hindering effective blood flow during CPR. The uterus should be displaced to the left to reduce pressure. Educational objective: Two important modifications for cardiopulmonary resuscitation of a pregnant client include performing chest compressions slightly higher on the sternum and displacing the uterus to the client's left side.

A Client at 32 Weeks Gestation Goes into Cardiac Arrest