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When assisting with a vacuum-assisted vaginal delivery, the nurse is aware that adherence to which guidelines for the vacuum device will minimize the nurse's liability in vacuum-assisted vaginal births? Select all that apply.

 

A.

Pump up the vacuum manually to the pressure indicated on the pump.

B.

Recognize that cup detachment (pop off) is a warning sign.

C.

The cup should not be on the fetal head for longer than 5 to 10 minutes.

D.

The procedure is timed from insertion of the cup into the vagina until the birth.

E.

Understand that pressure should be released between contractions.

Question Solution

Correct Answer : B,C,E

Choice A rationale

Pumping up the vacuum manually to the pressure indicated on the pump is a standard procedure but doesn't directly minimize liability.

 

Choice B rationale

Recognizing cup detachment (pop off) as a warning sign is critical, as it indicates excessive force or poor positioning, which can lead to fetal or maternal injury.

 

Choice C rationale

Limiting the cup's attachment to the fetal head to 5 to 10 minutes reduces the risk of scalp injury and other complications, thus minimizing liability.

 

Choice D rationale

Timing the procedure from insertion of the cup into the vagina until the birth is a guideline but doesn't specifically address liability concerns.

 

Choice E rationale

Releasing pressure between contractions prevents continuous suction on the fetal head, reducing the risk of injury and thereby minimizing liability.


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Correct Answer is D

Explanation

Choice A rationale

Numbness in the toes and heel might suggest nerve involvement but is not a typical sign of deep vein thrombosis (DVT), which involves the veins, not nerves.

Choice B rationale

Pain relieved by dorsiflexion (positive Homan's sign) is not reliable for diagnosing DVT. This symptom is outdated and not considered a definitive sign.

Choice C rationale

Spider-like and purple veins suggest superficial varicose veins, not deep vein thrombosis, which affects deeper veins and presents differently.

Choice D rationale

Swelling, redness, and warmth in the calf are classic signs of DVT due to the inflammation and obstruction of deep veins. These symptoms should prompt immediate medical evaluation and intervention. .

Correct Answer is D

Explanation

Choice A rationale

Placing a pacifier in the baby's mouth is inappropriate because it does not address the underlying cause of grunting, which can be a sign of respiratory distress.

Choice B rationale

Checking the baby's diaper is not relevant to assessing the cause of grunting. Grunting is usually related to respiratory issues rather than a dirty diaper.

Choice C rationale

Having the mother feed the baby is inappropriate because grunting may indicate respiratory distress. Feeding should be deferred until the baby's respiratory status is assessed and stabilized.

Choice D rationale

Assessing the respiratory rate is appropriate because grunting in a newborn can indicate respiratory distress. The nurse should evaluate the respiratory status to determine the need for further intervention.

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