The nurse is assisting the primary care provider (PCP) with a vacuum-assisted delivery because of a prolonged second stage of labor.
The nurse will inform the PCP when which guideline of the procedure is met?
Extension of the episiotomy is performed.
Signs of fetal compromise have resolved.
The "three-pull" rule has been achieved.
Patient is under full anesthesia status.
Patient is under full anesthesia status.
The Correct Answer is C
Choice A rationale
Extension of the episiotomy is not a guideline for vacuum-assisted delivery. Episiotomy extension is considered based on perineal conditions during delivery, not as a primary
guideline for vacuum procedures.
Choice B rationale
Signs of fetal compromise resolving is critical for fetal safety but isn't specific to the guidelines for a vacuum-assisted delivery. Continuous fetal monitoring assesses for compromise,
not just vacuum application.
Choice C rationale
The "three-pull" rule refers to the number of attempts allowed with the vacuum to avoid excessive force and trauma. This guideline ensures safety during the procedure, preventing
overuse of vacuum pressure.
Choice D rationale
Full anesthesia status is unrelated to the guidelines for vacuum-assisted delivery. Anesthesia choices depend on patient and procedural needs, but aren't a guideline criterion for
vacuum use.
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Correct Answer is ["A","B","C"]
Explanation
Choice A rationale
Massaging the fundus helps to stimulate uterine contractions, reducing bleeding and promoting firmness in the uterus. Ensuring IV access is critical for administering medications and
fluids quickly.
Choice B rationale
Methylergonovine (Methergine) is used to prevent and control postpartum hemorrhage by promoting uterine contractions. Oxytocin bolus also helps stimulate contractions, preventing
further blood loss.
Choice C rationale
Carboprost tromethamine (Hemabate) is another uterotonic agent used to control severe postpartum hemorrhage by causing uterine contractions. Its use depends on the patient's
response to other treatments.
Correct Answer is A
Explanation
Choice A rationale
History of preterm birth is the principal risk factor for predicting preterm birth. Previous preterm births significantly increase the likelihood of subsequent preterm deliveries due to
underlying etiological factors.
Choice B rationale
Low prepregnancy weight is a risk factor but not as significant as a history of preterm birth. It can contribute to complications in pregnancy but does not have the same predictive value.
Choice C rationale
Smoking during pregnancy increases the risk of preterm birth but is not the principal risk factor. It is a modifiable behavior that contributes to poor pregnancy outcomes.
Choice D rationale
Obesity can impact pregnancy outcomes but is not the principal risk factor for preterm birth. It is associated with other complications rather than directly predicting preterm delivery.