A maternal indication for the use of vacuum extraction is
Maternal exhaustion.
Failure to progress past 0 station.
A wide pelvic outlet.
A history of rapid deliveries.
The Correct Answer is A
Choice A reason:
Maternal exhaustion is a maternal indication for the use of vacuum extraction. Vacuum extraction is a technique that can assist the mother in delivering the baby when she is unable to push effectively or when pushing poses a risk to her health. Vacuum extraction can shorten the second stage of labor and reduce maternal fatigue and distress. According to the Cleveland Clinic, vacuum extraction might be indicated if "the mother can't push anymore, either due to exhaustion or a health condition.".
Choice B reason:
Failure to progress past 0 station is not a maternal indication for the use of vacuum extraction. The station refers to the position of the baby's head in relation to the mother's pelvis. 0 station means that the baby's head is at the level of the pelvic inlet, or the narrowest part of the pelvis. Vacuum extraction is usually not performed before the baby reaches +2 station, which means that the head is 2 cm below the pelvic inlet and visible at the vaginal opening. According to the American Academy of Family Physicians, vacuum extraction should not be attempted if "the fetal head is not engaged (above 0 station).".
Choice C reason:
A wide pelvic outlet is not a maternal indication for the use of vacuum extraction. The pelvic outlet is the lower part of the pelvis that forms the exit for the baby during delivery. A wide pelvic outlet means that there is more space for the baby to pass through, which can facilitate vaginal delivery and reduce the need for instrumental assistance. Vacuum extraction is more likely to be indicated when there is a narrow pelvic outlet, which can obstruct labor and cause fetal distress.
Choice D reason:
A history of rapid deliveries is not a maternal indication for the use of vacuum extraction. Rapid deliveries, also known as precipitous deliveries, are those that occur within 3 hours of the onset of labor. Rapid deliveries can pose risks to both the mother and the baby, such as excessive bleeding, umbilical cord prolapse, or birth trauma. However, vacuum extraction is not usually indicated in these cases, as it requires time and preparation to apply the device and monitor its effects. Vacuum extraction is more likely to be indicated when labor is prolonged or stalled in the second stage, and when there is a nonreassuring fetal heart rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Obtaining blood glucose by heel stick is the appropriate action for a newborn who exhibits signs of diaphoresis, jitteriness, and lethargy. These signs are suggestive of hypoglycemia, which is a common and potentially serious condition in newborns. Hypoglycemia can result from various causes, such as maternal diabetes, prematurity, intrauterine growth restriction, or perinatal stress. A heel stick is a simple and quick method to obtain blood samples from newborns for glucose testing.
Choice B reason:
Initiating phototherapy is not the appropriate action for a newborn who exhibits signs of diaphoresis, jitteriness, and lethargy. Phototherapy is used to treat hyperbilirubinemia, which is a condition characterized by high levels of bilirubin in the blood. Hyperbilirubinemia can cause jaundice, which is a yellowish discoloration of the skin and eyes. Jaundice does not typically cause diaphoresis, jitteriness, or lethargy in newborns.
Choice C reason:
Monitoring the newborn's blood pressure is not the appropriate action for a newborn who exhibits signs of diaphoresis, jitteriness, and lethargy. Blood pressure measurement is not routinely performed in healthy newborns. Blood pressure may be indicated in newborns who have signs of cardiovascular compromise, such as cyanosis, tachycardia, or poor perfusion. Diaphoresis, jitteriness, and lethargy are not specific signs of cardiovascular compromise in newborns.
Choice D reason:
Placing the newborn in a radiant warmer is not the appropriate action for a newborn who exhibits signs of diaphoresis, jitteriness, and lethargy. A radiant warmer is a device that provides heat to maintain the newborn's body temperature. A radiant warmer may be used for newborns who are at risk of hypothermia, such as those who are premature, have low birth weight, or have cold stress. Diaphoresis, jitteriness, and lethargy are not specific signs of hypothermia in newborns.
Correct Answer is B
Explanation
The correct answer is choice B. Prolactin.
Choice A reason:
Estrogen. Estrogen is a hormone that plays a role in the development of the mammary glands and the ductal system during pregnancy. However, estrogen does not directly produce milk.
In fact, high levels of estrogen during pregnancy inhibit milk secretion by blocking prolactin. Therefore, estrogen is not the hormone necessary for milk production. • Choice B reason:
Prolactin. Prolactin is the hormone responsible for the production of breast milk. Prolactin is secreted by the pituitary gland in response to suckling or nipple stimulation. Prolactin levels rise during pregnancy and peak after delivery, when the sudden drop in estrogen and progesterone allows prolactin to take over and initiate lactation. Therefore, prolactin is the hormone necessary for milk production. • Choice C reason:
Progesterone. Progesterone is a hormone that also contributes to the development of the mammary glands and the alveoli during pregnancy. However, like estrogen, progesterone does not directly produce milk. Progesterone also inhibits milk secretion by blocking prolactin during pregnancy. Therefore, progesterone is not the hormone necessary for milk production. •
Choice D reason:
Lactogen. Lactogen is not a hormone, but a general term for any substance that stimulates lactation. There are different types of lactogens, such as human placental lactogen (hPL), which is produced by the placenta during pregnancy and has some lactogenic effects on the mammary glands. However, hPL is not the main hormone responsible for milk production. That role belongs to prolactin. Therefore, lactogen is not the hormone necessary for milk production.
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