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.

Answer and Explanation

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 B

Explanation

Choice A rationale

Labor dystocia involves prolonged labor. Her fast delivery history suggests the opposite, indicating rapid labor progress.

Choice B rationale

Rapid labor progression, frequent contractions, and previous short labors suggest she is at risk for precipitous labor, requiring immediate preparation for delivery.

Choice C rationale

Cephalopelvic disproportion indicates size mismatch between baby and pelvis, not rapid labor. Her history of quick deliveries does not align with this condition.

Choice D rationale

False labor typically involves irregular, less intense contractions. Her regular, intense contractions and labor history suggest active labor, not false labor.

A. Massage her fundus until firm and ensure IV access. B. Administer pain medication and prepare for possible surgical intervention. C. Reassess her vital signs and monitor for further changes. D. Immediately contact the attending physician for emergency intervention.

Correct Answer is A

Explanation

Choice A rationale

Massaging the fundus can help contract the uterus and reduce bleeding. Ensuring IV access is crucial for administering medications rapidly. Methylergonovine (Methergine) and oxytocin help stimulate uterine contractions and reduce postpartum hemorrhage, which can be life-threatening.

Choice B rationale

Administering pain medication might be necessary, but it doesn't address the immediate issue of uterine atony and hemorrhage. Surgical intervention is a last resort and should be prepared for only if medical management fails.

Choice C rationale

Reassessing vital signs and monitoring is important, but it doesn't provide an immediate solution to the bleeding and uterine atony. Immediate action to contract the uterus is crucial.

Choice D rationale

Contacting the attending physician is important, but immediate intervention to stop the bleeding and address uterine atony is critical to prevent further complications.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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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?