During birth, the doctor used vacuum extraction.
Which of the following might be a complication of this type of delivery?
Cephalohematoma of the newborn.
Depressed fontanelle.
Ruptured uterus.
Down syndrome.
The Correct Answer is A
Choice A rationale
Vacuum extraction involves applying a suction cup to the fetal scalp to assist with delivery. The pressure from the vacuum can cause a collection of blood between the periosteum and the skull, known as a cephalohematoma. This condition is confined to one cranial bone and does not cross suture lines. It typically resolves on its own over weeks to months.
Choice B rationale
A depressed fontanelle is a sign of dehydration or sunken sutures. In a vacuum-assisted delivery, the opposite often occurs, with the suction creating a "chignon" or caput succedaneum (scalp swelling) that can make the fontanelles appear full or even bulging, but not depressed. A depressed fontanelle is not a complication of this procedure.
Choice C rationale
A ruptured uterus is a rare but severe complication of labor. While it can be associated with oxytocin use or a history of previous uterine surgery, it is not a direct complication of vacuum extraction itself. The risk factors for uterine rupture are different and not directly related to the application of the vacuum cup to the fetal head.
Choice D rationale
Down syndrome is a chromosomal disorder (trisomy 21) that occurs at conception. It is not caused by labor or delivery methods, including vacuum extraction. This is a congenital condition resulting from an extra copy of chromosome 21. A vacuum delivery has no impact on the genetic makeup of the fetus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale
An ultrasound for cervical length is a crucial diagnostic tool for assessing preterm labor. A shortened cervix, typically less than 2.5 cm, is a significant risk factor for preterm birth. Measuring the cervical length helps to determine the probability of progressing to true labor and guides subsequent interventions, such as cerclage or progesterone therapy.
Choice B rationale
Amniocentesis, the sampling of amniotic fluid, is primarily used for genetic testing, assessing fetal lung maturity, or diagnosing fetal infection. It is not a standard procedure for a patient with intermittent back pain and pelvic pressure at 28 weeks gestation, as it carries risks, including inducing labor and infection, and isn't the first-line diagnostic for this presentation.
Choice C rationale
A glucose tolerance test is a screening tool for gestational diabetes, typically performed between 24 and 28 weeks of gestation. While the patient is at this gestational age, the test is not directly related to the symptoms of back pain and pelvic pressure, which are more indicative of potential preterm labor. The test wouldn't be a priority in this specific context.
Choice D rationale
A fetal fibronectin (fFN) swab is a diagnostic test used to predict the likelihood of preterm birth. The presence of fFN, a protein that acts as a "glue" for the fetal sac, in cervical or vaginal secretions between 22 and 34 weeks gestation suggests an increased risk of preterm labor within the next one to two weeks. It is a key tool in managing preterm labor.
Choice E rationale
Encouraging fluids and rest is a common initial intervention for a patient with symptoms of preterm labor. Dehydration can sometimes trigger uterine contractions, so rehydration may help to stop them. Resting can also reduce uterine irritability. This non-pharmacological approach is often the first step before more aggressive treatments are considered. *.
Correct Answer is C
Explanation
Step 1 is: Identify the start and end of the first stage of labor. The first stage begins with the onset of regular uterine contractions and ends with full cervical dilation (10 cm) and effacement (100%). The patient's contractions started at 3 a.m., and she arrived at the hospital at 8: a.m. with 5 cm dilation. She delivered at 3: p.m. but her labor progression is noted up to 2 p.m. with an overwhelming need to push which indicates she was likely in the second stage of labor.
Step 2 is: The first stage of labor is from 3 a.m. (onset of regular contractions) to the overwhelming need to push at 2 p.m., which indicates the end of the first stage and the beginning of the second stage.
Step 3 is: Calculate the duration. From 3 a.m. to 2 p.m. is 11 hours. The final calculated answer is 11 hours.
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