Which assessment finding is indicative of a major complication 1 ...

[nenivikky]

Which assessment finding is indicative of a major complication 1 hour following a forceps birth?
 
  a. Uterine fundus displaced at U + 1
  b. Complaints of vaginal and uterine pain
  c. Peripads showing moderate lochia rubra
  d. Increase in pulse rate from 90 to 110 bpm

Question 2

In which of these situations should the nurse anticipate the use of forceps or vacuum extraction?
 
  a. Complete dilation for 2 hours at +2 station
  b. Complete dilation for 1 hour, transverse arrest at station +1
  c. Complete dilation for 3 hours, fetus at +3 station, onset of late deceleration
  d. Complete dilation for 1 hour, fetal descent from 0 station to + 1 in 1 hour

[leahm14]

Answer to Question 1

ANS: D
Trauma to the vaginal area from a forceps birth may result in significant blood loss from hematomas or lacerations. Tachycardia is an early sign of compensation for excessive blood loss. A displaced uterine fundus is mostly likely indicative of a full bladder. Vaginal pain may be present even when the vaginal mucosa is intact. Moderate lochia rubra is a common finding early in the postpartum period.

Answer to Question 2

ANS: C
Forceps or vacuum extraction is considered if the second stage should be shortened for the well-being of the woman or fetus. Onset of late decelerations is an indication for an operative birth. With the fetus at +3 station, an outlet operative birth can be performed. Complete dilation for 2 hours at +2 station, complete dilation for 1 hour with a transverse arrest at station +1, and complete dilation for 1 hour with fetal descent from 0 station to +1 in 1 hour are situations in which client pushing and position changes would be used before operative intervention is indicated.

[nenivikky]

Thanks for the timely response, appreciate it

[Liddy]

TYSM