The patient requires vacuum extraction assistance. To provide easier access to the fetal head, the physician cuts a mediolateral episiotomy. After delivery, the patient asks the nurse to describe the episiotomy
The nurse responds, "The episiotomy: 1. "Goes straight back toward your rectum."
2. "Is from your vagina toward the urethra."
3. "Is cut diagonally away from your vagina."
4. "Extends from your vagina into your rectum."
3
Rationale 1: A midline episiotomy is straight back from the vagina toward the rectum.
Rationale 2: Episiotomies are not cut anteriorly toward the urethra unless the patient has had a female circumcision.
Rationale 3: A mediolateral episiotomy is angled from the vaginal opening toward the buttock.
Rationale 4: Extension into the rectum is a fourth-degree laceration.
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