The client has been pushing for two hours, and is exhausted. The physician is performing a vacuum extraction birth. What finding is expected?
1. The head is delivered after eight pulls during contractions.
2. A bruise is present on the occiput that does not cross the suture line.
3. The location of the vacuum is apparent on the fetal scalp after birth.
4. Positive pressure is applied by the vacuum extraction during contractions.
3
Rationale:
1. Use of the vacuum extraction for eight contractions is too many, and can create damage to the fetal head. If fetal descent does not occur with the first two pulls, the procedure should be discontinued, and cesarean birth should take place.
2. This is a cephalohematoma, and is a complication of vacuum extraction birth.
3. Caput in the shape of the vacuum cup is usually present immediately after birth, and resolves in 2–3 days.
4. Negative pressure is suction, which is needed to use the vacuum extractor to facilitate birth.
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