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
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.
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