1. If you believe that birth may occur before the mother can be safely transport
ID: 246140 • Letter: 1
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1. If you believe that birth may occur before the mother can be safely transported to the nearest hospital, you should do all of the following EXCEPT: A: See if any part of the baby is visible or becomes visible during contractions B: Put on protective equipment like gloves, gown, and face mask C: Remove any clothing obstructing your view of the vaginal opening D: Lay her on her right side with her knees bent 2. If the umbilical cord is around the baby's neck, emergency care includes: A: Gently loosening the cord with your fingers and slip it over the baby's head B: Pulling the umbilical cord until more of it comes out of the vagina C: Checking for meconium staining D: Placing two fingers inside the vagina, creating a V, so the baby can breathe 3. Your primary concern when caring for a baby is: A: Clearing the airway and ensuring that the baby is breathing B: Assessing for meconium staining C: Assessing whether the mother is having twins D: Determining the sex of the babyExplanation / Answer
1) If the mother is expected to deliver during transportation to nearest hospital then She should be allowed lay her on right side with knees bent.
Inferences: Its important to assess if any part of baby is visible out during contraction as it will help to determine the presentation and the safe expulsion of fetus. Put protective equipments will prevent infection. Removing constricting clothing will allow in easy assessment of progression of labour. The accurate position for delivery is lithotomy position.
2) If the umblical cord is around the baby's neck emergency care includes placing two fingers inside the vagina, creating a V,so that baby can breathe.
Inferences: If the cord is loose enough to slide down the neck then only its can be done. Unnecessary pulling the umblical cord may result in break of the cord and may impede further circulation.Checking the meconium staining is important but its not the priority in this scenario.
3) Our primary concern while caring for a baby is clearing the airway and ensuring that the baby is breathing.
Inferences: All the other three options can be performed after stabilizing the patient. The priority is clearance of airway.
4) Drying and warming the baby is not a method to stimulate the baby who is not breathing.
Inferences: Rubbing the back, slapping the buttocks and snapping your index finger at the sole are the various methods to stimulate cry in a baby who has not yet started breathing. Drying and warming is basically done once the baby starts breathing.
5) Neither A or B
Inferences: As soon as a baby is delivered, its the primary action to clamp the cord and cut it. It done to avoid the increase of RBC in newborn due to continued blood flow from placenta. This is applicable principle even if the baby is breathing or not, even if CPR is needed or not.
6)Taking a break between labor contractions.
Inferences: Giving oxygen prevents hypoxia in fetus. Providing emotional support to mother will boost her morale needed for going through the exhausting experience. Reassessing the mother and baby will keep health personel aware of the labor progression and early identification of complications if any. Taking break between labor contractions is risky as baby may get delivered any time with strong contraction and its a malpractice to leave ones patient unattended.
7) Mother has no prenatal care
Inferences: after the expulsion of first baby, the contraction usually decreases and then increases with the engagement of second baby. Pregnancy induced diabetes occurs with both single and twin pregnancy. It cannot be considered as a determining factor to rule out twin pregnancy. After pregnancy, the abdomen remains large for few days.This is time for involution of uterus. A mother who has no prenatal care, is unaware about the number of fetus present due to lack of adequate examination. In such condition twin pregnancy can be suspected.
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