Itfal

Question 1

**AGPGAR after baby delivery

Answer 1

do APGAR score at 1 and 5 mins after delivery

Question 2

** give heart compressions to a newborn with:

Answer 2

heart rate less than 60 or does not stay above 80 with ventilations

Question 3

**
respiratory distress in pediatrics…

Answer 3

really any respiratory issue even mild

Question 4

**

moms giving birth might up to lose 500mL of blood

Question 5

you would rescue or recover a ptnt with is a kid that fell thru the ice 30 mins ago

Answer 5

the question is really asking, could the ptnt still be alive.
there’s a chance the cold helped the kid stay alive, this is a rescue. and, the younger the more chance they can be resuscitated from the cold water

Question 6

lack of ___ indicates the child is in shock likely due to dehydration.

Answer 6

tears

Question 7

**
what you will do to a limp, unresp newborn:

Answer 7

dry and rub the infant with a clean towel, in hopes of stimulating to get breathing. maybe add a flick to the bottom of the feet..do this before considering any cpr

Question 8

cephalic or vertex presentation (delivery):

Answer 8

fetus is positioned headfirst

Question 9

when a baby is crowning in delivery, to prevent damage to baby or patient, as the head is descending, grasp bony parts of the head, avoiding the eyes and fontanelles (soft spots on the skull).
also don’t put too much pressure u are there to ensure the baby doesn’t pop out too fast and drop during a strong contraction and provide head/neck neutral alignment, support the head.

Answer 9

continue to support the head as it rotates.
again, be careful with the baby’s eyes and soft skull part.

wipe the newborns head and nose with a soft towel as it comes out. carefully guide the head down to help the shoulder out.

check if the umbilical cord is around the neck, get it free if its there.
if u can’t get it unwrapped cuz its too tight, u gotta cut it (use two clamps, cut in middle, carefully). the baby has to be delivered quickly if cut cuz thats the babys oxygen supply at that point cut off.

always suppport the head with one hand as the baby is coming out.

lower the head gently to get the upper shoulder out, and then raise it back up for the lower shoulder.

do not pull the fetus.

once the shoulders are out, the babys body comes out easily.

the baby will be slippery.

record babys time for birth cert.

(have assistant help with monitoring of mother)

Question 10

emergency situations in delivery of a fetus:

Answer 10

mom bleeds more than 500 mL bl BEFORE delivery of the placenta

moms placenta does not deliver after 30 mins

significant bleeding AFTER delivery of placenta

Question 11

golden minute:

Answer 11

first minute after a newborns birth - assess if the baby needs resuscitation.

4 initial steps (do in 30 secs):
airway positioning and suctioning if needed

drying (wipe down body with towel)

Warming (can place on moms chest)

tactile simulation (can be while warming baby with the towel)

if after 30 secs baby doesn’t have good tone adn adequate ventilation, use a bag mask device

normal responses are newborn begins breathing and cryign in 30 secs after birth, and HR is 100 beats/min or higher

*if the baby is lying down while u dry with towel, put the blanket/towel under the shoulders for neck alignment (that big head!)

suctioning of mouth/nose excretions might be necessary (sides of the mouth, not deep down middle)

can also rub the back, flick the feet to help stimulate

Question 12

newborn resuscitation:

Answer 12

for chest compressions use hand circling technique with two EMTs, and bag mask ventilation (make sure to ventilate during a pause after every THIRD compression, avoid compression and ventilation at same time this is disruptive.

3:1 compression to ventilation ratio (3 compressions, one ventilate at the pause)
this makes 120 “actions” in a minute

Question 13

APGAR:

Answer 13

highest possible score is 10. the ‘best’ good score for each of the 5 tests is 2 each. scores are either 0 (absent), 1 (so-so), and 2 (great).

measures all of Appearance, Pulse, Grimace, Activity, Respirations

do APGAR at one minute and 5 mins

if resuscitation is required, delay the APGAR.

Question 14

breech delivery:

Answer 14

buttocks delivered first. these deliveries are usually slow so, should be time to transport and delay delivery - but if the but is already crowning, the delivery has started.

puts fetus at great risk for trauma

heads almost always facedown w/this birth, you need to perform a life saving procedure , make a “V” with gloved fingers and put in vagina to keep the vagina walls from compressing fetus’s airway.

Question 15

limb presentation w/delivery:

Answer 15

can NOT successfully deliver the baby with this presentation.

give mom O2, do not push leg back or pull
put momma on her back with head down, pelvis up, to postpone delivery

Question 16

when umbilical cord presents before the baby this is:

Answer 16

prolapsed umbil cord

dangerous, the babys head could be pushing pressure down on the cord (cutting off babys o2 supply)

leave it be, transport , put mommas feet up about a foot, hips on pillow, OR on her knee-chest position (anythig to keep babys head off the cord)

you can also place gloved fingers in vagina to ensure baby’s head isn’t cutting off the cord supply

Question 17

effects of drug abuse of a pregnant woman on her baby:

Answer 17

effects of addiction on the baby:

premature birth
low birth weight
severe resp distress

fetal alcohol syndrome for fetuses exposed to alcoholic moms

Question 18

preggos woman having vag bleeding, diaphoretic, tachycardiac, hypotensive, put the ptnt in what position:

Answer 18

lateral recumbent on her LFT side

Question 19

amniotic fluid:

Answer 19

protects and insulates the babe

Question 20

upon delivery of a baby’s head, and its face is encased in the unruptured amniotic sac, you should:

Answer was NOT leave it alone and transport

the book however, goes on about popping this ONLY if the baby’s head is not in the way

but this question isn’t clear, it seems the baby’s head is in the way.

Answer 20

so the answer must be to rupture the sac and suction the babes nose, mouth

Question 21

children younger than ___ years, you don’t check BP

Answer 21

3

Question 22

components of PAT triangle assessment

Answer 22

appearance
work of breathing
circulation to skin

Question 23

which is true regarding pre-school age children:

not fearful of separation/pain
realize injs are not punishment
can identify painful areas when questioned

Answer 23

can identify painful areas when questioned