Nokea
You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:
- A. reassess the newborn every 5 minutes and transport after the placenta delivers.
- B. keep the newborn warm, give oxygen to the mother if needed, and transport.
- C. massage the lower part of the mother's uterus until the placenta delivers.
- D. give the newborn high-flow oxygen via a non-rebreathing mask and transport.
Correct Answer: B
Rationale: In this scenario, the appropriate action is to keep the newborn warm, ensure the mother receives oxygen if needed, and prepare for transport. The newborn is showing signs of central cyanosis (hands and feet being cyanotic), which can be due to various reasons, including inadequate oxygenation. Therefore, ensuring warmth and possible oxygen to the mother are important. Additionally, monitoring both the mother and baby during transport is crucial for their well-being.
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You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:
- A. begin positive-pressure ventilations and reassess the child.
- B. lower the extremities and reassess the child.
- C. listen to the lungs with a stethoscope for abnormal breath sounds.
- D. insert a nasopharyngeal airway and increase the oxygen flow.
Correct Answer: B
Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.
Which of the following signs is MOST indicative of inadequate breathing in an infant?
- A. Sunken fontanelles
- B. Heart rate of 130 beats/min
- C. Expiratory grunting
- D. Abdominal breathing
Correct Answer: C
Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.
A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing:
- A. a condition unrelated to pregnancy.
- B. gestational diabetes.
- C. a hypertensive emergency.
- D. preeclampsia.
Correct Answer: D
Rationale: The symptoms of swollen ankles, tight rings, and elevated blood pressure in a pregnant woman at 22 weeks gestation are concerning for preeclampsia. Preeclampsia is characterized by high blood pressure and signs of organ damage, commonly seen with symptoms such as swelling (edema) and protein in the urine. It is crucial to monitor and manage preeclampsia promptly as it can lead to severe complications for both the mother and the baby.
You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?
- A. Inform the parents of your suspicions.
- B. Transport the child to the hospital regardless of the parents' wishes.
- C. Call the police and have the parents arrested.
- D. Advise the parents that the child needs to be transported.
Correct Answer: D
Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported for further evaluation and care is the appropriate initial step. This ensures that the child receives necessary medical attention while also addressing the suspicion of abuse through proper channels. It is essential to involve appropriate authorities and follow established procedures to protect the child and investigate any potential abuse further.
You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?
- A. Poison oak exposure
- B. Allergic reaction
- C. Heat illness
- D. Acute asthma attack
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.