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GOODLUCK
,Which of the following techniques represents the MOST appropriate method of
opening the airway of an infant with no suspected neck injury?
• A:Perform the technique as you would for an older child or adult.
• B:Lift up the chin and hyperextend the neck.
• C:Tilt the head back without hyperextending the neck.
• D:Gently lift the chin while maintaining slight flexion of the neck.
You selected C; This is correct!
Reason:Opening the airway in infants and small children involves keeping the head in a
neutral or slightly extended position. Because the occipital region (back of the head) of
the skull is proportionately larger in infants and small children when compared to an
adult, hyperextension of the neck can result in a reverse flexion of the neck and
subsequent airway blockage.
Following delivery of a newborn, the 21-year-old mother is experiencing mild
vaginal bleeding. You note that her heart rate has increased from 90 to 120
beats/min and she is diaphoretic. In addition to administering high-flow oxygen,
treatment should include:
• A:uterine massage and transport.
• B:internal vaginal pads and treating for shock during transport.
• C:treating for shock and uterine massage during transport.
• D:placing her on her left side and transport.
You selected C; This is correct!
,Reason:Blood loss of up to 500 mL within the first 24 hours after delivery is considered
normal and usually is well tolerated by the mother. However, any bleeding, regardless
of the severity, with accompanying signs of shock, must be treated accordingly. In this
case, you should apply high-flow oxygen, treat the patient for shock by elevating her
legs (if allowed by local protocol) and providing warmth, and provide rapid transport to
the hospital while massaging the uterine fundus en route. Placing the mother on her left
side is appropriate before she delivers and prevents supine hypotensive syndrome.
Dressings should never be packed into the vagina; placing pads into the vagina
increases the risk for maternal infection.
Which of the following signs is MOST indicative of inadequate breathing in an
infant?
• A:Heart rate of 130 beats/min
• B:Sunken fontanelles
• C:Expiratory grunting
• D:Abdominal breathing
You selected C; This is correct!
Reason:Expiratory grunting in an infant or a child with a respiratory problem is an
ominous sign; it indicates impending respiratory arrest. Grunting represents the child's
attempt to maintain oxygen reserve in the lungs. Sunken fontanelles, the soft spots on
the infant's skull, indicate dehydration. Because infants have a protuberant abdomen
and rely heavily on their diaphragm to breathe, their abdomen appears to move more
than their chest during breathing; this is a normal finding and is why infants are often
, referred to as "belly breathers." An infant or a child with inadequate breathing may be
tachycardic at first; however, as hypoxia becomes more severe, bradycardia often
occurs. Bradycardia in an infant or a child with a respiratory problem indicates
impending cardiopulmonary arrest.
In contrast to the contractions associated with true labor, Braxton-Hicks
contractions:
• A:consistently become stronger and are not alleviated by changing position.
• B:may be intensified by activity and are accompanied by a pink discharge.
• C:do not increase in intensity and are alleviated by a change in position.
• D:generally follow rupture of the amniotic sac and occur with regularity.
You selected C; This is correct!
Reason:During pregnancy, the mother may experience false labor, or Braxton-Hicks
contractions, in which there are contractions but they do not represent true labor. Unlike
true labor contractions, Braxton-Hicks contractions do not increase in intensity, are not
regular, and are typically alleviated by activity or a change in position. The contractions
associated with true labor, once they begin, consistently get stronger and closer
together and are regular; a change in position does not relieve the contractions. True
labor is also commonly followed by, or in some cases preceded by, a rupture of the
amniotic sac (bag of waters) and a pink or red vaginal discharge that is generally
accompanied by mucus (bloody show).
A 44-year-old male experienced burns to his anterior trunk and both arms. He is
conscious and alert, but is in extreme pain. Assessment of the burns reveals