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13. A 25-year -old woman delivered her baby at a health center . You attempt to deliver the placenta actively with intramuscular oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best : intervention at this level? ( Hidar 2012/December 2019 ) A. Put her on IV fluid, give ampicilline 2 g IV , refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal

Pergunta

13. A 25-year -old woman delivered her baby at a health center . You attempt to deliver
the placenta actively with intramuscular oxytocin but it was not successful. She
starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite
your attempt, the placenta neither expels out nor it shows sign of separation.
What is your best : intervention at this level? ( Hidar 2012/December 2019 )
A. Put her on IV fluid, give ampicilline 2 g IV , refer her
B. Change oxytocin with ergometrine and attempt CCT once again
C. Wait the placenta for additional 20 minutes, attempt manual removal
D. Give sedative agent and prophylactic antibiotics, attempt manual removal

13. A 25-year -old woman delivered her baby at a health center . You attempt to deliver the placenta actively with intramuscular oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best : intervention at this level? ( Hidar 2012/December 2019 ) A. Put her on IV fluid, give ampicilline 2 g IV , refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal

Solução

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BeatrizVeterano · Tutor por 11 anos

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The correct answer is B. Change oxytocin with ergometrine and attempt CC"I once again.<br /><br />In this scenario, the woman is experiencing heavy bleeding and the placenta is not delivering or showing signs of separation. The best intervention at this level would be to change the oxytocin with ergometrine and attempt controlled cord traction (CC"I) once again.<br /><br />Ergometrine is a medication that can help stimulate uterine contractions and promote the expulsion of the placenta. Controlled cord traction is a technique used to assist in the delivery of the placenta by applying gentle traction on the umbilical cord while applying counter-pressure to the uterus.<br /><br />By changing the oxytocin with ergometrine and attempting CC"I once again, you are providing the woman with the best chance of delivering the placenta and preventing further bleeding. This intervention is appropriate given the time elapsed since delivery and the lack of success with oxytocin alone.<br /><br />Option A is not the best choice as it involves giving ampicillin, which is an antibiotic and not indicated in this situation. Referring the woman without attempting further interventions may not be the most appropriate course of action.<br /><br />Option C suggests waiting for an additional 20 minutes and attempting manual removal, which may be considered if other interventions have failed. However, changing the oxytocin with ergometrine and attempting CC"I once again is the most appropriate initial intervention.<br /><br />Option D suggests giving a sedative agent and prophylactic antibiotics, which are not indicated in this scenario. Attempting manual removal without other interventions may not be the best course of action.<br /><br />Therefore, the best intervention at this level is to change the oxytocin with ergometrine and attempt CC"I once again.
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