Fundamentals of Nursing

(d) Use of clean instrument as hospital has many sources of infection

Second-stage care includes monitoring uterine contractions, placing the mother in the delivery position and caring for the perineum. Option D is the exception: because infection risk is high, sterile (not merely clean) instruments must be used for delivery.

Suicide

Suicide is the intentional or voluntary act of ending one's own life.

Keep her on head low position and check FHR

Cord prolapse is an obstetric emergency. The immediate first action is to relieve pressure on the cord by placing the woman in a head-low (Trendelenburg or knee-chest) position and to check the fetal heart rate to assess fetal wellbeing. Vacuum delivery and LSCS are later definitive measures, and "shouting for help" alone is not a clinical action.

A gush of blood appears from the vagina.

The classic signs of placental separation are: a sudden gush of blood from the vagina, lengthening of the umbilical cord, and the uterus becoming smaller, firmer and globular as it rises in the abdomen. Severe abdominal pain, fever and audible FHS are not signs of placental separation.

Echopraxia

Echopraxia is the involuntary imitation of another person's movements or actions. (Echolalia is imitation of speech, neologism is coining new words, and tangentiality is a thought disorder where replies go off-topic.)

6

Exclusive breastfeeding — only breast milk, with no water, other liquids or foods — is recommended for the first 6 months (180 days) of life. From 6 months onward, complementary foods are started along with continued breastfeeding up to 2 years or beyond.

Walk erect

At 12–15 months, the major gross motor milestone is independent walking (walking erect without support). Climbing stairs, using a spoon, and saying simple words are later or finer milestones.

Ignore till the baby do not harm themselves or others

Attention-seeking behaviour in children is best managed by planned ignoring — withholding the attention (scolding, coaxing, or giving in) that the child is seeking, while ensuring the child stays safe. Punishing or giving sweets/food reinforces the behaviour, and completely avoiding the child's genuine needs is not appropriate; attention should be given for positive behaviour instead.

Three vessels: one vein and two arteries

A normal umbilical cord contains three vessels — two umbilical arteries (carrying deoxygenated blood from the fetus to the placenta) and one umbilical vein (carrying oxygenated blood from the placenta to the fetus). Any deviation from this, such as a two-vessel cord, is an abnormality that must be noted during newborn assessment.

First year

A healthy baby typically doubles its birth weight by about 5–6 months and triples it by the end of the first year (around 12 months).

Working together with the corrective feedback

Supervision is a management process in which the supervisor works together with staff, guides them, and provides corrective feedback to improve performance and achieve organisational goals. Pointing out mistakes or punishing staff are only negative aspects and do not define supervision as a whole.

Motivation

Motivation is the internal drive or willingness that makes a person put forth effort and persist in the pursuit of goals. Influencing is about changing others' behaviour, orientation is about direction/induction, and evaluation is about judging performance — none of these refer to the willingness to exert effort.

Planned punishment for staffs

A staff assignment plan (duty roster) of a ward records who is assigned where and when — it includes the list of staff with the assignee's signature, the date, time and place of allocation, and coverage of all three shifts (morning, evening, night). Planning punishment for staff is a disciplinary matter and has no place in a duty allocation plan.

Assess injured patients to prioritize care

Triage is the process of quickly assessing and sorting mass-casualty victims according to the severity of injury and urgency of need, so that limited resources are used first for those who will benefit most. It does not mean treating all casualties or controlling visitor entry.

Observation

Observation is the method by which a supervisor directly watches the staff at work and can assess their performance immediately, on the spot. Anecdotal report, ranking and checklist are other performance-appraisal techniques, but they do not give an immediate, first-hand picture of performance in the same way.