Maternity Nursing Q 24
When the baby’s head is out, the immediate action of the nurse is
A. Cut the umbilical cord
B. Wipe the baby’s face and suction mouth first
C. Check if there is a cord coiled around the neck
D. Deliver the anterior shoulder
Correct Answer: C. Check if there is a cord coiled around the neck.
The nurse should check if there is a cord coil because the baby will not be delivered safely if the cord is coiled around its neck. Normally the umbilical cord coils to the left. Regardless of its origin, umbilical coiling appears to confer turgor to the umbilical unit, producing a cord that is strong but flexible. The role of umbilical cord coiling is not clear; nonetheless, it is thought to play a role in protecting the umbilical cord from external forces such as tension, pressure, stretching or entanglement.
Option A: The World Health Organization currently recommends clamping the umbilical cord between one and three minutes after birth, “for improved maternal and infant health and nutrition outcomes,” while the American College of Obstetricians and Gynecologists recommends clamping within 30 to 60 seconds.
Option B: Wiping off the face should be done seconds after you have ensured that there is no cord coil but suctioning of the nose should be done after the mouth because the baby is a “nasal obligate” breather. If the nose is suctioned first before the mouth, the mucus plugging the mouth can be aspirated by the baby.
Option D: Anterior shoulder in obstetrics refers to that shoulder of the fetus that faces the pubic symphysis of the mother during delivery. Depending upon the original position of the fetus, either the left or the right shoulder can be the anterior shoulder.