Which medication is commonly used to treat juvenile idiopathic arthritis (JIA)?

Choice A rationale

The Apgar score is a rapid assessment tool utilized at 1 and 5 minutes after birth to evaluate a newborn's physiological adjustment to extrauterine life. It assesses five critical parameters that reflect the newborn's cardiorespiratory and neurological status.

Choice B rationale

While there are five components in the Apgar score (Appearance, Pulse, Grimace, Activity, Respiration), each component can be scored 0, 1, or 2, not just 1 or 2. This scoring system allows for a more nuanced assessment of the newborn's condition.

Choice C rationale

It is not unexpected for a newborn to receive a score of 1 for color, especially at the 1-minute Apgar, as acrocyanosis (bluish discoloration of the hands and feet) is common due to immature peripheral circulation. This finding alone does not typically indicate significant distress.

Choice D rationale

Resuscitation interventions should be initiated based on the newborn's immediate clinical assessment, regardless of the Apgar score. If a newborn exhibits signs of distress, such as apnea or bradycardia, resuscitation should commence promptly without waiting for the 1-minute Apgar score.

Choice A rationale

Continuous labor support, often provided by doulas or trained birth companions, significantly reduces perceived pain intensity. This is mediated by physiological mechanisms like decreased sympathetic nervous system activation, leading to lower circulating catecholamines, and increased release of endogenous opioids, which naturally mitigate pain signals by binding to mu-opioid receptors in the central nervous system.

Choice B rationale

The presence of a supportive individual during labor fosters a sense of security and control for the birthing person. This psychosocial benefit contributes to a more positive subjective experience, reducing feelings of isolation and fear. Emotional support can lead to increased coping efficacy and a greater sense of satisfaction with the birthing process.

Choice C rationale

Research indicates that continuous labor support is associated with better fetal outcomes, including a reduced incidence of fetal distress and fewer low Apgar scores. This may be attributed to decreased maternal stress hormone levels, which can negatively impact uterine blood flow and oxygen delivery to the fetus, thus promoting a more stable intrauterine environment.

Choice D rationale

Improved client outcomes encompass a range of positive effects, such as reduced rates of medical interventions like epidural anesthesia and cesarean sections. The presence of support often empowers the client to labor more effectively, leading to shorter labor durations and a decreased need for pharmacological pain management, contributing to overall maternal well-being.

Choice E rationale

Increased anxiety is an incorrect benefit. Scientific evidence consistently demonstrates that continuous support during labor actually reduces maternal anxiety and stress levels. The presence of a supportive individual provides emotional reassurance and practical assistance, which helps to alleviate fear and promote a sense of calm during the birthing process.