The usage of feverfew has not been linked to any severe negative effects. Consequences can include bloating, digestive issues, and nausea.
What negative consequences does Tanacetum parthenium (feverfew) have?If dried leaves are consumed, the common adverse effects of Tanacetum parthenium are mouth ulcers and sore tongue. It may result in fast heartbeats, lightheadedness, anxiety, restlessness, nausea, diarrhea, and abdominal pain.
The liver is affected by feverfew?Consult your healthcare practitioner. The liver's ability to break down some drugs more quickly may be slowed by feverfew. Feverfew might intensify the effects and negative side effects of some drugs that are metabolized by the liver.
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the nurse is preparing to administer an intramuscular injection of vitamin k to a newborn. the nurse will ensure the amount per injection is within which range?
The nurse is preparing to administer an intramuscular injection of vitamin k to a newborn. the nurse will ensure the amount per injection is within 0.5 mg to 1.0 mg.
Why do newborn get vitamin k shot?
We can get vitamin K from foods such as green leafy vegetables, and lettuce. Vitamin K is essential for wounds to clot and heal, otherwise, bleeding would not stop in an event an individual sustains injury.
A newborn also needs vitamin K as they don't have the required amount of the vitamin. Few hours after being born, newborn should be administered a recommended dose of vitamin K so as to protect and prevent them from developing Vitamin K deficiency bleeding where their bleeding don't clot and might lead to death if bleeding becomes severe.
In summary, the nurse should give an intramuscular injection of vitamin k, within the range of 0.5 mg to 1.0 mg to all new born. This injection can be given on the thigh of the new born
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what is priority for the nurse to do when transporting a newborn back to the mother after completing the hearing test?
Answer: The nurse needs to compare the identification bracelets prior to leaving the newborn with the mother.
the physician orders a transfusion with packed red blood cells (rbcs) for a client hospitalized with severe iron deficiency anemia. when blood is administered, what is the most important action the nurse can take to prevent a transfusion reaction?
The most crucial step a nurse may take to prevent a transfusion response is to confirm the patient's identification when blood is provided per hospital policy. Iron deficiency is frequently brought on by a poor diet, persistent bleeding, pregnancy, and hard exercise.
It is possible to avoid acute hemolytic transfusion responses. Most hemolytic transfusion responses are caused by improper identification. One cannot overstate the importance of carefully marking blood samples and components and correctly identifying the recipient. The nurse's duty is to make sure the right blood component is transfused to the right patient.
A person may have an iron deficiency if they are unable to absorb iron. It is possible to treat iron deficiency by introducing foods high in iron to the diet.
Thus, we may conclude that verifying the patient's identification when blood is given in accordance with hospital protocol is the most important action a nurse can do to prevent a transfusion reaction.
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Your question is incomplete. Please find the complete question below.
Question: The physician orders a transfusion with packed red blood cells (RBCs) for a patient hospitalized with severe iron deficiency anemia. When blood is administered, what is the most important action the nurse can take to prevent a transfusion reaction?
A. Premedicate the patient with acetaminophen (Tylenol)
B. Administer the blood as soon as it arrives
C. Verify the patient identification according to hospital policy
D. Stay with the patient during the first 15 minutes of the transfusion
the nurse is caring for a client who has just returned to the postsurgical unit following renal surgery. when assessing the client's output from surgical drains, the nurse should physically assess what parameter(s)? select all that apply.
The client's output from surgical drains, the nurse should physically assess what parameter(s) are The dreams for a affected person with persistent renal failure include: Maintenance of best frame weight with out extra fluid. Maintenance of good enough dietary intake.
Renal Care Nurse gives expert nursing care to sufferers having remedy for renal impairments. You would possibly paintings with sufferers on dialysis or who're present process a kidney transplant. Renal Care Nurses would possibly screen sufferers' kidney feature and investigate associated symptoms.
During remedy, nurses put together fluids, regulate fluid settings to offer fluid balance, put together electrolyte additives, screen acid base and electrolyte levels, screen affected person and machine "essential signs," and, while necessary, diagnose circuit clotting and carry out a disconnection of the EC from the affected person.
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the clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). what are the general contraindications associated with receiving a live virus vaccine? select all that apply.
The general contraindications associated with receiving a live virus vaccine include the child having a previous anaphylactic reaction to the vaccine and the child having a disorder that caused a severely deficient immune system (Options b and e).
What is an anaphylactic reaction to a vaccine?An anaphylactic reaction to a vaccine refers to any adverse reaction as a consequence of some of its components which generally involve the presence of inactivated proteins of the pathogenic microorganism.
Therefore, with this data, we can see that an anaphylactic reaction to a vaccine may be harmful and therefore it should have into account during administration.
Complete question:
The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply.
a) The child has symptoms of a cold.
b) The child had a previous anaphylactic reaction to the vaccine.
c) The mother reports that the child is having intermittent episodes of diarrhea.
d) The mother reports that the child has not had an appetite and has been fussy.
e) The child has a disorder that caused a severely deficient immune system.
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a client has difficulty swallowing secondary to multiple sclerosis. the otr manually assists the client in performing a chin tuck prior to the client swallowing a bite of food. what is the primary benefit of facilitating this position?
The primary benefit of facilitating the given position is c)To prevent food and secretions from entering the larynx below the level of the vocal cords. So, the correct option is c.
Swallowing can be difficult if you also have multiple sclerosis (MS). Because the condition affects the muscle strength and motor coordination—both of which are actually involved in swallowing—you may experience discomfort or distress while eating or drinking.
Specific symptoms of dysphagia or Swallowing can vary and may include:
Excessive saliva or droolingDifficulty chewingInability to move food to the back of your mouthHence, the correct option is c.
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an angry client has just thrown a chair across the room and is racing to pick up another chair to throw. the most appropriate action by the nurse would be what?
Anger can be managed in a healthy and appropriate way by verbally expressing one's sentiments. Isolation and catharsis might make people feel more enraged and resentful.
Which of the following concerns nurses should be mindful of while dealing with angry, hostile, or violent clients?The practise of assertive communication and conflict resolution by nurses requires them to be conscious of their own thoughts regarding anger.
What should you do if a patient is ranting and upset with you?Keep your composure and act professionally if a patient becomes so enraged as to verbally abuse you. Keep your distance from the patient and hold off responding until the verbal assault is ended. When it does, call and speak softly.
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lsd psilocybin and morning glory seeds are hallucinogens that are sometimes referred to as indoles are chemically similar to
LSD, psilocybin, and morning glory seeds are hallucinogens often referred to as indoles. These types of drugs are chemically similar to: Serotonin.
What is serotonin?Serotonin, which has the chemical structure of 5-hydroxytryptamine, is a monoamine neurotransmitter that is responsible for acting as a mood stabilizer. It is chemically similar to the indoles as it has an electron-rich aromatic indole ring. LSD, psilocybin, and morning glory seeds also contain the indole substructure. The effects of the indoles are also similar to serotonin. For example, LSD alters our minds by targeting the receptor for serotonin in our brains.
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when assessing a client prescribed hemodialysis, the nurse notes the client's blood pressure is 140/82 mm hg, heart rate is 82 beats/min, and respirations are 12 breaths/min. the nurse also notes a continuous vibration over the client's fistula. what is the appropriate action by the nurse?
The nurse notes the client's blood pressure is 140/82 mm hg, heart rate is 82 beats/min with a continuous vibration over the client's fistula being observed then the appropriate action is to document the reading and monitor the blood flow.
Who is a Nurse?This is referred to as a healthcare professional who takes care of the sick and ensures that adequate recovery is achieved so as to reduce the risk of complications.
In a situation where the blood pressure is normal and there is continuous vibration over the client's fistula being observed then the appropriate action is to document the reading and monitor the blood flow.
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the nurse is performing a physical assessment of a 3-year-old girl. what finding would be a concern for the nurse?
The 3-year-old female will most certainly have a webbed neck and small stature, according to the nurse.Turner syndrome is a disorder that primarily affects females and is brought on by an X chromosome that is absent or partially deleted.
Turner syndrome can result in a wide range of physical and developmental problems, such as short stature, inability of the ovaries to mature, and heart defects.The prognosis, or outlook, for women with Turner syndrome (TS), is often positive.The life expectancy of women with Turner syndrome may be slightly decreased, despite the fact that they should anticipate leading essentially normal lives provided their abnormalities are identified and addressed.A 3-year-old customer is having a physical examination done by the nurse. The kid starts kicking and crying during the evaluation. This child is behaving out, according to the nurse.In an organised examination known as a physical assessment, the nurse gets a full understanding of the patient. A physical assessment uses the four procedures of inspection, palpation, percussion, and auscultation.Important vital signs including temperature, blood pressure, and heart rate are measured during a physical examination.
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a deficiency of thiamin that affects the cardiovascular, muscular, nervous, and gastrointestinal systems is called .
Beriberi is a thiamin deficit that impacts the gastrointestinal, neurological, muscular, and cardiovascular systems.
What is the benefit of thiamin?One of the B vitamins is thiamine, sometimes referred to as micronutrients or vitamin B1. To maintain a healthy neurological system, thiamine aids in the conversion of food into energy. Thiamine cannot be produced by your body. But typically, you can receive what you need from eating.
What results from thiamin deficiency?They include lethargy, irritability, amnesia, decreased appetite, trouble sleeping, abdominal discomfort, and weight loss. Problems with the heart, brains, and nerves may eventually show up as a result of a severe thiamin deficiency (beriberi). Various beriberi strains cause different symptoms.
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a client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. the client has not been discharged by the health care provider. the nurse finds that the client has dressed and is ready to go. what should the nurse's action be in this situation?
The nurse should call the nursing supervisor and inform her about the situation.
With their oversight of patient-care operations, assignment and supervision of staff nurses, and identification and implementation of quality improvements, nursing supervisors serve as a vital connection between hospital management and clinical care.
The most significant duties and responsibilities of a Nursing Supervisor are listed in this sample job description. This job description template for a nursing supervisor is editable and prepared for job boards. Use this sample job description for a nursing supervisor to save time, find eligible applicants, and select the top prospects.
A nursing supervisor is a healthcare professional with expertise in leading and managing a nursing team to establish and uphold a high standard of patient care.
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a patient diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. the nurse would expect a change to which medication?
Mood stabilisers, including lithium and anticonvulsants such as carbamazepine are a much expected change in medication of schizophrenia.
What is schizophrenia?
Schizophrenia is a severe mental illness in which reality is perceived by sufferers strangely. Schizophrenia may include hallucinations, delusions, and severely irrational thinking and behaviour, which can make it difficult to go about daily activities and be incapacitating.
Schizophrenia patients require ongoing care. Early intervention may help keep symptoms under control before major issues arise and may enhance the prognosis in the long run.
Over time, symptoms might change in nature and degree, with periods when they get worse and times when they go away. Some symptoms could be present at all times.
Schizophrenia symptoms in men often appear between the ages of 20 and 30. The typical onset of symptoms in women is in their late 20s. Schizophrenia is rarely diagnosed in children and even less frequently in people over the age of 45.
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the nurse is caring for a patient in a shock state. after reviewing the daily orders for the patient, the nurse notes that electrolyte levels have not been ordered. for which critical electrolyte imbalance should the nurse closely monitor this patient?
Hypokalemia is a critical electrolyte imbalance should the nurse closely monitor this patient.
A state of cellular and tissue hypoxia known as a shock is caused by either inadequate oxygen utilization, decreased oxygen delivery, increased oxygen consumption, or a combination of these processes.
Hypokalemia is a result of the body compensating for renal hypoperfusion by initiating the release of aldosterone. it is likely to result from the body compensating for renal hypoperfusion and initiating the renin-angiotensin-aldosterone system. This results in water retention in exchange for potassium loss, which causes hypokalemia. Hypokalemia can cause a variety of other problems in the body, so the nurse should monitor this condition closely so that early intervention can take place.
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what is the main benefit of interval training? select one: a. compared to continuous exercise, it allows for higher exercise intensities. b. it requires a lot of specialized equipment. c. it improves speed by stretching muscles immediately prior to a ballistic movement, like jumping. d. it introduces variety into a training program by combining many modes of exercise.
The main benefit of interval training is : compared to continuous exercise, it allows for higher exercise intensities.
A kind of exercise known as interval training comprises a sequence of high-intensity sessions separated by rest or relaxation intervals. While the recovery intervals entail low-intensity activity, the high-intensity phases are often at or near anaerobic exercise.
Exercises that last anything from a few seconds to several minutes are done repeatedly as part of interval training. You engage in a specified amount of time or distance of work (the work interval) and then a low-intensity rest phase during each interval (recovery interval).
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a nurse is caring for a client diagnosed with ovarian cancer. diagnostic testing reveals that the cancer has spread outside the pelvis. the client has previously undergone a right oophorectomy and received chemotherapy. the client now wants palliative care instead of aggressive therapy. the nurse determines that the care plan's priority nursing diagnosis should be:
The client wants palliative care instead of aggressive therapy therefore the nurse determines that the care plan's priority nursing diagnosis should be acute pain and is denoted as option D.
Who is a Nurse?This is referred to as a healthcare professional who takes care of the sick and ensures that adequate recovery is achieved so as to reduce the risk of complications.
In a patient who has undergone cancer treatment and wants to choose the type of therapy to do then the factor which should be prioritized is acute pain. This is because it signifies that a certain amount of force which could worsen the condition is being exerted.
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The options are:
a) Noncompliance.
b) Impaired home maintenance.
c) Knowledge deficit: Chemotherapy.
d) Acute pain.
which intervention would be most important when caring for the client with breech presentation confirmed by ultrasound?
Keeping an eye on the state of the mother and fetus is most important when caring for a client with breech presentation confirmed by ultrasound.
A fetus lying in a longitudinal position with the buttocks or feet closest to the cervix is referred to as breech presentation. Prematurity, uterine malformations or fibroids, polyhydramnios, placenta previa, fetal abnormalities (such as CNS malformations, neck masses, and aneuploidy), and multiple gestations are all risk factors for breech presentation. If the fetal heart is auscultated higher on the mother's abdomen, a breech presentation can be suspected. As a result, it's critical to keep an eye on both the mother and the fetus.
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the ____ is composed of the external shaft and glans and the internal crura.
The cli-toris is composed of the external shaft and glans and the internal crura.
The cli-toris is a feminine reproductive organ gift in mammals, ostriches and a restricted range of different animals. In humans, the visible portion – the glans – is at the front junction of the labium (inner lips), on top of the gap of the channel.
Crura are huge crossed fibres, known as limb cerebri, kind the center neural structure peduncle and function the bridge that connects every neural structure with the alternative half the neural structure. The crura arise from the anterior surface of the body part bone bodies and therefore the anterior longitudinal ligament from L1 through L3 and insert on the central connective tissue. It's longer on the proper facet.
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a nurse is assessing a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. which finding indicates a potential problem?
The potential problem from which the patient might be suffering from due to full thickness burns could be that urine output of less than 20 ml/hour in a client with burns indicates a deficient fluid volume.
Deep partial thickness burns are the second degree burns in a patient which are mainly in the topmost layer that is the epidermis and the lower layer which is the dermal layer. Full thickness burns are more painful as it damages all the underlying layer extending from the topmost layer. It also damages the nerves present beneath the skin. A patient who is suffering from such burns might be unable to get proper rectal temperature and may suffer from fluid deficiency because the related internal organ system could be damaged which would make it difficult for the body to retain proper fluid quantity.
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Refer to complete question for reference below:
A nurse is assessing a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. Which finding indicates a potential problem?
A. Partial pressure of arterial oxygen (PaO2) value of 80 mm Hg
B. Urine output of 20 ml/hour
C. White pulmonary secretions
D. Rectal temperature of 100.6° F (38° C)
the nurse is calculating a client's fluid intake for a 24-hour period. the client is on hemodialysis and urinates about 100 ml a day. the client is on a fluid restriction of 750 ml per day. the client drank 4 oz of tea and 4 oz of orange juice for breakfast, 4 oz of water at 1200 and at 1700 when taking his medications, and 4 oz of iced tea at lunch and supper. at 0800 and again at 1400, the client received his intravenous antibiotics in 50 ml of normal saline. how many ml of fluid does the client have left to drink for the day? fill in the blank.
Based on the difference between the volume of fluid intake and fluid output, the volume of fluid left to take is 30 mL.
What is fluid restriction?Fluid restriction refers to a situation where an individual is given medical advice on the volume of fluid that he or she can in a day.
The volume of fluid the client has left to take is calculated as follows:
The volume of tea taken is 4 * 30 = 120
The volume of orange juice taken is 4 * 30 = 120 mL
The volume of water taken at 12:00 is 4 * 30 = 120 mL
The volume of water at 17:00 is 4 * 30 = 120 mL
The volume of ice tea taken at lunch is 4 * 30 = 120 mL
The volume of ice tea taken at supper is 4 * 30 = 120 mL
The volume of intravenous antibiotics at 08:00 & 14:00 is 50 + 50 = 100 mL
Total intake volume of fluid intake = 820 mL
Urine output = 100 mL
The difference between the volume of fluid intake and fluid output is 820 - 100 = 720 mL
The volume of fluid left to take = 750 - 720
The volume of fluid left to take = 30 mL
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development team wants to gain full observability into the health of their applications and instances in order to provide the best service level to users of their applications. which services can help them monitor the health of their applications and instances? (choose 3)
The services that can help them monitor the health of their applications and instances are
A.route 53
B.Elastic Load Balancing
C.Elastic Beanstalk
A.route 53
route 53 can be used to configure DNS fitness exams to path visitors to wholesome endpoints or to monitor the health of your applications.
B.Elastic Load Balancing
Load balancers monitor the fitness of EC2 instances and path the traffic to most effective times which are in a healthful country.
C.Elastic Beanstalk
Elastic Beanstalk monitors utility fitness via a fitness dashboard.
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which response would the nurse make to the overstressed parent of a child with a tentative diagnosis of attention-deficit/hyperactivity disorder (adhd) who insists on medication for the child
"Having to deal with your child's behavior must be frustrating." -Admitting that it must be irritating helps parents express their emotions by acknowledging their suffering.
Inattention, impulsive conduct, and hyperactivity in varying degrees are the hallmarks of attention deficit hyperactivity disorder (ADHD), sometimes known as attention deficit disorder (ADD).
ADHD is "nature and nurture," meaning that both genetic and environmental factors play a role.
According to brain research on people with ADHD, dopamine transporter-1 is overexpressed and the dopamine receptor D4 (DRD4) receptor gene is defective (DAT1).
The DRD4 receptor modifies responses to and attention to one's environment via DA and NE.
There may not be enough interaction between the postsynaptic receptor and the dopamine transporter protein, or DAT1, which transports DA/NE into the presynaptic nerve terminal.
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A father requests information on how to care for his child with severe diaper rash. Which statement made by the child’s father indicates a need for additional teaching?
one potential medical treatment to stop cancer cell proliferation employs an inhibitor derived from human umbilical cord stem cells. in this exercise, you will compare two histograms to determine where in the cell cycle the inhibitor blocks the division of cancer cells.
The text in the question is actually a snippet of an article about glioblastoma (you can see the full details in the attachment). Based on the search, the question related to this article is:
"At what phase is the cell cycle arrested by an inhibitor?"The answer is that the treated glioblastoma cells were cultured with an inhibitor from umbilical cord stem cells, while the control cells were not.
What is glioblastoma?Glioblastoma is a deadly malignant type of cancer that can develop in the brain or spinal cord. Glioblastoma can develop at any age, although it is more common in older persons. It can aggravate nausea, headaches, vomiting, and seizures.
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which behaviors are expected of the nurse at the experienced informatics competency level? (select all that apply.)
One element of the nursing framework is data.that would be used first by the nurse.According to the American Nurses Association,I'll explain what nursing informatics is after is a field of study that combines nursing science.
Information science, computer science the control and dissemination of data, information,expertise and discernment in nursing practise".The connections between information, knowledge, and data The D IKW Pyramid demonstrates In the structure, data is placed first and is followed by information, wisdom, and knowledge. Each A step on the ladder is a component DATA: The foundation for information the framework's most basic components.• Information:- In a specific situation, data and context data has the meaning ascribed to it by context.to it. It is a collection of data that has been organised, structured, or analysed Understanding.LIFELONG LEARNING (option B) is the notion that the nurse who is presenting an in-service programme on nursing informatics competencies has to utilise to describe the requirement for computer fluency for nursing informatics competencies.
Learning new things is the definition of lifelong learning. It is a choice, individual learning process.Nursing informatics competencies heavily rely on computer proficiency, which is a lifelong learning endeavour. The following are two reasons why computer literacy is important.
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is tuberculin testing an example of in vivo serological test
Tuberculin testing is an example of in vivo serological test.
In vivo diagnosis of T.B. in goats is especially supported connective tissue liquid tests. different tests area unit evaluated so as to seek out tools to enhance designation of T.B. in goats. Serological tests together with connective tissue tests will maximize sensitivity. Serology tests check for the presence or level of specific antibodies within the blood.
Tuberculin testing, is procedure for the designation of T.B. infection by the introduction into the skin, typically by injection on the front surface of the forearm, of a second quantity of refined macromolecule spinoff (PPD) liquid.
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a client calls the primary health care provider's office to schedule an appointment because she has missed 2 menstrual cycles and has always been very regular. the client receives an appointment for the next day. the nurse should expect which findings to be present at this prenatal visit if the client is pregnant? select all that apply.
The nurse should expect the findings below to be present at this prenatal visit if the client is pregnant:
Positive pregnancy testChadwick's sign.What is Pregnancy?This is referred to as the period in which a fetus develops inside the uterus or womb of a female while nurses are referred to as healthcare professionals who specialize in taking care of the sick and infirmed and ensuring that adequate recovery is achieved.
Chadwick sign is referred to as an early sign of pregnancy which is characterized by a bluish discoloration of the cervix, vagina, and vulva and can be observed by the doctor.
Different types of test which indicates pregnancy such as detection of human chorionic gonadotropin is what will confirm if a woman is pregnant thereby making it the correct choice.
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why is a false positive more significant in hiv testing of patients than in screening donated blood for transfusions?
When a person receives HIV positive blood products, such as tissue or organs, HIV can be transmitted. To prevent this from happening, all of these products are tested before usage.The answer is true.
Additionally, since sterile, clean needles are used, it is impossible to contract HIV when giving blood. the response is accurate.Phlebotomists are the medical professionals in charge of drawing blood samples for testing; occasionally, biochemists will also draw blood, but only when necessary. Blood drawing is a skill that doctors and nurses have also been trained in, but the phlebotomist is the specialist in charge of this.It would be more prudent to choose patient B if you had to choose between the two.All viral replication in the HIV case takes place in lymphoid tissue. If a person who has recently received a blood transfusion and is experiencing blood loss is subsequently injected with fresh blood, it will put them at risk for a number of issues.
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the nurse is caring for an adult client who has developed a mild oral yeast infection following chemotherapy. what actions should the nurse encourage
The actions to be encouraged for a client who developed a mild oral yeast infection following chemotherapy should be:
Use a lip lubricant. Use dental floss every 24 hours. Rinse the mouth with normal saline.Chemotherapy is the chemical treatment for cancer where highly powerful chemicals are used for killing the cancer cells. These chemicals are therefore called anti-cancer drugs.
Dental floss is the dental tool used to remove the stuck food in between the teeth so as to prevent any infection or growth of bacteria. The floss is usually made of plastic or nylon material and is like a thread.
The given question is incomplete, the complete question is:
The nurse is caring for an adult client who has developed a mild oral yeast infection following chemotherapy. What actions should the nurse encourage ?
A) Use a lip lubricant.
B) Scrub the tongue with a firm-bristled toothbrush.
C) Use dental floss every 24 hours.
D) Rinse the mouth with normal saline.
E) Eat spicy food to aid in eradicating the yeast.
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a nurse sees a pregnant client at the clinic. the client is close to her due date. during the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?
During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of the possibility of contractions.
Who is a Nurse?This is referred to as a healthcare professional who is specially trained in the care of sick and infirmed individuals and also ensures that adequate recovery is achieved to prevent various types of complications.
A pregnant woman has to be evaluated quickly when her membranes rupture spontaneously and it is based on the understanding of the possibility of contractions which is an important occurrence during the birth of a child.
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