AMTSL consists of following activities except-

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Bimanual compression of the uterus is a therapeutic, emergency procedure used to physically compress the uterus to control severe bleeding from uterine atony.
It is not a routine, prophylactic (preventive) component of the Active Management of the Third Stage of Labor (AMTSL).
AMTSL consists of interventions aimed at preventing postpartum hemorrhage (PPH), whereas bimanual compression is a treatment for PPH that has already occurred.

Option A: Administration of a uterotonic drug, such as oxytocin, is a primary and essential component of AMTSL.
Option B: Controlled cord traction (CCT) is a standard step in AMTSL used to facilitate the delivery of the placenta.
Option D: Uterine massage is a key intervention in AMTSL, performed after the placenta is delivered.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Components of Active Management of Third Stage of Labor (AMTSL) as background academic context rather than a clinical decision trigger.
AMTSL is a critical, evidence-based practice that has significantly reduced the incidence of PPH, the leading cause of maternal mortality worldwide.
Nurses must be proficient in all steps of AMTSL and also be able to differentiate these prophylactic steps from emergency treatments like bimanual compression.
What if? If heavy bleeding occurs despite the correct application of all AMTSL components, the nurse must immediately suspect uterine atony or retained placental fragments. The next step would be to initiate the emergency PPH protocol, which may include bimanual compression, and escalate care to the physician.

How to Approach the Question

Identify the keyword 'EXCEPT', which indicates you need to find the option that does not belong.
The core topic is 'Active Management of the Third Stage of Labor' (AMTSL).
Recall the standard components of AMTSL, which are prophylactic (preventive) measures.
Evaluate each option: 'Uterotonic drug', 'Controlled cord traction', and 'Uterine massage' are all standard preventive steps in AMTSL.
'Bimanual compression of the uterus' is a therapeutic (treatment) measure for established postpartum hemorrhage, not a preventive one.
Therefore, bimanual compression is the exception and the correct answer.

Concept Tested & Keywords

Concept Tested: Components of Active Management of Third Stage of Labor (AMTSL)
Stem keywords: AMTSL, Active Management of Third Stage of Labor
Lead-in keywords: except
Negative lead-in flag: The question asks for the activity that is NOT part of AMTSL.

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 222-224

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 50-58

E6 Obstetrics Williams p. 10-26

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.