infant/Adolecent

A 19-year-old primigravida in the first trimester of pregnancy is diagnosed with gonorrhea. What dosage of ceftriaxone is recommended to prevent the transmission of gonorrhea?

Correct3 250 mg started immediately 250 mg of ceftriaxone is used to treat gonorrhea. This dosage should be taken during pregnancy as soon as the disease is diagnosed to prevent the transmission of infection to the fetus.

A nurse notes that an infant with a diagnosis of failure to thrive who has been receiving tube feedings for 3 days has very dry skin and mucous membranes. The nurse verifies that all feedings have been retained, but the daily urine output is consistently 250 mL, and the infant has lost weight. What does the nurse conclude?

R/ The infant is dehydrated, and the fluid intake needs to be increased. These are classic signs of dehydration; the healthcare provider should be notified because a prescription to increase fluids is needed. It is not common for the condition of an infant with failure to thrive to continue to deteriorate once therapy has been implemented. Although the infant may have a gastrointestinal problem, the classic signs of dehydration must be addressed before this conclusion is reached. These signs indicate dehydration, not undernutrition.

A primary healthcare provider prescribes a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question this prescription?

R/It could cause a fluid and electrolyte imbalance. Tap water enemas are hypotonic and are contraindicated; they may cause increased absorption of fluid through the bowel and may upset the balance of fluid in the body. Such enemas also interfere with the potassium ion balance; this electrolyte can be lost by way of the large intestine. The enema removes waste products from the bowel, not nutrients. Fear of intrusive procedures is typical of preschoolers, not infants. The temperature of the water is regulated, so shock from a temperature drop is not a concern.

A pregnant adolescent reports genital warts. What interventions would reduce the discomfort? Select all that apply.

Correct2 Consider cryotherapy Correct3 Bathe with an oatmeal solution Correct4 Wear loose-fitting cotton clothes Cryotherapy can be used treat the warts. Bathing with an oatmeal solution is used to reduce the irritation and discomfort of genital warts. Wearing loose-fitted cotton clothes also helps to reduce the irritation and friction. Imiquimod should not be prescribed to pregnant clients. Proper cleaning and hygiene of the genital area should not involve using less water.

An HIV-infected pregnant adolescent does not want a cesarean birth. Which finding would indicate the increased risk of perinatal transmission via vaginal birth?

2. A viral load of 1,200 copies/mL A vaginal birth in the case of a woman with a viral load of more than 1,000 copies/mL (1,200 copies/mL) has a high chance of perinatal transmission, so cesarean birth is the preferred method. A viral load less than 1,000 copies/mL (800 copies/mL) is not threatening and lessens the chances of perinatal transmission via vaginal birth. Women with ruptured membranes have to take intravenous zidovudine injection and may proceed for vaginal birth. Women undergoing antiretroviral therapy with viral loads of less than 400 copies/mL can opt for vaginal birth.

Which identity may fail to develop if the adolescent fails to feel a sense of belonging and acceptance?

2. Group Identity Failure to feel acceptance and belonging results in failure to establish a group identity. A lack of physical evidence of maturity can predispose the adolescent to fail to establish a sexual identity. Adolescents depend on these physical cues because they want assurance of maleness or femaleness and do not wish to be different from their peers. If an adolescent fails to foster independence and balance in the family structure, it may hamper family identity. Healthy adolescents evaluate their own health on the basis of feelings of well-being, ability to function normally, and absence of symptoms.

After an assessment, a nurse observes a feeling of an altered perception of body appearance in an adolescent. Which nursing interventions would be beneficial in this situation? Select all that apply.

Correct 3 Providing a therapeutic discussion of personal attributes perceived as positive Correct4 Encouraging a discussion of maladaptive behaviors surrounding food and fluid intake Correct5 Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment Providing a therapeutic discussion of positive personal attributes would be beneficial for an adolescent who has a feeling of an altered perception of body appearance. Encouraging a discussion on maladaptive behaviors surrounding food and fluid intake would provide consistency in therapy and allow for a mutual discussion. Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment also promotes a sense of accomplishment and enhances the self-image of the adolescent. When an adolescent's weight is below the ideal weight, then the nurse should develop a mutually agreeable targeted daily calorie intake goal with the adolescent. If an adolescent has misconceptions about his or her body image, then the nurse should monitor for detrimental activities such as purging and bingeing in the adolescent.

Which statements about acne in adolescents are true? Select all that apply.

Correct1 Early acne occurs in the midface region Correct3 Acne usually occurs in middle to late adolescence. Correct4 Intake of dairy products can contribute to acne severity.

An adolescent has pain, swelling, and inflammation of the testis, abdominal pain, and occasional immobilization of the scrotum. Which condition does the adolescent likely have?

Correct3 Testicular torsion Testicular torsion manifests as pain, inflammation, and hanging of the scrotum. The scrotum may become immobile an absence of the cremasteric reflex. Nausea, vomiting, and abdominal pain are accompanied along with the scrotal pain. Varicocele is the elongation, dilation, and twisting of the veins of the spermatic chord superior to the testicle. Epididymitis is the inflammation of the epididymis as a result of bacterial infection, chemical irritant, or local trauma. With epididymitis, there is no abdominal pain associated with the testicular pain. Testicular cancer may or may not cause pain, and nodular mass-like structures are present in the scrotum.

A nursing instructor asks a nursing student to describe teaching methods that are effective for adolescents. Which statement by the student indicates a need of further teaching?

Correct4 "Encourage adolescents to learn together through pictures and short stories." A preschooler, not an adolescent, is encouraged to learn together through pictures and short stories. Teaching should be used as a collaborative activity in adolescents. A problem-solving approach can also be adopted to help adolescents make choices. Adolescents should receive help learning about their feelings and need for self-expression.

An adolescent who works out 6 hours a day reports not eating well, weight loss, and an absence of menses for the past few months. Which nursing intervention is most appropriate?

Correct4 Modify the adolescent's diet to incorporate more nutrients If an athletic adolescent experiences symptoms of eating disorders, weight loss, and an absence of menses indicating female athlete triad, then her diet should be modified incorporate more nutrients. Asking the adolescent to stop exercising for a few days would not solve the problem. Stress does not cause amenorrhea. Being an athlete and having eating disorders rules out the chances for becoming pregnant.

One day in the well-child clinic a parent asks at what age the baby should first be able to drink from a cup. The nurse responds:

R/ "Around 12 months." By 12 months of age a child can usually drink from a cup, although fluid may spill and a bottle may be preferred at times. The child is just beginning to exert lip control at 5 months and cannot handle a cup. At 7 months a child can handle a bottle but not a cup. This skill is present at 12 months, and by 18 months most children are quite proficient.

During assessment of a newborn in the nursery, the nurse notices a large, dark pigmentation over the buttocks of one of the infants. What is the most important intervention?

R/ Checking the medical record regarding this finding at birth. Large dark areas of pigmentation over the buttocks are a common birth defect known as Mongolian spots. These hyperpigmented areas can resemble bruising but lessen over time and usually disappear by the time the child reaches school age. The nurse taking care of this infant should check the medical record for documentation of this finding at birth in the medical record. Mongolian spots are not caused by bleeding, trauma, or abuse.

Which nursing intervention provides the most support to the parents of an infant with an obvious physical anomaly?

R/ Encouraging them to express their concerns. Encouraging parents to express their concerns helps and encourages them to put their fears and feelings into words. Once these sentiments are expressed, they can then be examined and addressed. Discouraging the parents from talking about their baby will not help them cope with the problem, nor will it demonstrate the supportive, empathetic role of the nurse. Encouraging them not to worry because the anomaly can be repaired lacks insight, and parents will worry about their infant anyway. Showing postoperative photographs of infants who had a similar anomaly may or may not be helpful. 92%

A 5-month-old infant is brought to the pediatric clinic because of exposure to an adolescent sibling with measles. The infant's mother asks the nurse whether her baby can be vaccinated against measles at this age. What should the nurse consider before replying?

R/ Maternal diseases and immunizations It is important to determine whether the infant has maternally transmitted antibodies against measles. Vaccination against measles is performed when the infant reaches 12 to 15 months of age. The infant's previous viral illnesses have no relationship to the present exposure to measles. Maternal exposure to tuberculosis and herpes genitalis is not relevant in the determination of whether the infant has passive immunity to measles.