OB/PEDS final

When assessing a client who is at 12-weeks gestation, the nurse recommends that she and her husband consider attending childbirth preparation classes. When is the best time for the couple to attend these classes?

: At 30-weeks gestation is closest to the time parents would be ready for such classes

The nurse is caring for a one-year-old boy who has type 1 diabetes mellitus (DM). His mother asks how will she recognize hypoglycemia in her infant who cannot tell her how he feels. Which information should the nurse provide?

: Hypoglycemia in infants causes changes in behavior and cold clammy skin

Which instruction should the nurse include in the parents' discharge teaching plan for a three-year-old child with diarrhea?

: Monitor for the absence of tears

The nurse is assessing a 6 hour postpartum client following a vaginal delivery with episiotomy. Which finding is most important for the nurse to investigate?

: The client has saturated one perineal pad with mucus, blood clots and some placental rests

A client breastfeeding her child reports a painful swollen breast with cracked and sore nipple on the right side. What should the nurse instruct the client?

: feed the child every 2 to 4 hours and empty each breast completely

The nurse is caring for a female client with scoliosis who had a posterior spinal fusion and is in a body jacked cast. Which assessment finding indicates to the nurse the client is developing cast syndrome?

Abdominal distention.

. The nurse is giving an intramuscular injection of an antibiotic to a 16-month-old toddler with pneumonia. The toddler does not have any known allergies and been walking without assistance for one month. Which technique should the nurse select for administration?

Administer the injection into the middle of the lateral aspect of the thigh.

. A woman who gave birth 48 hours ago is bottle-feeding her infant. During assessment, the nurse determines that both breasts are swollen, warm, and tender upon palpation. What action should the nurse take?

Apply cold compresses to both breasts for comfort. The client is experiencing engorgement even though she is bottle-feeding her infant, and cold compresses (A) may help reduce discomfort.

During a follow up clinical visit a mother tells the nurse that her 5 month old son who had surgical correction for tetralogy of Fallot has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement?

Auscultate heart and lungs while infant is held

The nurse is interacting with a female client who is diagnosed with postpartum depression. Which finding should the nurse document as an objective signs of depression? (Select all that apply.)

Avoids eye contact. B. Interacts with a flat affect. C. Reports feeling sad. D. Expresses suicidal thoughts.

One day after a vaginal delivery of a full-term baby, a postpartum client's white blood cell count is 15,000/mm2. What action should the nurse take first?

Check the differential, since the WBC is normal for this client.

A new mother is having trouble breastfeeding her newborn. The child is making frantic rooting motions and will not grasp the nipple. Which intervention should the nurse implement?

Encourage the mother to stop feeding for a few minutes and comfort the infant.

A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective in preventing nipple soreness?

Ensure that the baby is positioned correctly for latching on

The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child?

Foods sweetened with aspartame

Pregnancy test hormone

Hormone of pregnancy >>> Human Chorionic gonadotropin HCG

A new mother who is breastfeeding her 4 week old infant has type 1 diabetes , reports that her insulin needs have decreased after the birth of her child. What action should the nurse implement ?

Inform her that a decreased need for insulin occurs while breastfeeding

During a routine first trimester prenatal exam, a pregnant client tells the nurse that she has noticed an increase in vaginal discharge that is white, thin, and watery. What action should the nurse implement?

Inform her that this is a normal physiological change.

Immediately after birth a newborn is suctioned, dried, and placed under a radiant warmer. The infant has spontaneous respirations and the nurse assesses an apical heart rate of 80 bpm and respirations of 20 bpm. What action should the nurse perform next?

Initiate positive pressure ventilation.

The nurse is reviewing the lab values for an eight-year-old client and notes that the child's absolute neutrophil count (ANC) is below 500 cells/mm3. (NEUTROPENIA). Which nursing intervention should the nurse implement first?

Initiate reverse isolation precautions for this child

Coke baby: mother was diagnosed with Coke. Baby is irritable, cries a lot. What do you do?

Initiate seizure precaution.

While auscultating the lung sounds of a 5 year old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take?

Inquire about the use of alternative methods of treatment.

parents asking nurse why heel stick is important for baby

It is routine exam to check for metabolic deficiency

What do you do for a bb from and HIV+ mom who receives zidovir what is the first intervention for this bb?:

Maternal antiretroviral drug therapy during pregnancy and labor, followed by six weeks of neonatal zidovudine therapy

Vaginal exam labor

Maternal status (vital signs, pain, prenatal record review) Vaginal examination (cervical dilation, effacement, membrane status, fetal descent, and presentation) Rupture of membranes Uterine contractions Leopold maneuvers

The nurse observes a new mother avoiding eye contact with her newborn. Which action should the nurse take?

Observe the mother for other attachment behaviors.

A mother expresses fear about changing the infant's diaper after circumcision. What information should the nurse include in the teaching plan?

Place petroleum ointment around the glans with each diaper change and cleansing.

Upon admission to the nursery, the nurse places a newborn supine under radiant warmer , an external heat source. What should the nurse implement first to ensure safe thermoregulation?

Place temperature probe on the abdomen in the line with the radiant heat source

In caring for an client with acute epiglottitis, which nursing action takes priority?

Prepare for endotracheal intubation

Safety is of the utmost concern in children with aplastic anemia. It is important to prevent injury in order to avoid hemorrhage

Risk of epistaxis

IPV

SAVE model

Which information is most important for the nurse to provide parents about long-term care for their child with hydrocephalus and a VP shunt?

Shunt malfunction or infection requires immediate treatment.

If a mom scheduled for a C-section tells "I ate a big breakfast and had OJ", what do you do?

TELL the ananaleosgist the risk for aspiration

A 3 month old has a VP shunt. The mother states, "Once the shunt is removed, the pressure in my baby's head will be reduced." What do you say?

The shunt will be replaced as the child grows to reduce the pressure in the child's head

The nurse is administering an oral medication to a reluctant preschool-age boy. Which intervention should the nurse implement?

Use straightforward approach with the child

fundal message technique

Uterine contraction after delivery serves to clamp down on open uterine sinuses after placental separation. Fundal palpation and massage stimulate uterine contraction and prevent postpartum hemorrhage

Pitocin interventions

a. reposition client, give oxygen via nonrebreather mask, increase IV fluids, modify pushing to improve oxygenation b. discontinue pitocin for category III heart tracing

When planning care for a laboring client , the nurse identifies the need to withhold solid foods while the client is in labor . What is the most important reason for this nursing intervention ?

an increased risk for aspiration

A 4-day postpartum client calls the clinic and reports that her nipples are so sore that she does not know if she can continue to breastfeed her infant. What instruction is best for the nurse to provide?

apply hot packs just before each feeding

During a prenatal visit, a client at 30 weeks gestation reports persistent heartburn during the past two weeks . The nurse notes the client has 3+ bilateral, pitting , pedal edema. Which action should the nurse implement?

ask if blurred vision and headache have occured

. An adolescent boy is hospitalized with full-thickness (third degreed) burns to both hands following a house fire. Three days after his admission to the burned unit, the nurse notes that teenager's hands are becoming more edematous. Which intervention is most important for the nurse to include in this client's plan care?

assess radial pulse every 2 hours

ruptured membrane

assessment of the FHR is important after rupture of the membrane to determine decelerations that could indicate cord prolapse

Nurse screening only the highest risk children for scoliosis?

between 10 and 14

buttocks sacrum

breech presentation

postpartum hemorrhage even after finishing oxytocin infusion:

check maternal BP

Mom wants to know what substance to use when changing baby's diaper.

clean water

pain control deep breathing

coaching the client to use a deep breathing technique with analgesic can assist the laboring the client to cope with the pain associated with uterine contractions

A pregnant woman have type 1 diabetes and is going to receives insulin teaching she tells the nurse that she is going to not eat in the morning because religion and is a holy month, what is the nurse best teaching:

collaborative work to create a new insulin schedule

Best birth control for a breastfeeding mom not the combined pill bc of the estrogen

condom with spermicide gel

A client receiving oxytocin (Pitocin) to augment early labor. Which assessment is most important for the nurse to obtain each time the infusion rate is increased?

contraction

A multiparous woman at 38 weeks gestation with a history of rapid progression of labor is admitted for induction due to signs and symptoms of pregnancy induced hypertension (PIH). One hour after the oxytocin infusion is initiated she complains of a headache. Her contractions are occurring every 1-2 mins , lasting 60-75 seconds and a vaginal exam reveals that her cervix is 90% and dilated 6 cm.What intervention is most important for the nurse to implement?

discontinue the Pitocin infusion

Capput Succedaneum

does not cross suture lines and manifests a few hours after birth

HIV positive mom gives birth & is worried about passing it to her baby:

explain to mom AZT for the baby after birth

chin mentum

face presentation

exercise - prepare for labor

flexion and extension of the ankle promotes venous return and aid in the prevention of thromo

Lamaze (psychoprophylactic) method:

focus on breathing and relaxation techniques

Bradley (partner-coached childbirth) method:

focus on exercises and slow, controlled abdominal breathing

A babysitter calls in regarding the child she is caring for who is a diabetic. Currently he is diaphoretic, weak, what instructions should be provided?

give the milk before bringing in (hypoglycemia)

Cyanotic 3 hour old infant temperature 96.5, 40 breaths/min, 165 beats/minute. Intervention best to implement?

gradually warm under heat source

A 2-day-old full-term infant is brought to the neonatal ICU for treatment of early onset sepsis. Which is the most likely infecting organism in this client?

group b

During a routine well-child exam, the nurse observes that a 12-month-old child is unable to pronounce any simple words or syllables. Which possible cause should the child be evaluated for first?

hearing

The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. What priority issue should the nurse address to ensure the newborn's...

heat loss

If mother has DM type 1, what do you expect for fetal complications?

hypoglycemia

Management of indigestion

inform pregnant mamas to avoid caffeinated beverages and not lying down 3 hours after a meal Heartburn and indigestion Small frequent meals Wet/Dry diet so stomach not distended Sit up after meals (don't lie down for at least one hour) Avoid tight clothes across abdomen

. Upon inspection, a nurse visualizes a blade of grass clipping stuck under the right upper eyelid of a teenage client complaining of eye pain, increased tear production, and redden sclera. What should the nurse use to remove the grass clipping?

moist gauze pad

woman has epidural anesthesia

monitor bp and hr

A 38-week primigravida is admitted to labor and delivery after a non-reactive stress test (NST). The nurse begins a contraction stress test (CST) with an oxytocin (Pitocin) infusion. Which finding is most important for the nurse to report to the healthcare provider?

pattern of fetal late decelerations

A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptom for a pediatric client with AIDs is

persistent cord

The parents of a male newborn have signed an informed consent for circumcision. What priority intervention should the nurse implement upon completion of the circumcision?

place petroleum

A client receiving epidural anesthesia begins to experience nausea and becomes pale and clammy. What intervention should the nurse implement first?

raise the foot of the bed

A new mother calls the nurse stating that she wants to start feeding her 6-month-old child something besides breast milk, but is concerned that the infant is too young to start eating solid foods. How should the nurse respond?

reassure the mother that the infant is old enough to eat iron-fortified cereal

While breastfeeding, a new mother strokes the top of her baby's head and asks the nurse about the baby's swollen scalp. The nurse responds that the swelling is caput succedaneum. Which additional information should the nurse provide this new mother?

scalp edema will subside in a few days after birth

scapula

shoulder presenation

A client at 30 weeks of gestation is on bed rest at home because of increased blood pressure. The home health nurse has taught her how to take her own blood pressure and gave her parameters to judge a significant increase in blood pressure. When the client calls the clinic complaining of indigestion, which instruction should the nurse provide?

take your blood pressure now and if it is seriously elevated go to the hospital

Bischop scores

the vaginal exam and determines if the cervix is ready for labor

A new mother asks the nurse about an area of swelling on her babys head near the posterior fontanel that lies across the suture. line, how should the nurse respond?

this is called caput succedaneum, it will absorb and cause no problems

Mother of a 4 month old asks RN for preventing diaper rash -

use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change

which nursing intervention is helpful in relieving after pains?

using relaxation breathing techniques

occipital bone

vertex presentation

A client in the first trimester of pregnancy joins a childbirth education class. During this trimester, the class is most likely to cover which physiologic aspect of pregnancy?

warning signs of complications

Pregnancy-positive sign

(something that can be verified by a provider) Ultrasound verification of embryo or fetus (4 to 6 weeks) Fetal movement felt by experienced clinician (20 weeks) Auscultation of fetal heart tones via Doppler (10 to 12 weeks)

first trimester weight

- 3.5 to 5

Urinary changes

- Dilation of renal pelvis; elongation, widening, and - increase in curve of ureters Increase in length and weight of kidneys Increase in glomerular filtration rate; increased urine flow and volume - Increase in kidney activity with woman lying down; greater increase in later pregnancy with woman lying on side

Dick-Read (natural childbirth) method:

- focus on dear reduction via knowledge and abdominal breathing techniques

A breastfeeding postpartum client is diagnosed with mastitis, and antibiotic therapy is prescribed. Which instruction should the nurse provide to this client?

. Breastfeed the infant, ensuring that both breasts are completely emptied.

second and third trimester

1 lb/week

Screening test for PKU

2 to 3 days of life or after enough breast or formula is ingested to allow for determination of thebody'ss ability to metabolize amino acidphenylalaninen

PKU baby

25 % any babies born later will have it too

healthy BMI

25 to 35