Thermoregulation Part 1

A newborn is placed under a radiant heat warmer, and the nurse evaluates the infant's body temperature every hour. Maintaining the newborn's body temperature is important for preventing: A. respiratory depression. B. cold stress. C. tachycardia. D. vasoconstriction.

B

Heat loss from the body via convection occurs by: A. evaporation of electromagnetic waves. B. transfer of heat through currents of liquids or gas. C. dilation of blood vessels bringing blood to skin surfaces. D. direct heat loss from molecule-to-molecule transfer.

B

Hikers are attempting to cross the Arizona desert with a small supply of water. The temperatures cause them to sweat profusely and become dehydrated. The hikers are experiencing: A. heat cramping. B. heat exhaustion. C. heat stroke. D. malignant hyperthermia.

B

What is the most appropriate measure for a nurse to use in assessing core body temperature when there are suspected problems with thermoregulation? A. Oral thermometer B. Rectal thermometer C. Temporal thermometer scan D. Tympanic membrane sensor

B

A nurse wants to teach about one of the primary organs responsible for heat production. Which organ should the nurse include? A. Pancreas B. Liver C. Adrenal medulla D. Heart

C

A patient with hypotension and an elevated temperature after working outside on a hot day is treated in the emergency department (ED). Which patient statement indicates to the nurse that discharge teaching has been effective? A. "I'll take salt tablets when I work outdoors in the summer." B. "I should take acetaminophen (Tylenol) if I start to feel too warm." C. "I need to drink extra fluids when working outside in hot weather." D. "I'll move to a cool environment if I notice that I'm feeling confused"

C

During orientation to an emergency department, the nurse educator would be concerned if the new nurse listed which of the following as a risk factor for impaired thermoregulation? A. Impaired cognition B. Occupational exposure C. Physical agility D. Temperature extremes

C

In administering vitamin K to the infant shortly after birth, the nurse understands that vitamin K is: A. important in the production of red blood cells. B. necessary in the production of platelets. C. not initially synthesized because of a sterile bowel at birth. D. responsible for the breakdown of bilirubin and prevention of jaundice.

C

When the nurse is taking a patient's temperature, which principle should the nurse remember? Regulation of body temperature primarily occurs in the: A. cerebrum. B. brainstem. C. hypothalamus. D. pituitary gland.

C

What infant response to cool environmental conditions is either not effective or not available to them? A. Constriction of peripheral blood vessels B. Metabolism of brown fat C. Increased respiratory rates D. Unflexing from the normal position

D

When a patient has a fever, which of the following thermoregulatory mechanisms is activated? A. The body's thermostat is adjusted to a lower temperature. B. Temperature is raised above the set point. C. Bacteria directly stimulate peripheral thermogenesis. D. The body's thermostat is reset to a higher level.

D

Which finding indicates that the nurse should discontinue active rewarming of a patient admitted with hypothermia? A. The patient begins to shiver. B. The BP decreases to 86/42 mm Hg. C. The patient develops atrial fibrillation. D. The core temperature is 94° F (34.4° C).

D

Which similar exemplar should the nurse consider when planning care for a patient with hypothermia? A. Heat exhaustion B. Heat stroke C. Infection D. Prematurity

D

A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, "What is this black, sticky stuff in her diaper?" The nurse's best response is: A. "That's meconium, which is your baby's first stool. It's normal." B. "That's transitional stool." C. "That means your baby is bleeding internally." D. "Oh, don't worry about that. It's okay."

A

A new mother states that her infant must be cold because the baby's hands and feet are blue. The nurse explains that this is a common and temporary condition called: A. acrocyanosis. B. erythema neonatorum. C. harlequin color. D. vernix caseosa.

A

A patient is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on "high." The nurse instructs the mother that the fan should not be directed toward the newborn and the newborn should be wrapped in a blanket. The mother asks why. The nurse's best response is: A. "Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." B. "Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." C. "Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and prevent cool air from blowing on him." D. "Your baby will get cold stressed easily and needs to be bundled up at all times."

A

After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is prescribed. Which action will the nurse include in the plan of care? A. Initiate cooling per protocol. B. Avoid the use of sedative drugs. C. Check mental status every 15 minutes. D. Rewarm if temperature is below 91° F (32.8° C).

A

An unresponsive 79-yr-old patient is admitted to the emergency department (ED) during a summer heat wave. The patient's core temperature is 105.4° F (40.8° C), blood pressure (BP) is 88/50 mm Hg, and pulse is 112 beats/min. What action should the nurse plan to take? A. Apply wet sheets and a fan to the patient. B. Provide O2 at 2 L/min with a nasal cannula. C. Start lactated Ringer's solution at 1000 mL/hr. D. Give acetaminophen (Tylenol) rectal suppository.

A

As related to the normal functioning of the renal system in newborns, nurses should be aware that: A. the pediatrician should be notified if the newborn has not voided in 24 hours. B. breastfed infants likely will void more often during the first days after birth. C. "Brick dust" or blood on a diaper is always a cause to notify the physician. D. weight loss from fluid loss and other normal factors should be made up in 4 to 7 days.

A

For evaporation to function effectively as a means of dissipating excess body heat, which one of the following conditions must be present? A. Moisture B. Fever C. Pyrogens D. Trauma

A

Nurses can prevent evaporative heat loss in the newborn by: A. drying the baby after birth and wrapping the baby in a dry blanket. B. keeping the baby out of drafts and away from air conditioners. C. placing the baby away from the outside wall and the windows. D. warming the stethoscope and the nurse's hands before touching the baby.

A

The cheese-like, whitish substance that fuses with the epidermis and serves as a protective coating is called: A. vernix caseosa. B. surfactant. C. caput succedaneum. D. acrocyanosis.

A

Which interventions will the nurse plan for a comatose patient who will have targeted temperature management/therapeutic hypothermia? (Select all that apply.) A. Assist with endotracheal intubation. B. Insert an indwelling urinary catheter. C. Begin continuous cardiac monitoring. D. Prepare to give sympathomimetic drugs. E. Obtain a prescription for patient restraints.

A, B, C

The emergency department (ED) nurse is starting targeted temperature management/therapeutic hypothermia in a patient who has been resuscitated after a cardiac arrest. Which actions in the hypothermia protocol can be delegated to an experienced licensed practical/vocational nurse (LPN/VN)? (Select all that apply.) A. Insert a urinary catheter to drainage. B. Continuously monitor heart rhythm. C. Assess neurologic status every 2 hours. D. Place cooling blankets above and below patient. E. Attach rectal temperature probe to cooling blanket control panel.

A, D, E

What are modes of heat loss in the newborn? (Select all that apply.) A. Perspiration B. Convection C. Radiation D. Conduction E. Urination

B, C, D

A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, what fact should be included? A. Physiologic jaundice occurs during the first 24 hours of life. B. Physiologic jaundice is caused by blood incompatibilities between the mother and infant blood types. C. The bilirubin levels of physiologic jaundice peak between 72 to 96 hours of life. D. This condition is also known as "breast milk jaundice."

C

A meconium stool can be differentiated from a transitional stool in the newborn because the meconium stool is: A. seen at age 3 days. B. the residue of a milk curd. C. passed in the first 12 hours of life. D. lighter in color and looser in consistency.

C

Which statement describing physiologic jaundice is incorrect? A. Neonatal jaundice is common, but kernicterus is rare. B. The appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process. C. Because jaundice may not appear before discharge, parents need instruction on how to assess it and when to call for medical help. D. Breastfed babies have a lower incidence of jaundice.

D