Family Health Weeks 8-11

A new mother asks the nurse administering erythromycin ophthalmic ointment to her newborn why her baby must be subjected to this procedure. What is the best response by the nurse? 1. "It will keep your baby from going blind." 2."This ointment will protect your baby from bright lights." 3. "There is a law that newborns must be given this medicine." 4. "This antibiotic helps keep babies from contracting eye infections."

4. "This antibiotic helps keep babies from contracting eye infections."

Which virus is responsible for causing infectious mononucleosis in clients? 1. Parvovirus 2. Coronavirus 3. Rotavirus 4. Epstein-Barr virus

4. Epstein-Barr virus

The primary healthcare provider prescribes one unit of packed red blood cells to be administered to the client who suffered a hip fracture. Several minutes after the start of the infusion, the client reports itching. Upon further assessment, the nurse observes hives on the client's chest. Which action should the nurse take next? 1.Call the primary healthcare provider to obtain a prescription for an antihistamine. 2.Flush packed red blood cells with 5% dextrose and 0.45% normal saline. 3.Slow down the rate of the infusion. 4.Stop the transfusion immediately.

4. Stop the infusion immediately

Normal neonatal blood pressures

80/46 each extremity

Normal neonate temperature

97.8-98.9 degrees, axillary

Signs of Magnesium Sulfate Toxicity

BURP Blood pressure decrease Urine output decrease Respiratory rate decrease Patella reflex absent (deep tendon reflexes)

How do you treat variable deceleration?

IV Fluid bolus, reposition mom, apply 10L O2 via non breather mask, stop Pitocin.

How do you treat early decelerations?

IV Fluids, maternal position change

How do you treat prolonged deceleration?

IV bolus, switch maternal positions, shut off Pitocin, apply 10L O2 via non rebreather mask.

A toddler with cystic fibrosis has been hospitalized with bacterial pneumonia. The nurse determines that the child has no known allergies. What does the nurse conclude is the reason that the healthcare provider selected a specific antibiotic? 1. Tolerance of the child 2.Sensitivity of the bacteria 3.Selectivity of the bacteria 4.Preference of the healthcare provider

2.Sensitivity of the bacteria

A nurse is caring for a 13-year-old child who has an external fixation device on the leg. What is the nurse's priority goal when providing pin care? 1.Easing pain 2.Minimizing scarring 3.Preventing infection 4.Preventing skin breakdown

3. Preventing infection Pin sites provide a direct avenue for organisms into the bone. Pin care will not ease pain. Some scarring will occur at the pin insertion site regardless of pin site care. Skin has a tendency to grow around the pin, rather than break down, as long as infection is prevented.

Which type of client eye disorders are caused by Staphylococcus aureus? Select all that apply. 1.Ectropion 2.Trachoma 3.Hordeolum 4.Conjunctivitis 5.Chalazion

3.Hordeolum 4.Conjunctivitis

A young pregnant adolescent is diagnosed as having bacterial vaginosis. What further complications related to bacterial vaginosis may occur during pregnancy? Select all that apply. 1.Neonatal sepsis 2.Cervical dysplasia 3.Preterm labor and birth 4.Intraamniotic infection 5.Postpartum endometritis

3.Preterm labor and birth 4.Intraamniotic infection 5.Postpartum endometritis

What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)? 1.Shark cartilage enhances immunity 2.Shark cartilage reduces oral thrush 3.Shark cartilage is a complementary therapy 4. Shark cartilage is a nutritional supplement

3.Shark cartilage is a complementary therapy Rationale: Shark cartilage is considered as an alternative or complementary therapy to prescribed medications for clients with HIV and AIDS. Lymphocyte transfusions and bone marrow transplants are used to improve immunity in clients with HIV and AIDS. Lemon juice and lemongrass may provide relief from oral thrush in some clients with HIV and AIDS. A high-calorie, high-protein diet is advised to clients with HIV and AIDS to improve their nutritional status.

Normal neonatal respirations

30-60 per minute. Report nasal flaring, chest retractions, noisy respirations, grunting or moaning respirations

Subinvolution

Failure of the uterus to return to pre pregnant size

Lochia Alba

(Albino) White discharge, continues until cervix is closed

How many cm's does the fundus descend every day, until day 10?

1 cm or 1 fingerbreadth

A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action? 1. Applying cold compresses to the affected area 2.Ensuring the client keeps the skin clean and dry 3.Monitoring for neurological and cardiac symptoms 4.Advising the client to launder all clothes with bleach

1. Applying cold compresses to the affected area

What is the most common cause of ophthalmia neonatorum in infants born to adolescent mothers? 1. Chlamydia 2.Gonorrhea 3.Human papilloma virus 4.Herpes simplex virus1

1. Chlamydia

Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply. 1.Dyspnea 2.Dry cough 3.Diaphoresis 4.Mild chest pain 5.High temperature

1. Dyspnea 3. Diaphoresis 5. High Temperature

Before administering the first series of immunizations to a 2-month-old infant, the nurse tells the parent that reactions may occur. What are the characteristics of these reactions? 1.Local or systemic and usually mild 2.Often serious, possibly requiring hospitalization 3.Sometimes causing ulceration at the injection site 4.May be responsible for permanent neurological damage

1. Local or systemic and usually mild Mild reactions consist of redness and induration at the injection site, slight fever, and irritability. Serious reactions are not common. Induration at the injection site may occur, but not ulceration. Permanent brain damage is not likely after an immunization.

The urinalysis report of a client reveals cloudy urine. What does a nurse infer from the client's report? 1.The client has a urinary infection. 2.The client has a biliary obstruction. 3.The client has diabetic ketoacidosis. 4.The client has been on a starvation diet.

1. The client has a urinary infection The urine becomes cloudy when an infection is present due to the presence of leukocytes. Therefore the nurse concludes that the client has a urinary infection. In cases of biliary obstruction, the urine contains bilirubin. The presence of ketones in the urine indicates diabetic ketoacidosis or prolonged starvation.

A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to prevent malaria? 1.Mosquito bites 2.Untreated water 3.Undercooked food 4.Overpopulated areas

1. mosquito bites

A young child with acute nonlymphoid leukemia is admitted to the pediatric unit with a fever and neutropenia. What are the most appropriate nursing interventions to minimize the complications associated with neutropenia? 1.Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques 2.Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion 3.Avoiding rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture 4.Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes

1.Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques

Which cytokine is used to treat multiple sclerosis? 1.β-Interferon 2.Interleukin-2 3.Erythropoietin 4.Colony-stimulating factor

1.β-Interferon

What should the babies heart rate normally be between?

110-160

What is physiologic jaundice?

A normal process and is NOT harmful to the infant. Develops between 1 and 5 days after birth because babies organs are not able to get rid of excess bilirubin effectively.

Moro refelx

A startled infant will draw legs up and arms out

Preterm baby's blood sugar

Above 30

Term baby's blood sugar

Above 40

Stability phase

After 24 hours of age, the sleep wake pattern becomes more stabilized.

Fetal Asphixia

Asphixia in utero due to hypoxia. Possible causes are uteroplacental insufficiency, abruptio placentae, placenta prévia, uterine tetany, maternal hypotension.

Fundus Height 6-12 hours postpartum

At the level of the umbilicus

Pseudomestration

Blood tinged mucousy discharge from the neonatal vagina, caused by hormone withdrawal from the mother at birth

BUBBLE-HE

Breasts Uterus Bladder Bowel Lochia Episiotomy Hemorrhoids/Homan's Emotions

Lochia Rubra

Bright red, first 2-3 days after birth

Antidote for Magnesium Sulfate Toxicity

Calcium Gluconate

Transitional stool

Changing, loose greenish yellow with mucous

Cephalohematoma

Collection of blood beneath the periosteum of the cranial bone *will not cross suture line

Fetal Asphixia

Considered the most fatal abnormal stressor after labor.

What causes variable deceleration on fetal heart monitoring?

Cord Compression, Episodic, Non-reassuring

A primigravida has just given birth. The nurse is aware that the client has type AB Rh-negative blood. Her newborn's blood type is B positive. What should the plan of care include? 1. Determining the father's blood type 2. Preparing for a maternal blood transfusion 3. Observing the newborn for signs of ABO incompatibility 4.Obtaining a prescription to administer Rho(D) immune globulin to the mother

Obtaining a prescription to administer Rho(D) immune globulin to the mother

Jaundice that occurs the first day of life is normal. True/False

FALSE! It is not normal and should be recorded and reported. Assess for dehydration, infection, poor nutrition, I/O.

What are accelerations indicative of on fetal heart rate monitoring?

Fetal brain health

Meconium

First poop in 8-24 hrs

What causes early decelerations on fetal heart monitoring?

Head compressions, Reassuring

Second reactive phase

Over the next few hours of life, the newborn will gradually become more responsive and alert. Perfect time to initiate breastfeeding.

When does the 4th Trimester being?

Immediately after childbirth

IgA

Immunoglobulin produced after the neonatal period (after 28 days) it is contained in breast milk and provides some resistance to respiratory and GI infection

IgM

Immunoglobulin produced by the newborn. Elevated level could indicate infection

IgG

Immunoglobulin that crosses the placenta and gives the newborn passive immunity to infections which mom is immune to. Last 3 months or less

What is the mechanism of action of penicillin? 1.Prevents reproduction of the pathogen 2.Inhibits cell wall synthesis of the pathogen 3.Inhibits nucleic acid synthesis of the pathogen 4.Injures the cytoplasmic membrane of the pathogen

Inhibits cell wall synthesis of the pathogen

Normal neonatal pulse rate

Irregular and rapid at 110-160. Listen for murmur and notify physician.

What happens when an infants jaundice becomes more pronounced?

Irritable, sluggish, and have a high-pitched scream.

What is breastfeeding jaundice?

It is caused by mild dehydration, which prolongs and intensifies physiologic jaundice. Occurs when the baby does not get enough fluids.

How does dehydration contribute to jaundice?

It makes removing bilirubin from the body even harder for babies immature systems.

What causes a prolonged deceleration?

Lasts more than 2 minutes! Unknown cause, Non-reassuring, Episodic

How do you treat late decelerations?

Maternal position change, IV Fluids, O2 10L via non rebreather mask, stop Pitocin. or DELIVERY

Perinatologist

Maternal-fetal medicine specialist

Does insulin cross the placenta?

No, baby may be hypoclycemic shortly after birth due to no longer receiving sugar from mom.

Lochia Serosa

Pink, day 3-10

After changing a dressing that was used to cover a draining wound on a client with vancomycin-resistant enterococci (VRE), the nurse should take which step to ensure proper disposal of the soiled dressing? 1.Place the dressing in the bedside trash can. 2.Place the dressing in a red bag/hazardous materials bag. 3.Contact Environmental Services personnel to pick up the dressing. 4.Transport the dressing to the laboratory to be placed in the incinerator.

Place the dressing in a red bag/hazardous materials bag.

What are some nursing cares for after pains?

Prone position with ABD pillow, Sitz baths, encourage ambulation, mind analgesics,

Infant mortality

Ratio of infant deaths younger than 1 year of age in any given year

What does REEDA stand for?

Redness Edema Ecchymosis Discharge Approximation

Immediate Adjustments at Birth

Respiratory system, circulatory system, thermoregulation

Infant morbidity

State of being diseased or sick. Shows incidence of disease in a certain population.

Caput Succedaneum

Swelling that occurs in the soft tissues in the scalp in addition to molding

Moderate Variability

The Gold Standard, Reassuring

15-20 hours a day

The amount of time a newborn baby sleeps

Kernicterus

The effect of not treating bilirubin. (Brain damage from increased bilirubin) Can result in hearing loss, intellectual disability, and behavior problems.

First reactive phase

The first 30 minutes of life the newborn is awake and alert. This is best to bond with the parents

What is the puerperium?

The first 6 weeks after child birth

Heat loss

The most critical event in the thermoregulation process.

Rooting reflex

The newborn turns head toward a brush on ththe cheek in anticipation of a feeding

Why are premature babies more likely to be jaundice than full term babies?

Their organs are not fully developed, and are less able to eliminate bilirubin effectively.

Infant rate of metabolism

Twice greater than that of an adult. At high risk for acidosis due to this.

Fundus Height Day 1 Postpartum

Typically 1cm BELOW umbilicus

Cryptorchidism

Undecscended testes

VEAL Chop

V:Variability; caused by Compression E: Early Decelerations; caused by Head A: Accelerations; caused by Oxygenation L: Late decelerations: Placental Insufficiency

What is microsomal?

When a babies weight is greater than 9lbs.

Dancing Reflex

When a baby is held upright with its feet on the table, it's normal Reflex is to

Head lag

When placed on stomach the baby should be able to raise its head briefly. When lifted from the bed the head will naturally fall back

How long should accelerations last after 32 weeks gestation?

greater than 15 seconds and peak above 15 bpm

How long should an acceleration last before 32 weeks gestation?

greater than 10 seconds and peak greater than/equal to 10 bmp

What causes late decelerations on fetal heart monitoring?

placental insufficiency, Non-reassuring, Periodic