Chapter 36: Hemolytic Disorders and Congenital Anomalies Lowdermilk: Maternity & Women's Health Care, 12th Edition Test.

Chapter 36: Hemolytic Disorders and Congenital Anomalies Lowdermilk: Maternity & Women's Health Care, 12th Edition Test. 1. 1. To explain hemolytic disorders in the ANS: B newborn to new parents, the nurse who Hemolytic disorders in the newborn are the cares for the newborn population must be aware of the physiologic characteris- tics related to these conditions. What is the most common cause of pathologic hyperbilirubinemia? a. Hepatic disease b. Hemolytic disorders c. Postmaturity d. Congenital heart defect 2. 2. Which infant is most likely to express Rh incompatibility? a. Infant of an Rh-negative mother and a father who is Rh positive and homozy- gous for the Rh factor most common cause of pathologic hyperbiliru- binemia (jaundice). Although hepatic damage, prematurity, and congenital heart defects may cause pathologic hyperbilirubinemia, they are not the most common causes. ANS: A If the mother is Rh negative and the father is Rh positive and homozygous for the Rh factor, then all the ottspring of this union will be Rh pos- itive. Only Rh-positive ottspring of an Rh-neg- b. Infant who is Rh negative and a moth- ative mother are at risk for Rh incompatibility. er who is Rh negative Only the Rh-positive ottspring of an Rh-negative c. Infant of an Rh-negative mother and a mother are at risk. If the mother is Rh negative father who is Rh positive and heterozy- gous for the Rh factor and the father is Rh positive and heterozygous for the factor, a 50% chance exists that each d. Infant who is Rh positive and a mother infant born of this union will be Rh positive, and who is Rh positive 3. 3. What is the highest priority nurs- ing intervention for an infant born with myelomeningocele? a. Protect the sac from injury. a 50% chance exists that each will be born Rh negative. No risk for incompatibility exists if both the mother and the infant are Rh positive ANS: A A major preoperative nursing intervention for a neonate with a myelomeningocele is the pro- tection of the protruding sac from injury to pre- b. Prepare the parents for the child's paralysis from the waist down. c. Prepare the parents for closure of the sac when the child is approximately 2 years of age. d. Assess for cyanosis. 4. 4. Which nursing diagnosis is most ap- vent its rupture and the resultant risk of central nervous system (CNS) infection. The long-term prognosis in an attected infant can be deter- mined to a large extent at birth, with the de- gree of neurologic dysfunction related to the level of the lesion, which determines the nerves involved. A myelomeningocele should be surgi- cally closed within 24 hours. Although the nurse should assess for multiple potential problems in this infant, the major nursing intervention is to protect the sac from injury. ANS: D propriate for a newborn diagnosed with Herniation of the abdominal viscera into the a diaphragmatic hernia? a. Potential for impaired parent-infant attachment b. Inadequate nutrition c. Potential for infection d. Reduced gas exchange thoracic cavity may cause severe respiratory dis- tress and represent a neonatal emergency. Oxy- gen therapy, mechanical ventilation, and the correction of acidosis are necessary in infants with large defects. Although inadequate nutri- tion may be a factor in providing care to a new- born with a diaphragmatic hernia, the priority nursing diagnosis relates to the oxygenation is- sues arising from the lung hypoplasia that oc- curs with diaphragmatic hernia. The nutritional needs of this infant may be a clearly identified need; however, at this time the nurse should be most concerned about reduced gas exchange. This infant has the potential for infection, es- pecially after the surgical repair has been per- formed. The extent of the herniation may have 5. 5. What is the clinical finding most likely to be exhibited in an infant diagnosed with erythroblastosis fetalis? a. Edema b. Immature red blood cells c. Enlargement of the heart d. Ascites 6. 6. Which statement regarding congeni- tal anomalies of the cardiovascular and respiratory systems is correct? a. Cardiac disease may demonstrate signs and symptoms of respiratory ill- ness. hindered normal development of the lungs in utero, resulting in respiratory distress. ANS: B