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Terms in this set (60)
A nurse is caring for a newborn. Poor feeding: Hypoglycemia, Hyperbilirubinemia, Sepsis
8 hr of age: Lethargy: Hypoglycemia, Sepsis
Temp: 37.1 C(98.8 F) Axillary Yellow sclera and oral mucosa: Hyperbilirubinemia, Sepsis
Pulse rate: 132/min Decreased temperature: Hypoglycemia, Sepsis
Resp rate: 52/min Respiratory distress: Hypoglycemia, Sepsis
Ecchymotic caput succedaneum: Hyperbilirubinemia
36 hr of age:
Temp: 36.1 C (97 F) Axillary
Pulse rate: 160/min
Resp rate: 78/min
For each assessment finding, click to specify if the
finding is consistent with hypoglycemia,
hyperbilirubinemia, or sepsis. Each finding may support
more than one disease process.
A nurse is assessing a newborn following a circumcision. b. Chin quivering
Which of the following findings should the nurse identify
as an indication that the newborn is experiencing pain?
a. decreased heart rate
b. chin quivering
c. pinpoint pupils
d. slowed respirations
A nurse is teaching a client who is at 10 weeks of d. "I should take 600 micrograms of folic acid each day."
gestation about nutrition during pregnancy. Which of the
following statements by the client indicates an
understanding of the teaching?
a. "I should increase my protein intake to 60 g each day."
b. "I should drink 2 liters of water each day"
c. "I should increase my overall daily caloric intake by
300 calories each day."
d. "I should take 600 micrograms of folic acid each day."
A nurse is planning care for a client who is to undergo a d. Instruct the client to press the provided button each time fetal movement is
nonstress test. Which of the following actions should the detected
nurse include in the plan of care?
a. Maintain the client NPO throughout the procedure.
b. Place the client in a supine position.
c. Instruct the client to massage the abdomen to
stimulate fetal movement.
d. Instruct the client to press the provided button each
time fetal movement is detected.