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NUR 113 Exam With 100% Correct Answers Latest Update

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NUR 113 Exam With 100% Correct Answers Latest Update



Newborn assessment- abdomen - Answer Abdomen

Umbilical cord

One vein and two arteries- should be able to see those vessels

Single artery may be associated with renal and GI anomalies; SGA infants

Whitish blue-gray, contains a gelatinous tissue called Wharten's jelly

Inspect for bleeding, infection, inflammation, drainage, and redness

Auscultate bowel sounds

Reflexes



Rooting, sucking, gag, Moro, tonic neck, Babinski, swallow, blink, burp, hiccup, palmar
grasp, plantar and sneeze

A two vessel cord often means nothing but other times is associated with small for
gestational age babies or other defects-variation in their normal makeup that is not quite
normal-like an anus that is not patent and sometimes associated with a heart defect



These reflexes tell us that their neuro system is intact

Some girls have a mucous or blood-tinged discharge due to mother's residual hormones
and should reassure parents

Newborn assessment- genitalia - Answer Genitals

Scrotum of males and labia of females may be swollen due to fluid accumulation.

The penis should be observed for the position of the urethral meatus.

Girls may have a mucus discharge tinged with blood

Observe anus for patency. Presence of meconium indicates patency

We no longer do a rectal thermometer, now we wait for them to pass meconium and if
has been over 24 hours without it then we will check but we do not want to traumatize
the anus with the temperature probe unnecessarily

,Newborn assessment-extremities and back- Answer Extremities



Arms and hands are generally flexed against the body, both arms should move evenly

Limbs: of equal length, hips freely movable

Hands and Feet: to be inspected for syndactyly and polydactyly

Spine

Straight with no curvature

Also, check for a sacral dimple or pit at the base of the spine: this may be within normal
variant, but if it is very deep and there is something that resembles a tuft of hair in the
bottom of it, it must be investigated to ensure that that pit doesn't communicate all the
way to the spinal cord.

Shoulder dystocia may lead to clavicle injury and they believe it is the force of labor that
fracture the clavicle rather than the dystocia shoulder

Polydactyl-extra number of fingers or syndactyl-fingers joined together

Newborn care- testing - Answer Laboratory and diagnostic tests

Universal newborn screening

Serum Bilirubin

Congenital heart disease- O2 sat on babies left hand and O2 sat on one of the feet and
making sure that those values are very close together to help screen for congenital
heart issues before they go home

Newborn hearing screening

Normal levels for serum bilirubin will depend upon the infant's age in hours.

Baby gets a heel stick to get blood drawn

Most all the enzyme deficiencies they test for, like sickle cell traits, PKU, and a lot of the
disorders, are all checked in universal newborn screening. Blood goes on little circles of
paper and to test the blood they hole punch the paper off to test it.

This means if the baby has PKU (Phenylketonuria) that you are unable to process phenal
ketones and this is important to know right away because there is a lot of food that has
those ketones in it.

Every baby also receives a bilirubin test in the blood because of an immature liver.

Jaundiced hyperbilirubinemia is the most common issue with babies.

,Hearing screen - Answer The one that is most commonly used assesses the auditory
brainstem response to ensure that the brainstem is responding to the sound rather than
looking for the baby to turn toward the sound.



Newborn care- hygiene - Answer Hygiene



Diaper changes- clean the diaper area well with each change

No lotions or powders- been associated with some reproductive cancers

Care of the umbilical area avoid getting wet

Circumcision care

First bath for the new born:

Stabilization of body temperature

An opportunity for detailed examination

Relaxation/ comfort

Teaching for parents/child/family

For circumcision care first priority assessment is to check for bleeding followed by
urinary output

We wait for at-least 24 hours before bathing

Newborn care- bonding -Answer Parent Child Bonding

Vasoconstriction of the placental decidua - Answer The spiral arteries in preeclamptic
women are constricted and cause decreased perfusion to the placenta



Proteinuria: False Positives - Answer Urine dipstick is routine but is unreliable. False
positives result from:

Vaginal discharge/blood

SG and pH

Bacteria

Renal disease

Clinical Management for Reproduction - Answer Primary Prevention: disease prevention

, and wellness-related approaches to promoting sexual health

Patient education

Counseling

Referral

Secondary Prevention

Screening - diagnose existing disease in its early stages.

This is referred to as screening with a goal of reducing morbidity and

mortality and preserving quality of life.



Primary Prevention focus areas: abstinence, contraception, safer sex practices, STIs
healthy relationships, and community resources.



Featured Exemplars for Reproduction - Answer Menstrual Dysfunction

PCOS

Endometriosis, Uterine Fibroids

Sexually Transmitted Infections

Family Planning



Menstrual Cycle- Proliferative Phase: - Answer Proliferative (Follicular) Phase

Days 1-12 (Stimulation to Ovulation)

Low estrogen/progesterone production in ovaries signals hypothalamus to produce
gonadotropin-releasing hormone (GnRH).

GnRH orders ant. pituitary to release follicle stimulating hormone (FSH)

FSH stimulates follicle production in ovary (10-20 start to develop but usually only 1
matures).

Developing follicles in ovary produce estrogen.

Estrogen stimulates endometrial cells (lining of uterus) to enlarge: endometrial spiral
arteries dilate, lining thickens 6-8 fold, cervical mucus thins and becomes more alkaline
to allow sperm to penetrate

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