Maternal Child Health NUR 2633 Final Exam Rasmussen College

Maternal Child Health NUR 2633 Final Exam Rasmussen College A nurse is caring for a child who is on clear liquid diet. Lunch, the child consumbed .5 cup of juice and 3oz of jello 1 oz ice pop and 20 ml of ginger ale with medications. How many ml should the nurse chart as the childs intake? - 260 nurse planning care of infant. Most appropriate site to assess pulse? - Apex of the heart Teaching parent of a toddler about nutrition. What should be included? - Decreased interest in eating Born with spina bifida. Instructor asks student what other condition may be present with spina bifida. She is accurate with which answer? - Hydrocephalus Pedi hotline receives call from mother how plans to admin ASA to toddler for a fever and what to know the dosage - Give her acetaminophen not ASA Caring for child who has been phys abused by a family member. Appropriate statemtn for the nurse to say to the child? - It is not your fault that this happened Type of play is noted in all children at time but this remains the primary form of play for a child it may be sign of developmental delays - Onlooker play Hearing impaired children are at risk for which of the following - Speech impairments Caring for an adolescent who has a newly applied fiberglass cast for fractured tibia. Immediately following application of the cast the nurse should recognize that the priority action is to do... - Perform a neurovascular assessment An infant has an elevated bilirubin and the provider has requested phototherapy at the mother's bedside. What education should the nurse provide to the mother regarding use of the bili lights? Select all. - Use an eye shield on infant, Increase oral intake to the infant, Keep infant supine?, Protect genital area fro bili lights Client in labor has external fetal monitor. Nurse nots late decels and interprets them as indicating which of the following? - Delivery of fetus is imminent the nurse knows that all women should perform self breast exams to ID changes. If a woman telephones your clinic and reports a lump in her breast what is the nurse's best response to her? - Please make an apt to come to the clinic. The provider will see you and discuss options after an exam. Pregnant client presents to L&D with no prenatal care and it is quickly determined to ultrasound that she is 39wks gest. What lab specimens must the nurse obtain which will direct the care given to the client. Select all. - Group b strep, CBC, Blood type and Rh 6wks. She has had previous spontaneous abortion at 14wks and pregnancy that she delievered vaginally at 39wks. What is her gravidity and parity using the GTPAL system? - 3-1-0-1-1 a woman arrives at the clinical for pregnancy test. The first day of her last menstrual period was july 21, 2015. What is her EDD using Naegles Rule? - Apr. 28, 2016 Woman presents to the ED with complaints of unilateral LQ ab pain and some vaginal bleeding. She relates having a positive home pregnancy test 1 wk ago. What should the nurse be concerned about with this patient? - She may be experiencing an ectopic pregnancy 30wk pregnant client is receiving mg sulfate for preeclampsia. Nursing interventions that a nurse will complete while administering mg sulfate to this patient. Select all - provide continuous fetal monitoring, Foley cath for urinary output For what medical issues is mg sulfate administered to pregnanct women - Preterm labor and preeclampsia Fetal wellbeing is a responsibility of the nurse. How does the nurse assess for fetal wellbeing - Fetal movement A prescription for morphine sulfate IV Bolus has been ordered for a child who is in pain. The nurse preparing to administer the medication realizes that the client appears small for her age. Which of the following actions should the nurse take - Weigh the child and calculate the dosage range The nurse is caring for a 17yo cline who is experiencing a relapse of leukemia and is refusing chemotherapy. The client's mother insists that the client receive treatment. Which of the following nursing actions should the nurse take? - Notify the charge nurse of the situation A nurse in a well child clinic is assessing a 6mo infant. Which of the following assessment should the nurse expect to make? - Posterior fontanel is closed A nurse is caring for a 4yo client who just had ab surgery. Which of the following techniques should the nurse use to get the client to take deep breaths - Lets play a game of blowing cotton balls across your table 5yo scheduled for cardiac cath. what does the nurse know about the preop teaching for this client. - Adapt the education to his age and level of development so he can understand Parents of a 3yo child with congenital heart disease are afraid to let their child play with other children because of possible over exertion. Which statements by the nurse is true? - Child needs opportunities to play with others Several complications can occur when a child received a blood transfusion. What is an immediate sign of an air embolus - Sudden difficulty breathing The nurse is caring for an adolescent who has just started dialysis. 15yo seems angry hostile and depressed. Nurse should recognize this is related to which of the following issues? - Adolescents have a few coping skills The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What is the most essential part of the nursing assessment to detect early signs of worsening conditions - LOC Which of the following does not predispose the child to UTI - Lower urine pH The most immediate threat to life in children with thermal injuries? - Shock A child has a chronic nonproductive cough and diffuse wheezing during the expiratory phase of respiration. What should this suggest to the nurse - asthma all but which of the following techniques are acceptable for medications administration to an infant? - Inserting the needleless syringe into the side of the infants mouth Choose the nursing interventions for a child after a cardiac cath. select all. - Maintain a patient peripheral IV Cath, Assess the affected extremity for color and temperature, Check pulses above the procedure site for equality and symmetry Which action is likely to encourage parents to talk about their feeling related to their childs illness - Use openended questions In preparing to insert an IV into a 5yo then nurse should consider which of the following. Select all. - Use procedure room, Have a family member or assistant in the room, Use a transitional object for explaining While planning postop care for the toddler. The nurse recognizes that the child is likely to have which concern based on age? - Separation from parents Infant weighted 6 lbs at birth. expected weight at 1 yr? - 18 Perinatal nurse prepares the laboring woman for an epidural anesthesia insertions. What nursing action should be taken to prevent maternal hypotension - Admin a rapid IV infusion of 500mls of NS Methergine is prescribed for a woman to treat postpartum hemorrhage. What is that priority nursing assessment before administering this drug to the postpartum client. - BP Receiving MgSulfate for the management of preeclampsia. A nurse determines that the client is experiencing toxicity from the med if which of the following is noted on assessment - RR of 10bpm A nurse in the newborn nursery is monitoring newborn infant for respiratory distress syndrome. Which assessment signs if noted in the newborn would alert the nurse to the possibility of this syndrome - Tachypnea and retractions Nurse determines that a new mother understands the teaching about prevention of newborn abduction if she makes which statement - If I am planning a shower I should return the baby to the nursery if my husband is not here Developing a plan of care for a child who is at risk for seizures. What are the nursing interventions that the nurse should perform if the child has a seizure. Select All. - Provide a safe environment, Ensure the child has an adequate airway, Stay with the child A new mother expresses concerns regarding SIDS. She asks the nurse how to position the new infant for sleep. What is the nurses best response to this new mother - Back rather than on tummy Hospitalized 2yo with croup is receiving corticosteroid therapy and the mother asks why the provider did not prescribe antibiotics? What is the best response to the mother? - Antibiotics are not indicated unless a bacterial infections is the cause of illness Nurse is monitoring an infant with CHF. Which of the following symptoms alerts the nurse to suspect fluid accumulation and the need to call the provider? - Weight gain of 1lb in 1day When is it generally recommended that a child return to school with an acute strep pharyngitis - after taking antibiotics for 24hrs Which type is croup is considered a medical emergency - Epiglottitis An appropriate nursing intervention when caring for a child with pneumonia is which of the following - Encourage rest Infant brought to the ED with poor skin turgor weight loss lethargy an tachycardia. What does the nurse suspect is the problem? - Dehydration Therapeutic management of a child with acute diarrhea and mild dehydration usually beings with what nursing action? - Oral rehydration solution toddler's parents ask for suggestions on dealing with temper tantrums. What is the most appropriate recommendation the nurse can share with the parents? - Ignore the behavior provided that is not injurious That is most critical nursing action in caring or the newborn immediately after birth - Keeping the newborns airway clear Newborns that maybe more at risk for developing cold stress are those infants without sufficient brown fat thermogenesis. The neonatal nurse will recognize which baby is at the greatest risk? - IUGR whose mother underwent an emergency c-section for preeclampsia Young child brought to ED with severe dehydration secondary to acute diarrhea and vomiting Therapeutic management of this child will begin with which nursing intervention? - IV Fluid 3mo infant dies shortly after arriving to the ED. Infant has a subdural and retinal hemorrhages but no external signs of trauma. The nurse should expect which injury? - Shaken baby syndrome 1min after birth the nurse assesses the infant and notes a HR of 80bpm some flexion of extremities a weak cry slight grimacing and pink body but blue extremities. The nurse would calculate an APGAR score as which number. - 5 clinic is lending a federally approved car seat to an infants family. The nurse should explain where the safest place is to put the car seat in the vehicle - rear facing back student nurse notes that population of a STI health clinic consists largely of teenagers. The nurse explains that adolescents are at greater risk for contracting STIs because of which factor? - Adolescents are risk takers and believe they are invincible Pedi nurse routinely administers blood products to the patients on the unit. Safe administration includes the following procedure - allow 4hrs for maxium time for blood infusion school aged girl who has had a cardiac cath. the child tells the nurse that her bandage is too wet. The nurse find the bandage and bed soaked with blood. What is the most appropriate initial nursing action? - Apply direct pressure about the cath site What is the priority nursing intervention when a child is unconscious after a fall - Establish adequate airway After the acute stage and during the healing process the primary complication from burn injury is - Infection A mother brings her 15mo old child to the clinic. During nursing assessment the mother makes the following comments. Which comment warrants further investigation. - Is not crawling yet 10yo is discharged home from the ED after a fracture his left lower extremity. Cast was applied and nurse give discharge instruction to the patient and his parents. The nurse notes the parents require additional education when the mother states which of the following - I will use a hair dryer to help dry the cast faster Informed consent requires which of the following actions - A signature of someone of legal age which is 18 in most states The nurse is caring for a laboring client and notes the fetal monitor pattern of accelerations. Which of the following is appropriate? - Document the normal finding and reassure the monitor and family A nurse has ID that her pregnant client has a labor dystocia and is not progressing normally through the labor process. The nurse is preparing to augment her labor and will prepare the client for which of following nonpharm procedure? - Amniotomy Uterine atony occurs after your patient has vaginal delivery of her 9lbs baby. The initial nursing intervention to prevent hemorrhage is which of the following interventions? - massage fundus Health teaching that the nurse would provide for parents of an immunosupp child focuses on which important measure? - hand washing the nurse observed some children in the playroom. Which play situation exhibits the characteristics of parallel play. - A playing with a truck next to B playing with a truck Appropriate nursing Dx for a child with anemia - Activity intolerance R/T gen weakness Discipline is important to the growth and development of children. Discipline can teach a child how to manage behavior. Some discipline will destroy a childs self esteem. Which discipline is appropriate. Select All - Distraction, Removal of privileges, Time out, Consequences of actions 4yo comes into ED. Has frog-like croaking sounding upon inspiration is agitation and is drooling. She insists on sitting upright. Priority action? - Maintain an open airway 12y/o dx with type 1 diabetes. Pedi nurse explains to the nurse explains to the patients parents that the symptoms of this disease include which of the following? - Unintended weight loss ____________ is described as enhancing the quality of life by keeping the patients comfortable in the face of terminal condition such as cancer. - Palliative Why are cool mist vaporizers vs steam heat humidifiers recommended in home treatment of respiratory tract infections - Safer 8yo dx with sickle cell anemia. Hospitalized and nurse recognized which of the following as the initial nursing intervention - hydration and pain management advantage of peritoneal dialysis - parents and older children can perform treatments at home The student nurse is preparing education for the parents of a 6yo that will begin Fe supps following a dx of Fe deficient anemia. What should be included in the ed. Select all that apply. - Fe should be given with a glass of OJ, Black tarry stools, Cause constipation Pedi nurse assesses 7mo infant brought to the clinic with S/S of irritability N?V and taut anterior fontanel. Based on the standard growth chart, the nurse notes that the child has an increased head circumference which may indicate which of the following med conditions? - Brain tumor To offset chemo related effects of nausea and vomiting. The pediatric nurse administers which medications? - Ondasetron The periatric nurse is familiar with kubler ross stages of grief. Parents who are feeling confused and refuse to discuss the disease with any nurse or doctor are in which stage of grief? - Denial During a pedi nursing orientation session to a new unit. The child like specialist is introduced as an important member of the healthcare team. What is an important role of the child like specialist. - To provide opportunities for therapeutic play and information The pedi nurse is caring for a child who has been in a motor vehicle collision. The dr explains to the family that there serious physical disabilities. The father is upset and states I don't know how I will be able to cope. I have two other children. What can I do? What is the nurses response? - Many parents find the initial news to be overwhelming. What questions can I answer for you? Asking the pregnant woman about her use of recreational drug is essential component of the prenatal hx. The use of rec drugs cause harm to the fetus resulting in which OB outcomes? Select all. - Miscarriage/ spontaneous abortions, Low birth weight Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be away that the optimal pharm therapy for pain is? - NSAID Screening at 23wks reveals that a pregnant woman has gest DM. in planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. What is the fetus at greatest risk for? - Macrosomia The nurse caring for a pregnant client knows that her health teach regarding fetal circulation has been effective when the client reports that she has been sleeping in what position? - In a sidelying position Which of the following are S/S that a pregnant woman should report immediately to her health care provider? Select all. - Ruptured membranes, Vaginal bleed, HA that do not respond to usual therapy 34wks, experiencing preterm labor. Interventions nurse will provide for client. Select All. - Iv fluid bolus, Obtain urine specimen, Place on fetal monitor Perinatal nurse prepare the laboring woman for an epidural. What intervention can the nurse provide to prevent maternal hypotension? - Encourages frequent cleansing breaths after the patient has been placed in the correct position for the anesthesia admin According to agency policy the perinatal nurse provides which intrapartal nursing care for the patient with preeclampsia? - Admin mag sulfate according to agency policy Perinatal nurse providing care to a laboring woman recognizes a nonreassuring FHR tracing. An appropriate initial actions is to which of the following? - Assist the laboring woman to a left lateral position Nurse performs assessment of the newborns skin and documents the presence of a yellow coloration of the skin surface sclera and oral mucous membranes. What condition is most likely the cause of these findings? - Jaundice 4yo has croup is admitted to the hospital and wes the bed overnight. When the parent comes to visit the next day the nurse explains the situation and the parents says my child neer wets the bed at home. I am so embarrassed. Which of the following is an appropriate response by the nurse? - It is normal for hospitalized children to regress. The toileting skills will return when your child is feeling better A nurse is assessing a newborn to a mother who is addicted to drugs. Which assessment findings would the nurse expect to note during the assessment of this newborn - Incessant crying A nurse performs an admission assessment on a child and suspects physical aburse. Based on this suspicion, the primary legal nursing responsibility to which of the following? - Report the case in which the abuse is suspected to the local authorities and your supervisor or charge A nurse is caring or a child after tonsillectomy. The nurse monitors the child knowing that which of the following indicates that the child is bleedling - Frequent swallowing A nurse provides home care instructions to the parents of a child with congestive heart failure regarding the procedure for administration of digoxin. Which statement made indicated need for for further instructions? - If child vomits after med, I will repeat the dose