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The nurse is providing teaching to a client with type 2 DM about important points for disease and symptom
management. Which statement by the client indicates understanding?
A) Using salt, herbs, and spices will improve the flavor of foods
B) Get an eye exam with an opthalmologist annually
C) Arrange diet schedule around three regular meals a day
D) Inspect feet every month for ingrown nails, cuts, and caluses - (ANSWER)B) Get an eye exam with an
opthalmologist annually
The nurse is providing educations to a client who experiences recurrent levels of moderate anxiety to situations and
perceived stress. In addition to informations about prescribed medications and administration, which instruction should
the nurse include in the teaching?
A) Center attention on positive upbeat music
B) Find outlets for more social interaction
C) Practice using muscle relaxation techniques
D) Think about reasons the episodes occur - (ANSWER)C) Practice using muscle relaxation techniques
,The charge nurse is planning for the shift and has a RN and a PN on the team. Which client should the charge nurse
assign to the RN?
A) A 75-year old client with renal calculi who requires urine straining
B) A 64-year old client who had a total hip replacement the preious day
C) A 30-year old depresses client who admits to suicide ideation
D) An adolescent with multiple contusions due to a fall that occurred 2 days ago - (ANSWER)C) A 30-year old
depresses client who admits to suicide ideation
NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1 mother, who was diagnosed with
gestational diabetes. Following a spontaneous vaginal birth, she received Apgar scores of seven at one minute and eight
at five minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with acrocyanosis and a moderate amount of
subcutaneous fat. She is noted to be slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower back, Ballard maturity rating 37 weeks.
(For each assessment finding, click to indicate whether the findings are associated with an infant of a diabetic mother or
normal presentation.)
Soft Fontanelles
Blood Glucose 35
Axillary temp. 96F
,Acrocyanosis
Ballard score maturity rating 37 - (ANSWER)Diabetic Findings:
BG 35
Axillary temp 96
Ballard score maturity rating 37
???????
Normal Presentation:
Soft Fontanelles
Acrocyanosis
(normal findings include acrocyanosis, soft fontanelles, mongolian spots, and Apgar scores 7 to 10)
NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1 mother, who was diagnosed with
gestational diabetes. Following a spontaneous vaginal birth, she received Apgar scores of seven at one minute and eight
at five minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with acrocyanosis and a moderate amount of
subcutaneous fat. She is noted to be slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower back, Ballard maturity rating 37 weeks.
The nurse recognizes that the infant of a diabetic mother is at risk for _________ , _____________ , and
_________________ - (ANSWER)Hyperbilirubinemia , Resppiratory Distress Syndrome , and Cardiomyopathy
, NGN: Orders
Breast-feed immediately once stable then on demand. If unstable, may feed breastmilk via orogastric tube. If two feeding
attempts failed to increase the glucose levels or if symptoms of hypoglycemia develop, apply dextrose gel inside the
babies cheek. If the above are ineffective, IV glucose should be administered to maintain glucose levels above 45. Bolus
of 2mL/kg glucose 10% IV, hello by a continuous glucose perfusion of 6 to 8mg/kg/min, maintain glycemic levels over
40.
Which 6 orders take priority?
A) Feed Immediately
B) Monitor for respiratory distress
C) Apply dextrose gell inside the baby's cheek
D) Keep in warmer with bilirubin lights
E) Monitor temp every 30 min
F) Bolus 2 mL/kg glucose 10% IV
G) Contact RT for ABG and oxygen therapy
H) Echo
I) Transfer to NICU
J) Blood glucose level - (ANSWER)A) Feed Immedicately
B) Monitor for Respiratory Distress
D) Keep in warmer with bili lights