Maternal Child Final Exam- Rasmussen 100% Correct

When discussing an ailment with a patient, what data do you collect FIRST? - ANSWER Background information How do parents develop the developmental task during infancy in Erikson's theory? - ANSWER *Trust vs Mistrust* Primary caregiver(s), regular interactions, positive experiences, security, calm/reassuring attitude, feeding regular schedule/availability. Know the states of Kubler-Ross's stages of grief. - ANSWER Stages of grief- Denial, Anger, Bargaining, Depression, and Acceptance Treatment for pain associated with dysmenorrhea. - ANSWER *NSAID's (Advil, Motrin)*, *Hormone treatments* (combined estrogen/progestin oral contraceptives). What are important teaching points when a provider prescribes an antibiotic? What illnesses do providers NOT prescribe antibiotics for? - ANSWER Allergies completion of Rx *viral infections* Know how to administer ear and eye drops. - ANSWER EYE-Pull down lower lid, drop carefully into the conjunctival sac, instruct patient to close eye and roll eyeball around, do not touch with dropper, gently hold gauze to soak up excess when eye closed. EAR-Child pull ear down and back, tilt head to opposite side. *Older pull ear up and back.* What is the single most important task of a nurse during any abuse case? - ANSWER Ensure safety and report. Know the complications of strep pharyngitis: - ANSWER *Rheumatic Fever* get adequate antibiotic treatment asap Post- tonsillectomy nursing care, what is the main focus besides pain? - ANSWER Hemorrhage/swallowing blood. *Hydration!* people don't want to drink anything when they've had a tonsillectomy. Know the signs of pneumonia. - ANSWER Fluid builds in lungs: *Cough* (productive with greenish or yellow sputum) *Fever* *crackles* What are the nursing considerations of the medication pancrelipase? - ANSWER May interfere with Iron Absorption, risk of anemia. *Take it before or with a snack or meal* Know how to use a metered-dose inhaler. - ANSWER Inhaler use: *Shake*, Exhale, *Activate as placing in mouth and begin to inhale*, long slow inhalation, hold breath for *5-10 seconds, exhale normally*. One puff at a time, one minute between puffs. What are common treatments for croup? (Think medications) - ANSWER Cool moist air combined with a corticosteroid, such as dexamethasone, or *racemic epinephrine administered with nebulizer, Bronchodilation!* Dexamethasone. Maintain airway and monitor fluid balance, Humidification, Tylenol, or Ibuprofen for FEVER What is the mechanism of action of digoxin. - ANSWER Digoxin increases cardiac output and slows the heart rate. HF, A.Fib, Improves myocardial contract ability, Monitor pulse withhold medication as ordered, *DECREASED HR, INCREASE FORCE.* Know nursing care and interventions for chest tubes. - ANSWER · Child's respiratory rate remains within age-appropriate parameters; there are no rales, crackles, or other adventitious breath sounds; chest tubes function effectively. · Keeping the system closed and below chest level · Monitor for bubbles in water seal chamber · *CLAMP IF TUBES BECOME DISCONNECTED* What does a patent ductus arteriosus (PDA) sound like? - ANSWER *Machine sounding murmur!* Distinct murmur What is the single most important way to prevent disease? - ANSWER Handwashing Nursing care/assessment of a patient with coarctation of the aorta. - ANSWER Assess femoral and radial pulse at the same time Teaching/considerations for a child with tetralogy of Fallot (what would you do if you noticed the child was blue?) - ANSWER In a hospital setting, along with *knee-to-chest positioning* blow-by oxygen can be beneficial to enhance circulating oxygen and possibly dilate the distal pulmonary bed Know the signs/symptoms of placental abruption - ANSWER *Sharp abdominal pain (contractions that do not relax)* *Fresh vaginal bleeding* Hypotension FHR decreases Nursing interventions of sickle cell anemia. - ANSWER Pain management Adequate hydration O2 Blood transfusions Genetic testing. Common signs/symptoms and treatment for severe dehydration. - ANSWER Decreased skin turgor, rapid pulse, decreased BP, sunken fontanel/eyes Tx: Iv fluids, O2 Know where/how to install a car seat. - ANSWER rear-facing car seats placed in the back seat, five-point harness with broad straps, 45 degree angle Which age group is most likely to contract STI's? - ANSWER 15-19: adolescents Know the nursing responsibilities for a cystourethrogram - ANSWER Voiding during an x-ray Explain to mother and child, prepare for the procedure Child may be intimidated; make sure the mother explains what will happen. *Insert foley catheter.* What must immunocompromised individuals avoid social gatherings? - ANSWER *Infection risk/ prevent infection* wear mask. Common cause of glomerulonephritis - ANSWER Strep Throat Infection, Streptococcal sore throats, also rheumatic fever has same risk factors. *Group A beta-hemolytic streptococci* Complications of congenital adrenal hyperplasia: - ANSWER Dehydration Treatment of growth hormone deficiency: - ANSWER *Recombinant Human Growth Hormones via IM.* (rhGH) given daily at *bedtime.* Signs/symptoms of diabetes mellitus type 1: - ANSWER *Marked weight loss* *Polydipsia, Polyphagia, Polyuria* (bedwetting can be an indication), Blurred vision fatigue mood changes. What is the main cause of Type 2 diabetes? - ANSWER Obesity, diet and sedentary lifestyle. Metabolic disturbances that result in *insulin resistance.* Common findings in a patient with Cushing syndrome. - ANSWER Moon face excessive hair growth(hirsutism) red cheeks weight gain pendulous abdomen *abdominal striae (purple)/Stretch Marks* easily bruised arms and legs slow wound healing. Signs of hypoglycemia in a newborn: - ANSWER Serum glucose of less than 40mg jitteriness lethargy and seizures resp distress Know how to administer insulin (pen, syringe, short acting, long acting, etc.) - ANSWER Clear (short acting: regular) to cloudy (long acting: NPG) What is ALL? - ANSWER *Acute lymphoblastic leukemia* - most common form of childhood cancer. Avoid rectal temps in these patients due to risk of bleeding/ increase risk of bleeding. Teaching points on iron administration, what should we tell the parents of a child receiving iron? - ANSWER Take with Orange Juice (citrus) may cause constipation and black tarry stools Teaching considerations on how to avoid skin cancer. - ANSWER *Avoid tanning beds* stay out of sun midday, limit direct sun exposure, *use sunscreen* UV sunglasses *avoid severe sunburns, two or more episodes of sunburns have been linked to malignant melanoma* What is the criteria for failure to thrive in an infant? What would show that this is resolving? - ANSWER Falls below 5th percentile for weight and height on a standard growth chart. Poor feeding, sleep apnea. Increased weight (if not related to fluid overload) and height, better eating and sleeping patterns. Nursing considerations for a patient with seizures, what precautions should we take? - ANSWER Bed at a low height, having O2 available, padded side rails. Remove any thing nearby during a seizure and place pillow under head. *Stay with the patient and place on their side, maintain their airway, and keep their environment safe!* Nursing assessment for a head injury? - ANSWER *LOC* *Seizures* Vomiting Irritability when regaining consciousness Crying (fright or pain) Know the signs/symptoms of asthma: - ANSWER Asthma-Barrel chest tripod breathing pursed lip breathing. *Chest tightness* *pain* *wheezing when exhaling* *sob* *trouble sleeping.* As well as nonproductive cough and anxiety Signs of sexual abuse: - ANSWER Children = repeated uti infections abdominal pain withdraw when approached anxiety trouble sleeping acting weird around a certain person change in school performance What is the moro-reflex and when does it go away? - ANSWER Infant response to sudden loss of support *4-5 months* What is the calculation to predict an infant's weight at one year? - ANSWER An infant typically *triples birth weight* and increases length by 50% Developmental stage for a toddler - what is it and what are some examples: - ANSWER *Autonomy vs Shame & Doubt: 18m to 3yrs.* Development of physical skills, walking, grasping. May feel a sense of accomplishment or shame/doubt with failures. *Want to do EVERYTHING themselves* Nursing care for a newly placed cast, what type of assessment will we be doing? - ANSWER Assess the child's knowledge of broken bones and bruising and why trauma leads to head concussions. Assess pain level on a 1-10 scale. *Neurovascular assessment.* Teaching on how to treat/prevent childhood obesity. - ANSWER *Well balanced diet (WHOLE family)* add fiber to their diet (whole grain cereal and raw fruits) reduce refined sugars and saturated fats. *Encourage sports to increase exercise* *after school activities.* Know how to score an infant using APGAR: - ANSWER A=appearance-skin color 0= blue, 1= blue extremities, 2= pink P=pulse 0= absent, 1= 100, 2= 100 G=grimace-response to stimuli 0= absent, -1, -2 A=activity-muscle tone 0= absent, 1= minimal, 2= moving R=respiration-crying pattern 0= absent, 1= when aroused, 2= crying What are epiphyseal lines and when do they close? - ANSWER Ossified growth plate Closure happens at 16-17yrs for females *18-20 yrs in males.* Sexual activity teaching in adolescents: - ANSWER *Explain abstinence (only 100%)* birth control STI education *safe sex practices* *Don't give into peer pressure* What are some ways to help kids not feel lonely while in the hospital? (hint: Parents and friends) - ANSWER Pictures, tablets with zoom or skype Encourage family to room in with pt. *Social media.* When a patient is a part of a single-parent family and needs a procedure, what must the nurse first do LEGALLY? - ANSWER Ensure the parent with legal MEDICAL custody is there to sign. What is the anterior fontanelle and when does it close? - ANSWER Known as the soft spot, the anterior is about 2-3cmW , 3-4cmH, this closes at about *12-18 months.* Know how to score a woman using the GTPAL system: - ANSWER Gravidity= Total number of pregnancies Term=Term Pregnancies (delivered at 38 wks) Preterm= Preterm Pregnancies (delivered at 23-37wks) Abortion= Abortion or miscarriage Living= Living children What is a negative outcome of using narcotics during labor? - ANSWER Abstinence syndrome Decreased RR Withdrawing