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Maternity and Peds Hesi Review 3

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Maternity and Peds Hesi Review 3 Mother of a preschool-aged child calls school RN to report her child was bitten by a tick while on a school outing last wk. Mother tells RN she removed tick & flushed it down toilet. What action should school RN take? Schedule test for Lyme disease if rash appears.  Dr. prescribes phenytoin (Dilantin) for school-aged child diagnosed with tonic-clonic epilepsy. Which info should RN provide parents when teaching about seizure management with phenytoin? Monitor child’s serum phenytoin levels routinely while taking Dilantin.  During newborn admission assessment, RN palpates newborn’s scrotum & does not feel the testicles. Which assessment technique should RN perform next to verify absence of testes: Perform transillumination of scrotal sac to visualize shadows of testes.  The parents of a 14-month-old-child who is hospitalized due to febrile seizures tell RN that they fear their child will have lifelong seizures. What info should RN convey to these parents? Reassure the parents that febrile seizures decrease as child grows older.  In determining the one min Apgar score of a male infant, RN assesses a heart rate of 120 beats per min & 44 respirations per min. He has a loud cry with stimulation, good muscle tone, & his color is acrocyanotic. What Apgar score should RN assign? 9  School-aged child with otitis media receives prescription for azithromycin (Zithromax) 100 mg once, then 50 mg daily for 4 days. Med available in solution containing 200 mg/5 ml. How many ml should RN give on first day? 2.5  39-wk-gestational multigravida is admitted to L & D with spontaneous rupture of membranes (SROM) & contractions occurring every 2-3 mins. A vaginal exam indicates that cervix is dilated 6 cm, 90% effaced, & the fetus is at a +2 station. During last 45 mins FHR has ranged between 170 & 180 beats/min. What action should RN implement? Take oral maternal temp.  During admission of newborn, RN identifies localized swelling that does not cross suture line on the posterior area of the parietal bone. What action should RN implement? Notify Dr of cephalhematoma.  Mother of 6 y/o girl is concerned about her child’s obesity. The child’s weight plots at 75 percentile, & the height at the 25 percentile. The child’s BMI is at 85 percentile for age & gender. Which interventions should RN implement? SATA: Determine child’s usual physical activity pattern, Ask if school has PE program, Obtain child’s 3-day diet history based on mother’s input.  Woman 36-wks & Rh negative admitted to L & D with abdominal cramping. She is placed on strict bedrest & FHR & contraction pattern are monitored with external fetal monitor. Two hrs later, RN notes large amount of bright red vaginal bleeding. Highest priority nursing action? Assess FHR & Pt’s contraction pattern.  Nutritional info RN should give mother of 6-mo-old on introducing solid foods? Introduce foods one at a time, at 4-7 day intervals.  Digoxin is prescribed to 3-month-old with congenital heart disease. RN should teach parents to do what if they miss giving a dose of this med? If less than four hrs have elapsed, give the missed dose.  A 10 y/o boy has been seen frequently by the school RN over the past three wks after school begins in the fall. He reports headaches, stomach aches, & difficulty sleeping. What intervention should RN implement? a. Ask the boy to describe a typical day at school. 1

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