Maternal/Child Final Review

Maternal/Child final review 1. Before administering baby/child Iron a. Teaching give with orange juice, b. May cause black tarry stool, c. and constipation 2. Baby with n/v and they have anterior bulging fontanel, you re ...

Maternal/Child final review 1. Before administering baby/child Iron a. Teaching give with orange juice, b. May cause black tarry stool, c. and constipation 2. Baby with n/v and they have anterior bulging fontanel, you realize head circumference is not normal size. a. Brain tumor 3. Infant with cancer, what do you give for meds? a. Zofran (Ondansetron), offsets the chemotherapy effects of nausea and vomiting. med is for safe and effective and given to ped, PRN 6-8 hr 4. What Stage of grief, Pt/Child dx of cancer, they may not want to talk to about Denial. 5. Health care setting, you have child life specialist, they provide: a. Opportunities b. Interact with the child and patient c. Therapeutic communication therapies d. To provide opportunities for therapeutic play. 6. If you have a pregnant mother, hemoglobin, 7.0,8.0,9.0 - What will happen to the developing fetus? It decreases oxygen…so, Intrauterine growth restriction (IUGR). Restricts growth of fetus. Interfere with the fetus growth. 7. A mother who has been smoking marijuana and pregnant. What do you think will happen to fetus? a. Child will have low birth weight b. Miscarriage c. Preterm birth. d. or other complications are a risk. 8. Dysmorrhea, pt has pain with menses-What is effective medication: a. Give Ibuprofen, Aleve, (no Tylenol). b. NSAID/anti-inflammatory agent. – endomethacin, ibuprofen, aleve. 9. Pt who is 25 weeks pregnant have gestational diabetes. Why would you not want patient to go full term? a. Mascrosomia baby. (they take all sugar) 10. Pt is 38 weeks, uncomfortable, sleeping. What is the best side to sleep on.? a. Turn them to the left.- sidelying. 11. Discharge teaching for a 34 weeks pregnant patient: patient should be advised to report: a. Bleeding b. Ruptured membrane, c. Headache that does not respond to medication d. Heartburn accompanied by headache. 12. Preterm labor –interventions-Contractions two to three minutes apart. Happening last three hours. a. Hook up to fetal monitor, b. IV therapy, bolus 500 ml fluids, c. Get urine sample/ a UTI could cause contractions!!!!! 13. Prevent hypotension in a patient during labor and they just got an epidural: a. IV fluids, (nothing by mouth) administer a rapid 500 ml of normal saline. 14. Fetal monitor with non-reassuring contractions-what do you do? a. Change position, first, Change position to lateral side. Left is best. b. If not working and the heart rate of 80 or Delivery baby now! Position the pregnant woman to the left side. If this does solve the problem prepare for the delivery of the baby. 15. Newborn skin assessment- (not breaking down bili) a. Eyes are yellow, and the Skin is yellow. –jaundice TREATMENT. a. Treatment is light therapy,-cover the newborn eyes. b.Treatment is breastfeed/bottle-feed 16. Most common trauma on a child being born is: a. …clavicle fracture/shoulder break 17. Child born on drugs (drug mom) What do you look for,: a. Incessant crying, b. Inconsolable crying. c. They tend to posture when cuddled. 18. Suspect child abuse, and signs of skin bruising…. a. Report to supervisor b. Report to authorities. As healthcare worker we are mandated reporters. 19. Accelerations of fetal heart monitor. What do you do? a. Record as normal finding b. Document the findings and tell the mother that the patterns on the monitor indicates well-being. 20. Labor dystocia, not progressing normally through labor process: Non pharmacological procedure: a. Amniotomy (rupture of membrane) 21. Pt had 9-pound baby. What do you do if bleeding? a. Fundal massage with lower segment support. Meds for bleeding. -Pitocin -Hemabate -Methergine 22. Precaution for child who is immunocompromised. a. Hand washing Health teaching that the nurse would provide for parents of an immunocompromised child focuses on which important measure? Hand washing. 23. Know that to do parallel play…. a. side by side, not together b. Brian playing with his truck next to Kristina playing with her truck. 24. Diagnosis for a child with anemia- a. Activity intolerance due to weakness 25. Discipline to child that is appropriate- a. Redirection, b. Consequences of actions. c. Time out, d. Removal of privileges, e. Distraction 26. You have a child comes with croup, they can’t breathe. Assess? a. – Check airway Maintain airway patent. 27. Type 1 diabetes in a 10 year old, what do you expect to see? a. Weight loss b. Excessive intake of water. 28. Critical action immediately after newborn…. a. Keeping the newborns airway clear. -Suction-get rid of fluid 29. Tell parent with child of terminal disease- palliative care? Or a child chronically ill? Palliative care- is described as enhancing the quality of life by keeping the patient comfortable in the face of a terminal condition such as cancer. a. Keep them comfortable 30. Teaching: Child has allergies a. Cold mist vaporizer use because it is safer, b. no feather pillow, c. no carpet 31. You have pt. with sickle cell anemia. Interventions: a. pain management and b. hydration 32. If 15-16 yr old going through dialysis at home: The nurse is caring for an adolescent who just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is likely related to? a. Adolescents often resenting the control and enforced dependence imposed by dialysis. b. Peritoneal dialysis – What is the advantage of peritoneal dialysis?  Have fewer side effects  Can allow for fewer dietary restrictions.  Allows for travel  Do not have to travel to the dialysis center for treatment.  Greater flexibility and freedom in your treatment schedule  Can do dialysis while sleeping. 33. Temper tantrum/child. (throw themselves on the floor) a. Ignore behavior, make sure they are safe. 34. What infants are at high risk of cold stress. …hypothermia a. premies, b. low for birth weight premies, and c. C-section, risk for hyperthermia d. Cover with hat 35. 6 month old baby, 21 episodes of diarrhea in the past 10 hours-Intervention: a. IV fluids 36. Baby Subdural retinal bleeding or hemorrhage: doing assessment, based on bleeding, what do you suspect? a. Shaken baby syndrome (baby will have seizures) A 3 month old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should expect which injury? Shaking baby syndrome. 37. How to read APGAR score: Heart Rate: Absent 0, Slow: below 100-1, Above 100 -2 Respiratory: Absent- 0, Slow: irregular, weak cry -1, Goodstrong cry -2 Muscle Tone: Flaccid -0, Some flexion of extremities-1, Well flexed -2 Reflex Irritability: no response -0, Pink body,blue extremities-1, Completely pink -2 Answer 5. At 1minute after birth the nurse assess the infant and notes; a heart rate of 80 beats/min, some flexion of extremities, a weak cry, slight grimacing, and a pink body but blue extremities. The nurse would calculate an Apgar score as which number. 5 38. Car seat instruction, discharge a teenage car, a. Sit in back, rear facing 39.Why increase STI’s in teenagers? b. Invisibility. They think they can do anything. No consequences. RISK TAKERS. 39. Safe to blood transfusions, How long should you transfuse? a. be less than 4 hrs. 40. Walk in pt. room and has cardiac catheter. Bandage is soaked. The nurse is caring for a school age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is “too wet”. The nurse finds the bandage and bed soaked with blood. What is the most appropriate initial nursing action? Apply direct pressure above the catheterization site. a. Interventions: Apply pressure above 41. Child 8 months old, fall unconscious, Interventions: a. Establish Airway! And LOC check. (They could have bled in brain.) What is the priority nursing intervention when a child is unconscious after a fall? Establish an adequate airway. 42. Primary complication for burn injury: a. NCLEX – burn infection- if not specific After an acute stage and during the healing process the primary complication from burn injury is infection. b. Thermal burn injury…is Shock (high temperature, blanket, water, heat stroke, dehydration. Because fluid shifts to the 3rd space) What is the most immediate threat to life in children with thermal injuries? Shock. 43. Care of cast, patientt broke ankle and mother says I will have her take a bath and use the hair dryer. Keep it dry (no hair dryer) A 10 year old boy is discharged home from the emergency department after a fracture of his left lower extremity. A cast was applied and the nurse gives discharge instructions to the patient and his parents. The nurse notes that the parents require additional education when the mother states which of the following? I will have him take a bath and use the hair dryer to dry the cast. 44. Post partum hemmorhage, Big deal, Medication for that Methergine. What is priority ? a. blood pressure. (can drop) Methergine is prescribed for a woman to treat postpartum hemorrhage. What is the priority nursing assessment before administering this drug to the postpartum client? Blood pressure. 45. Pitocin (oxytocin) Is infusing- pt has been been having contraction for few hours. Why would you stop infusion. You turn hyper stimulation. If Contractions too forceful, this baby may not progress. a. Uterine Hyperstimulation 46. Magnesium sulfate toxicity a. Respiration of less than 10! b. 4g loading dose, 2 g maintenance dose c. relaxes muscles and prevents seizures d. Listen to lungs sounds q 1 hr e. Stops contractions by relaxing muscle in uterus A patient is receiving magnesium sulfate for the treatment of pre-eclampsia. A nurse determines that the client is experiencing toxicity from the medication if which of the following is noted on assessment? Respiratory rate of 10. 47. ARDS- What is your primary assessment.  The nurse in a newborn nursery is monitoring a preterm newborn 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. a. High HR, b. Retraction, c. Tachypnea 48. Read about Maternal newborn abduction teaching…what do you tell the children????? a. ID anklets and on arms b. Compare ID on baby to ID on mom c. Security on alarm tags d. Make sure if baby is transported, use crib e. Do not give baby to anyone without the ID tag The nurse determines that a new mother understands the teaching about prevention of newborn abduction if she makes which statement? I will ask the nurse to attend to my infant if am napping and my husband is not here. 49. 3 ½ son in the hospital starts sucking thumb. a. It’s normal. (Regression) A 4year old child who has croup is admitted to the hospital and wets the bed overnight. When the parent comes to visit the next day, the nurse explains the situation and the parent says “my child never wets the bed at home. I am 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. 50. SIDS Prevention for the baby… a. Sleep on back, b. Remove blankets A new mother expresses concern regarding sudden death syndrome. She asks the nurse how to position the new infant for sleep. What is the nurse’s best response to this new mother? Position baby on back rather than belly. 51. Viral infections, Croup, Cortico-therapy, manage only symptoms manage the symptoms, a. No antibiotics, are not indicated for viral infections. b. Just steroid- Corticosteroids A hospitalized 2 year old child with croup is receiving corticosteroid therapy and the mother asks why the provider did not prescribe antibiotic? What is the best response to the mother? Antibiotics are not prescribed unless a bacterial infection are present. 52. Infant with CHF, what is your assessment, a. weight gain over 1 lb. per day is concerning A nurse is monitoring an infant with congestive heart failure. Which of the following symptoms alerts the nurse to suspect fluid accumulation and the need to call the provider? A weight gain of 1LB in 1 day. 53. School age child can return to school after infection when? When is it generally recommended that a child return to school with an acute streptococcal pharyngitis? After taking antibiotic for 24 hours. a. Standard…After antibiotic therapy. 24 hr??? 54. Different types of Respiratory infections in children: (different types of croup and what is an emergency) a. Croup b. Epiglottitis-considered medical emergency. c. RSV d. Laryngitis What type of croup is considered medical emergency? Epiglottis. 55. Interventions with a child with Pneumonia: a. Promote rest b. Hydrate c. Monitor respiratory status frequently. 56. 3-4 months baby, High Heart Rate, lethargic, weight loss, poor skin turgor. a. Dehydration An infant is brought to the emergency department with poor skin tugor, weight loss, lethargy, and tachycardia. What does the nurse suspect is the problem? Dehydration. 57. What is Initial Therapeutic intervention for child with Acute diarrhea? a. Oral fluids 58. 6 yr old, going to have cardiac catheterization procedure, Teaching: a. don’t use big words b. use pictures c. show them things d. few words and age appropriate Jose is 5 years old child scheduled for a cardiac catheterization. What does the nurse know about preoperative teaching for this child? Adapt the education to his level of development so he can understand. 59. Child born Congenital heart disease: Teaching to parents: a. Encourage play with other kids 60. Child, just got done with blood transfusion and have trouble breathing: Suspect: a. Chest pain b. Air embolism…Reaction is usually immediate 61. Side effects of Corticosteriods therapy- decreased immune system a. Increased appetite, weight gain b. GI symptoms c. Hyperglycemia. 62. Teenage pt. End stage Renal Disease, Peritoneal dialysis…Therapeutic, Will they be accepting? a. Probably not accepting. Self-conscious b. May give up c. Noncompliant 63. Pt 3 yr old toddler, fell, initially conscious, was vomiting, but not anymore vomiting; Suspect brain injury: Interventions a. CT scan b. Monitor LOC 64. Autism spectrum disorder—Read about 65. Goiter- a. Caused by enlarged thyroid gland 66. Care for a child with Empetigo a. Infectious, you do not want to transfer to another person b. Hand washing important 67. What would predispose children to UTI a. Short urethra in girls. b. Baths c. Inability to hold bladder d. Hands by genitals e. Push fluids f. Lower pH does not predispose them to a UTI!! 68. Why Medicate with pain meds before debridement? a. Painful- debridement is painful. Relief the pain. b. Morphine 69. Pediatric pain medication, very effective and metabolizes very quickly. N? a. __morphine??? 70. Pt. assessing lung sounds, wheezes and what else? Nonproductive cough, expiratory wheezes, not when breathing in, expiratory breathing. This patient has Asthma. 71. Pt teaching: treating for bacterial pneumonia, give instruction on how to give medication, do you give in formula? a. No- they may not drink the milk. And chemical break down of med. 72. Digoxin toxicity- side effects a. halos, green b. vomiting  If the child vomits after the medication administration do not re-administer. 73. Heart failure child-getting Lasix-Encourage parents to give foods high in: a. Potassium 74. What are two interventions for pt after cardiac catherization? a. Maintain IV line (they could bleed out) need to push fluids b. Assess for color (cyanosis), Motion, Sensitivity(tingling) (they may not be perfusing properly. 75. Pt. comes in, tells you had child at 34 weeks, Child screams, child is different from other children. What do you advise? a. Reassure her, two kids with different temperaments. b. Temperament has nothing to do with gestational age. 76. Encourage parent to talk of child illness? a. Ask open-ended questions. b. Talk by listening c. Tell me more about that d. Don’t’ ask yes or no questions 77. 5 yr old little girl, a cyst on leg, they need surgery, Child is screaming, they do not want to take off underwear and put on gown. a. __ 78. 3 yrs old Hospitalized. What is concern for that age of development: Concern: a. Separation (anxiety ). b. Have parent room with pt. 79. 8 lbs baby, at one year they should weigh? Babies double their weight by 6 months and triple by a year. 8x3=24lbs. a. 24 lbs. 80. 16 yr old that felt a lump on breast? Advise.  A 20 year old client calls the clinic to report that she has found a lump in her breast. The nurses best response to her is which of the following? a. Most lumps are benign b. But still come in to get checked Many women have benign lumps and bumps in their breasts. However to make sure that it is benign, you should come in for an examination by your physician. 81. Serum alpha-fetoprotein testing: When? (if 25 wk gestation, can they have it?)  What would the prenatal clinic nurse conclude to be a contraindication for maternal serum alpha-fetoprotein testing (or quad screen) for a pregnant clinic? Being 25 weeks gestation. a. No. done between 15-20 weeks b. Diagnoses problems such as down syndrome. 82. 5 weeks pregnant, spontaneous abortion at 13 weeks, stillborn at 39 weeks. a. GTPAL……. 3,1,0,1,0 83. Cardiovascular system changes during pregnancy, 2nd trimester, you can expect higher heart rate, because: a. __ 84. Calculate Due date: a. __nageles rule. 85. Read about pregnancy induced hypertension, pt with baseline of 140/82 or 90, even though bp is low, 130 or 120….be concerned a. Concerning 86. Pg women receiving magnesium sulfate: What is assessment: a. Hypoactive of reflexes, knee 87. Assessment for Preeclampsia, regarding urine a. Watch protein of 3 or 4 + b. Urine retention---- 88. Magnesium sulfate. Why is it given to women with preeclampsia a. Prevents seizures 89. Adolescents with acne (read about) a. ____pregnancy test before medications. 90. Hemophilia (read about) a. _ 91. Interventions to decrease premenstrual syndrome (read about) a. Tell to increase consumption of fruits, b. Decrease salt intake c. Decrease sugar and fat 92. What is the bacterium responsible for UTI? a. E.coli. [Show less]