Maternity and Peds Hesi Review Fall 2019 Latest Update.

Maternity and Peds Hesi Review Fall 2019 MP Hesi.1 • Mastitis: antibiotic therapy, wear a supportive bra, warm compress • Pyloric stenosis: olive size obstruction on abdomen • Anchor the lower part of the uterus - then massaging the fundus • High bp maybe with preeclampsia: check for protein in the urine (proteinuria) • Boy child frequent visits to the school nurse headache, irritable for few weeks: ask how daily school day is • BMI 6 -year old: physical activity at the school, girls physical activity at home, and diet • Saturated 2 pads in 30 mins: massage the fundus • Tick bite: test for Lyme disease • HIV AZT is given to slow down the transmission to the fetus • Clear water to clean for diaper change • APGAR = 9, acrocyanotic only gets 1 point for color • Mom says baby not sleeping through night, nurse should assess severe skin breakdown on the baby to plan family care • Blind child with traction - bring familiar objects or stuff animals from home • Drooling, temp - epiglottitis need to notify the provider • Muscular irritability from hemorrhaging • Osteomyelitis - give milkshake as snack- high protein, high fiber • Hypoglycemic: give milk • Croup- barking sound, high pitch on breathing - bring in shower with warm mist • Transillumination throughscrotal sac to test if testes are present • Earache if meningitis • Hypothyroidism: D- TSH is high so T4 is low by thyroid gland • Tetralogy of Fallot - cyanotic limbs crying • Cephalohematoma noticed near occiptal sutures- notify Dr • Increase AFP- need to do an sonogram • • • 30 week gestation age 38 inches fundal height - do an ultrasound, bc should’ve been equal • Inguinal Hernia - palpate to get it back in • • Breastfeeding 5 day with yellow stools - this is normal • Spontaneous rupture of membranes - ask the color and consistency • 3+ pitting edema with GERD- normal during pregnancy?? • Postpartum depression - may need to be evaluated ** Know the length of PPD • Afebrile seizures - will eventually go away • MD - wobble legs at this stage • Tonsillitis-signs of bleeding - need to inspect the oral cavity • Movements caused from rh??? they temporary something a C --wasn’t this the amniocentesis- testing the rh for rhogam? Yes testing maternal blood to see if they need to administer RhoGam • Fetal heart pattern in V form - priority is change mother’s position • Braxton Hicks will go away with walking it is not true labor • Placenta Previa - check fetal HR • I’m having pain in my stitches - look at the episiotomy • Use breathing techniques after giving pain meds 30 mins ago • Female - parenteral antibiotics administration is most effective • Introducing solid foods - 1 food at a time for 4-7 days • Digoxin - missed dose can give if it’s been less than 4hrs /if more than 4 hrs wait until next dose/If miss 2 doses, call HCP • Dilantin - check the serum levels • UTI child - return for another urine sample • 3 hour newborn with irregular respirations and small/soft murmur - put pulse ox on the foot • Mag toxicity possibility: mag was 8? With hypoactive reflexes • Gonorrhea infection tell other partners to seek treatment • Adolescent gets a rubella vaccine at maternal bearing age - use another form of birth control for 28 days • Diaphragm – use same as before giving birth - get resized? Use another form of bc? • Tonic clonic seizure and heart issue - monitor calcium • Amniocentesis priority - something with to get Rh factor for rhogam *Breasts- need supportive bra, antibiotics, cold compress *infant vital signs- normal *DMD- weak muscles and gait - I remember something with DMD & serum Ca+ *preeclampsia- check urine for protein MP Hesi 2017 1. dosage : 700. 77 lb baby. 2. 20 units of oxytocin+1L LR→ 125 . 3. Gerd: sugar cookies 4. Mom is Rh-: check Rh immunoglobulin or check FHR 5. Cystic fibrosis: infertility 6. Tetanus questions: clean and antibiotic!!! 7. folic acid, doesn’t like green lefy veggies: strawberries 8. Diaper rash: zinc oxide 9. young parents, 24hrs birth: evaluate feeding 1 0. mom forcing kid to eat means and veggie(requires further. 11. sickle cell: hot and thirsty 12. pyloric stenosis: olive-shaped 13. Pyloric stenosis, hungry and irritable after feelings, first intervention→ crying or weight 14. turn to side and suction 15. fractured clavicle 16. jitteriness: check glucose 17. Normal primipara finding: 2 saturated pads for 1st hr. I put pulse 56. 18. Dad called few days post-partum - hormonal swings are normal. 19. MgSO4 priority: calcium gluconate 20. HIV: AZT 21. Assess FHR and coombs 22. check for after amniocentesis: monitor for labor 23. Post-partum mood swings vs. depression: fatigue&not making decisions? 24. eye ointment: prevent eye infection 25. intussuception: brown stool notify HCP 26. girl SATA: 27. girl who druinks: atta boy 28. ADHD: refer or help with HW?? 29. transitional phase: monitor contractions, help mantain control 30. AFP: Sonogram 31. Priority pt: ARF and hyperkalemia!!! 32. mastitis: antibiotics, bra support, warm support 33. Open heart surgery:demonstration of splintintg, deep breathing etc 34. rupture membranes 12hrs ago--: temperature 35. C-section priority: uterine atony or positive homans??? 36. AGN: Sore throat 37. hemophilia: NOT motrin(elevate and immobilize. 38. Resp distress: nasal flaring 39. Leopolds: anchoring fundus 40. Drooling, s/o epiglotitis→ emergency response!!! 41. flick the sole 42. RF: Chorea 43. after c section lacerated. trickle of blood: BP 44. +2 edema: MgSO4 45. position on stomach 46. HPV: C “immunization is amust to prevent it” 47. scoliosis: girls 10-14 48. metabolic alkalosis-vomiting or pyloric 49. MDI: spacer or cold??? 50. position on stomach 51. sesnse of security 52. IUGR: sonogrm 53. Flaring of the nare 54. Developmental delay: maximum potential 55. 8 mos expected: sitting up unassisted MP Hesi 2017 • Protruding cord - knees to chest • Child who had Slipped Capital Femoral Epiphysis (SCFE. - pin and something • 4-month old what to do to prevent diaper rash - use a barrier cream, such as zinc oxide • Mother with mastitis, what would you advise - start on the unaffected breast first • Adolescent turns 18 and mother calls for lab results - must get permission from daughter • Different acid base levels - normal acid base • A breastfeeding mother wants to avoid having another pregnancy. What do you do? use condoms and gel • Infant getting phototherapy - Cover the infant’s eyes • 6 month baby goes in for routine vaccine and flu shot - give all immunization and influenza but alternate site and injection • Medication to prevent respiratory issues in the baby - betamethasone IM • 15 mo breastfeeding & now 6 mosprego - get nutrition history • Postpartum hemorrhage even after finishing oxytocin infusion - check maternal BP • Math questions were 10 and 10 • Baby got otitis media after an acute respiratory infection, why do infants get otitis media - shorter eustachian tubes • Boy with spine injury after driving accident - maintain alignment • Obese question SATA - find out what physical activities she does& if school has PE class, 3 day diet history from mother • Iron supplement - take with meal • Preeclamptic women received Pitocin IV and is having contractions 1 to 2 minutes apart - discontinue Pitocin • Lyme disease - if rash, then test • Esophageal atresia, highest priority - body temperature • Baby regurgitation and vomiting - suction the mouth and nose • An adolescent received an above the knee amputation. Would do you tell them to do everyday - inspect the stump daily • Women says about 6 mos pregnant &smokes a pack of cigs/day, how to check for estimated gestation age:ultrasonography • 8 month old development, you would notice - sitting unassisted • Glucose was 800 mg - give IV normal saline and insulin • Rubella - give after delivery within 72 hours • Newborn has swollen, tender, testicles. Suspect hydrocele. What do you do? Use transillumination to check for fluid • Fetal heart rate dropped abruptly to a V - change mom’s position • Pregnant had a temp of 101 – chorioamnionitis • Epidural anesthesia - check maternal HR and BP • Teenagers who are pregnant, be sure to include - nutrition requirement during pregnancy • Patient who was 9 cm and 80% effacement - ? • Transitional phase - assess uterine contractions • Infertile couple - allow them to control if they want to stop or support group before another IVF cycle • 4 neonates, who to see first – Tet • 9yr old (school age. – industry • Child with pneumonia - assess lung sounds • Child is dehydrated. What to check for? Weak cry but no tears • Pyloric stenosis - metabolic alkalosis • Assess for cryptorchidism - warm the room • “He doesn’t feed himself, I make him eat vegetables and meat” • A newborn infant is crying, temperature is 96.5, has elevated bp and is cyanotic. What do you do? Warm that baby up (answer) MP Hesi 2017 • What put kid at risk for bacterial meningitis?? Earache NOT VARICELLA IT’S A VIRUS • Tree bark flies in eyes Put on patches & call ophthalmologist • Kid is 2 years old drinking with bottle drinking sweetened soda, what should Nurse discuss? Don’t drink out of a cup, soda leads to obesity, & soda lead to dental caries • Kid with type I Diabetes & Blood sugar 180 wants to play in his soccer game what does Nurse recommend? The kid can play soccer w/o eating a snack or taking insulin • Mom depressed how does she feel? Tired, sad, dec. appetite • Mag toxicity DTR +1, UO was 25, Mag was 8, Respiration 14 Closely follow up • Intussusception & now has brown poop Notify HCP • Kid sees the school nurse with stomach acheNotify HCP • Cleft Lip/Cleft Palate See genetic counselor • Hx of syphilis & chicken pox urine sample/blood sample • Salt wasting Check the Perineum • What do you report to Dr first with an epidural? Blood Pressure, • She has excessive bleeding, what do you let the dr know Report BP or Apical HR • Administering Epiduralslows the labor process • Palpate with one hand & the other hand is there to do what? Anchor the uterus • The uterus was firm midline & in place she felt like she had vag pressure check perineum • Episitomyvisualize the perineum • The person is oozing blood & has muscle irritability, what electrolyte level are you most concerned about? Calcium • Budding breasts &