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Maternal Newborn Practice B 2019 With Rationale

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Maternal Newborn Practice B 2019 With Rationale Vaginal Examination, umbilical cord protruding from vagina, action to take: Apply internal upward pressure to the presenting part using 2 gloved fingers Rational: Prolapse of the umbilical cord during labor can result in decreased perfusion to the fetus, which can lead to hypoxia. After calling for assistance, the nurse should relieve the compression on the umbilical cord by applying upward internal pressure on the presenting part with two gloved fingers. The nurse should not move their hand. 2hr postpartum, interventions during taking-hold phases of behavior adjustment: Demonstrate to the client how to perform a newborn bath. 36 wk gestation, nonstress test: "You will be offered orange juice to drink during the test." Nutritional intake, 8 wk gestation, inc daily intake of: Iron (Fe) 35 wk placenta previa, action to take: Initiate continuous external fetal monitoring. Rational: client who has a placenta previa and is actively bleeding is at an increased risk for preterm labor and hemorrhage. The nurse should initiate interventions such as bed rest, pelvic rest, and continuous fetal heart monitoring, which assesses fetal well-being and the presence of contractions. The nurse should obtain IV access and monitor laboratory values. Also, the nurse should implement interventions to prepare for an emergency birth. FHR, fetal position left occipital anterior, area to apply ultrasound transducer to assess point of maximum intensity: Left lower Quadrant Admin of azithromycin, 16 wks gestation, positive chlamydia culture Admin 1g orally NOW Avail: 250mg tablets How many tablets should the nurse admin? 1g into 1000 mg 1000mg/250mg= 4 tablets Newborn undergoing phototherapy, tx hyperbilirubinemia, action to take: Cover the newborns eyes while under the phototherapy light Teaching about levonorgestrel contraception, info to include In teaching: "You should take the med w/in 72hrs following unprotected sexual intercourse." Rational: Levonorgestrel is an emergency contraceptive which inhibits ovulation to prevent conception. The nurse should instruct the adolescent to take this medication as soon as possible within 72 hr after unprotected sexual intercourse. Teaching about family planning, new prescription for diaphragm: "You should leave the diaphragm in place for at least 6hrs after intercourse." 22wks gestation, concern abt blotchy hyperpigmentation on forehead, action to take:

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Fall 2022 Patho Midterm
Pierre Robin Sequence
-Constraint of mandibular growth Mandibular micrognathia
-Failure of the tongue to descend Glossoptosis and airway obstruction
-Preventing fusion of the palatal shelves Palatal cleft
Leukoedema
Normal variation of mucosa
Not premalignant
More intense in dark skinned races
More intense in smokers
Bilateral, opalescent film
Reduces when mucosa is stretched
Fordyce Granules
Buccal mucosa: The most common location
Upper lip: The second most common location
Macroglossia
Congenital such as Dawn syndrome
Neoplasia such as lymphangioma, neurofibromatosis
Amyloidosis, myxedema
Ankyloglossia
"Tongue-tied"
Occurrence of gingival recession
Frenectomy, as usual treatment
Lingual Thyroid (Ectopic Thyroid)
Results from the failure of migration of the primitive thyroid tissue from its
developmental (base of the tongue) location to its normal position in the neck.
As a nodule at the base of the tongue, in the midline
Maybe the patient's only functional thyroid tissue.
Fissured Tongue
Association with geographic tongue.
A component of MelkerssonRosenthal syndrome (fissured tongue, facial paralysis, and
cheilitis granulomatosis).
Oral Hairy Leukoplakia
EBV-associated condition
Not developmental, not premalignant
Mostly in HIV + patients
Eagle Syndrome
Elongated and/or calcification of the styloid ligament
Head and neck pain is elicited by chewing, yawning, opening mouth
Stafne Defect
-Latent bone cyst, static bone cyst, lingual mandibular salivary gland depression, as the
synonymous
 Below inferior dental canal
 Pseudo cyst (no epithelial lining)
 Depression in lingual wall of mandible, mostly in the posterior region.

,  Accommodates salivary gland tissue
Non-Odontogenic Developmental Cysts
Palatal cysts of newborn (Epstein's pearls, Bohn's nodules)
Nasolabial cyst
Nasopalatine duct cyst (cyst of incisive canal) Median palatal cyst
Dermoid cyst
Thyroglossal tract cyst
Branchial cleft cyst
Oral lymphoepithelial cyst
Palatal Cysts of Newborn Epstein's pearls, Bohn's nodules
Epstein's pearls, in the midline arise from epithelium entrapped along the line of fusion.
Bohn's nodules, hard palate/soft palate junction, derived from the minor salivary glands.
Nasolabial Cyst
- Within the soft tissue of the lip and below the ala of the nose
- Soft tissue cyst not intrabony
Nasopalatine Duct Cyst (Incisive Canal Cyst)
Well defined oval or heart-shaped radiolucency between apices of roots of vital
maxillary central incisors
Dermoid cyst
Arising from entrapped surface epithelial tissue remnants.
Floor of the mouth as the common location above the myelohyoid muscle.
Cervical Lymphoepithelial Cyst (Branchial Cleft Cyst)
In lateral aspect of the neck, anterior to the sternocleidomastoid muscle.
Mostly late in childhood
Two theories for origin:
1. Remnant of the second branchial cleft
2. Entrapped salivary duct epithelium in the lymph nodes of the lateral neck
Oral Lymphoepithelial Cyst
Developing within benign lymphoid aggregates
Floor of the mouth, lateral and ventral tongue, and soft palate, as most common sites
As a submucosal yellow-white nodule, often < 5 mm
Regional Odontodysplasia
Localized, nonhereditary developmental abnormality
Affects enamel, dentin and pulp.
"Ghost teeth"-enlarged pulp chambers, thin enamel and dentin.
Treatment: Generally extraction
Caraniosynostosis Syndromes
A group of syndromes, characterized by premature closure of cranial (cranio-) sutures (-
synostosis)
Two examples: Crouzon syndrome and Apert syndrome
Mutation in "fibroblast growth factor receptor 2" gene (FGFR2)
Abnormal head shapes
Beaten metal appearance of inner table of the skull
Apert Syndrome
Another name: acrocephalosyndactyly
More severe head deformity compared to Crouzon syndrome

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