NUR 2633 Maternal Child Health FINAL REVIEW EXAM LATEST UPDATE 2023/2024

NUR 2633 Maternal Child Health FINAL REVIEW EXAM I. Before administering baby/child Iron a. Teaching give with orange juice, b. May cause black tarry stool, c. and constipation  What are two interventions for pt after cardiac catherization? a. Maintain IV line (they could bleed out) need to push fluids a. Assess for color (cyanosis), Motion, Sensitivity(tingling) (they may not be perfusing properly.  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.  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  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.  3 yrs old Hospitalized. What is concern for that age of development: Concern: a. Separation (anxiety ). b. Have parent room with pt.  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.  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.  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.  5 weeks pregnant, spontaneous abortion at 13 weeks, stillborn at 39 weeks. a. GTPAL……. 3,1,0,1,0  Cardiovascular system changes during pregnancy, 2nd trimester, you can expect higher heart rate, because: a.  Calculate Due date: a. nageles rule.  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  Pg women receiving magnesium sulfate: What is assessment: a. Hypoactive of reflexes, knee  Assessment for Preeclampsia, regarding urine a. Watch protein of 3 or 4 + b. Urine retention----  Magnesium sulfate. Why is it given to women with preeclampsia a. Prevents seizures  Adolescents with acne (read about) a. pregnancy test before medications.  Hemophilia (read about) a. _  Interventions to decrease premenstrual syndrome (read about) a. Tell to increase consumption of fruits, b. Decrease salt intake c. Decrease sugar and fat  What is the bacterium responsible for UTI? a. E.coli. II. Baby with n/v and they have anterior bulging fontanel, you realize head circumference is not normal size. a. Brain tumor III. 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 IV. What Stage of grief, Pt/Child dx of cancer, they may not want to talk to about Denial. V. 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. VI. 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. VII. 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. VIII. Dysmorrhea, pt has pain with menses-What is effective medication: a. Give Ibuprofen, Aleve, (no Tylenol). b. NSAID/anti-inflammatory agent. – endomethacin, ibuprofen, aleve. IX. 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) X. Pt is 38 weeks, uncomfortable, sleeping. What is the best side to sleep on.? a. Turn them to the left.- sidelying. XI. 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. XII. 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!!!!! XIII. 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. XIV. 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. XV. 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 XVI. Most common trauma on a child being born is: a. …clavicle fracture/shoulder break XVII. Child born on drugs (drug mom) What do you look for,: a. Incessant crying, b. Inconsolable crying. c. They tend to posture when cuddled. XVIII. Suspect child abuse, and signs of skin bruising…. a. Report to supervisor b. Report to authorities. As healthcare worker we are mandated reporters. XIX. 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. XX. Labor dystocia, not progressing normally through labor process: Non pharmacological procedure: a. Amniotomy (rupture of membrane) XXI. Pt had 9-pound baby. What do you do if bleeding? a. Fundal massage with lower segment support. Meds for bleeding. -Pitocin -Hemabate -Methergine XXII. 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. XXIII. 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. XXIV. Diagnosis for a child with anemia- a. Activity intolerance due to weakness XXV. Discipline to child that is appropriate- a. Redirection, b. Consequences of actions. c. Time out, d. Removal of privileges, e. Distraction XXVI. You have a child comes with croup, they can’t breathe. Assess? a. – Check airway Maintain airway patent. XXVII. Type 1 diabetes in a 10 year old, what do you expect to see? a. Weight loss b. Excessive intake of water. XXVIII. Critical action immediately after newborn…. a. Keeping the newborns airway clear. -Suction-get rid of fluid XXIX. 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 XXX. Teaching: Child has allergies a. Cold mist vaporizer use because it is safer, b. no feather pillow, c. no carpet XXXI. You have pt. with sickle cell anemia. Interventions: a. pain management and b. hydration XXXII. 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. XXXIII. Temper tantrum/child. (throw themselves on the floor) a. Ignore behavior, make sure they are safe. XXXIV. 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 XXXV. 6 month old baby, 21 episodes of diarrhea in the past 10 hours-Intervention: a. IV fluids XXXVI. 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. XXXVII. 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 XXXVIII. Car seat instruction, discharge a teenage car, a. Sit in back, rear facing