p p p p p p
tail Solutions and Resource for the test)
p p p p p p
AgingpProcess
NewbornpAssessment:pExpectedpFindings
● NormalpAssessmentpFindingspforpHead:pShouldpbep2-
3pcmplargerpthanpchest.
● Anteriorpfontanelpshouldpbeppalpatedpandpapproximatelyp5pcmponp
averagepandpdiamondpshaped.
● Posteriorpfontanelpispsmallerpandptriangle-
shaped.pShouldpbepsoftpandpflat.pMoldingpofpsuturespispnormal.
Psychosocialp Integrity
CrisispIntervention
SexualpAssault:pPrioritypIntervention
● Providepapprivatepenvironmentpandplimitppersonnelpwhopexaminepthepclient.
● Assesspclientpemotionspandpprovidepsupport
● Assess,ptreat,pandpdocumentpallpinjuries
● Usepapnonpjudgementalpandpempatheticpapproach
Abuse/Neglect
PsychosocialpIssuespofpInfants,pChildren,pandpAdolescents:pCaringpforpapChildpWho
,ReportspSexualpAbuse
● Removepthepchildpfrompthepsituation
● Mandatorypreportingpforpallphealthpcarepworkers;pthereparepcivilpandp
criminalppenaltiespforpnotpreporting
● AssesspforpunusualpbruisingponpABD,pbackpandpbuttocks
,Sensory/PerceptualpAlterations
EffectivepCommunication:pRespondingptopapClientpWhopIspObesepandpIspCryingpPsychot
icpDisorders:pCaringpForpapClientpWhopIspExperiencingpDelusions
● Askpthepclientpdirectlypaboutphallucinations.pThepnursepshouldpnotpargueporpor
agreepwithpthepclient’spviewpofpthepsituation.
● Dopnotparguepwithpapclient’spdelusions,pbutpfocusponpthepclient’spfeelingspandp
possiblypofferpreasonablepexplanations.
● Assesspthepclientpforpparanoidpdelusions,pwhichpcanpincreasepthepriskpfor
violencepagainstpothers.
BasicpCarepandpComfort
Elimination
PostpartumpPhysiologicalpAdaptations:pInterventionsptopPromotepVoiding
● Assistpwithpfrequentpurination
● Providepnoninvasivepmeasuresptoppromotepurination
● Performpbladderpscan
NutritionpandpOralpHydration
Burns:pSupportingpNutritionalpRequirements
● Clientpwithpaplargepburnpinjurypwillpbepinpaphypermetabolicpstatepandpmayp
exceedp5,000pcalories/day
● Increasepproteinpintakeptoppreventptissuepbreakdownpandppromotephealing
● EnteralporptotalpparenteralptherapypispoftenpnecessarypMedicatio
nspforpDepressivepDisorders:pFoodpandpMedicationpInteraction
● MAOIs-pavoidpfoodspcontainingptyraminep(meats,pcheeses,palcohol)
● SSRIp&pSNRI-pavoidpalcohol
● Tricyclic-pdopnotpadministerpwithpMAOIsporpSt.pJohn'spWart
, RenalpDisorders:pTeachingpapClientpWhopHaspChronicpKidneypDisease
● StrictpI&Os