Nokea
A blood sample for measurement of bilirubin is required from a newborn receiving phototherapy. In what environment should this blood sample be drawn?
- A. While phototherapy lights are turned off
- B. While newborn remains under phototherapy lights
- C. When newborn is covered with a blanket
- D. When newborn has been off phototherapy for 30 to 60 minutes
Correct Answer: D
Rationale: The blood sample for measurement of bilirubin should be drawn when the newborn has been off phototherapy for 30 to 60 minutes. The reason for this is that phototherapy can alter bilirubin levels through photoisomerization, making it challenging to interpret the results accurately while the newborn is still under the lights. Allowing a period of 30 to 60 minutes for the newborn to be off phototherapy helps to ensure that the bilirubin level obtained from the blood sample reflects a more accurate baseline level. This practice helps in guiding clinical management decisions related to managing hyperbilirubinemia in newborns.
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Mrs. Zeno continues to become a weaker despite .treatment with neostigmine. Edrophonium HCL is ordered:
- A. For its synergestic effect
- B. Because of the client's resistance to
- C. To rule out cholinergic crisis Neostigmine
- D. To confirm the diagnosis of myasthenia
Correct Answer: C
Rationale: Edrophonium HCL is ordered to rule out cholinergic crisis caused by possible overdose of neostigmine. In myasthenia gravis, patients are normally given neostigmine to help improve muscle strength by prolonging the effect of acetylcholine at the neuromuscular junction. However, if too much neostigmine is given, it can lead to a cholinergic crisis characterized by excess stimulation at the neuromuscular junction. Edrophonium HCL is a fast-acting drug that can help differentiate between a myasthenic crisis (worsening of symptoms due to under-dosing of anti-cholinesterase medication like neostigmine) and a cholinergic crisis (worsening of symptoms due to over-dosing). By administering edrophonium HCL, the healthcare provider can observe the patient's response and determine if the weakness is due to under-treatment or over-treatment with
Which side effects should the nurse monitor when a child is taking an antipsychotic medication? (Select all that apply.)
- A. Extrapyramidal effects
- B. Hypertension
- C. Bradycardia
- D. Dizziness
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a high-risk newborn with an umbilical catheter in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action?
- A. Elevate feet 15 degrees.
- B. Place socks on newborn.
- C. Wrap feet loosely in prewarmed blanket.
- D. Report findings immediately to the practitioner.
Correct Answer: C
Rationale: When the nurse notes blanching of the feet in a high-risk newborn with an umbilical catheter in a radiant warmer, the most appropriate nursing action is to wrap the feet loosely in a prewarmed blanket. Blanching indicates poor circulation to the area, which can be a result of cold stress or constriction of blood vessels. By wrapping the feet in a prewarmed blanket, the nurse can help to restore adequate blood flow to the feet and improve circulation. This action addresses the potential cause of the blanching and promotes the newborn's comfort and well-being.
The bronchospasm and dyspnea are clinical manifestation of organophosphorus poisoning are caused by :
- A. muscarinic action
- B. nicotinic action
- C. CNS action
- D. all the above
Correct Answer: A
Rationale: The bronchospasm and dyspnea seen in organophosphorus poisoning are primarily caused by the muscarinic action of the toxic substance. Organophosphates inhibit acetylcholinesterase, leading to an excess of acetylcholine at the neuromuscular junctions. This results in overstimulation of muscarinic receptors, causing symptoms such as bronchoconstriction, increased secretions, and respiratory distress. Nicotinic actions primarily lead to muscle weakness and paralysis, while CNS actions can cause seizures and altered mental status. So, in the case of bronchospasm and dyspnea, the muscarinic action is the main contributing factor.
What should be included in the plan of care for a preschool-age child who is admitted in a vasoocclusive sickle cell crisis (pain episode)?
- A. Pain management
- B. Administration of heparin
- C. Factor VIII replacement
- D. Electrolyte replacement
Correct Answer: A
Rationale: Pain management is a crucial component in the plan of care for a preschool-age child admitted with a vasoocclusive sickle cell crisis. Sickle cell disease causes blood vessels to become blocked, leading to ischemia and pain. Managing pain promptly and effectively is necessary to improve the child's comfort level and prevent complications. Pain management strategies typically involve the use of analgesic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, tailored to the child's age and weight. Additionally, non-pharmacological interventions like distraction techniques and positioning can help in reducing pain and promoting relaxation in children during a sickle cell crisis.