Nokea
The parents of a newborn who has just died decide they want to hold their deceased infant. What is the most appropriate nursing intervention?
- A. Explain gently that this is no longer possible.
- B. Encourage parents to accept the loss of their newborn.
- C. Offer to take a photograph of their newborn because they cannot hold newborn.
- D. Get the newborn, wrap in a blanket, and rewarm in a radiant warmer so parents can hold their deceased infant.
Correct Answer: D
Rationale: The most appropriate nursing intervention in this situation would be to get the newborn, wrap in a blanket, and rewarm in a radiant warmer so parents can hold their deceased infant. This is known as a "cold cuddle" technique, where the infant is gently rewarmed for a short period of time to allow the parents to hold and say goodbye to their baby. This practice has been shown to help parents in the grieving process and is a compassionate way to support them during this difficult time. It allows the parents to have a physical connection with their child and provides them with some closure and the opportunity to create lasting memories.
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What is oral candidiasis (thrush) in the newborn?
- A. Bacterial infection that is life threatening in the neonatal period
- B. Bacterial infection of mucous membranes that responds readily to treatment
- C. Yeastlike fungal infection of mucous membranes that is relatively common
- D. Benign disorder that is transmitted from mother to newborn during the birth process only
Correct Answer: C
Rationale: Oral candidiasis, also known as thrush, is a yeastlike fungal infection of the mucous membranes in the mouth. It is relatively common in newborns, as their immune systems are still developing and can be easily affected by the overgrowth of Candida fungi. Thrush can present as white patches or plaques on the tongue, gums, or inner cheeks. It is important to treat oral thrush to prevent any discomfort for the newborn and potential complications such as difficulty feeding or spreading of the infection.
Chemotherapeutic agents such as methotrexate and cyclophosphamide are sometimes used to treat JRA. Why are these medications used?
- A. Effective against cancer, like JRA.
- B. Affect the immune system.
- C. Are similar to NSAIDs.
- D. Are absorbed into the synovial fluid.
Correct Answer: B
Rationale: Chemotherapeutic agents like methotrexate and cyclophosphamide are used to treat Juvenile Rheumatoid Arthritis (JRA) because they work by suppressing the immune system. In JRA, the immune system is overactive and attacks the body's own tissues, leading to inflammation and joint damage. By suppressing immune system activity, these medications can help reduce inflammation and prevent further joint damage in patients with JRA.
A client is being treated for acute pyelonephritis and will undergo laboratory tests. These tests are expected to help determine the clients BUN, creatinine, and serum electrolyte levels. Why should the nurse evaluate these test results?
- A. To determine the severity of the disorder
- B. To identify signs of fluid retention
- C. To determine the location of discomfort
- D. To determine clients response to therapy
Correct Answer: A
Rationale: Evaluating the client's BUN, creatinine, and serum electrolyte levels when being treated for acute pyelonephritis is crucial in determining the severity of the disorder. BUN and creatinine levels are indicators of renal function, where elevated levels may suggest impaired kidney function due to inflammation in the kidneys from pyelonephritis. Abnormal electrolyte levels, such as potassium and sodium, may also reflect the impact of the infection on renal function. Therefore, monitoring these test results helps healthcare providers assess how well the kidneys are functioning and the severity of the pyelonephritis to guide appropriate treatment decisions.
Which of the ff would describe the discomfort experienced by a client with a tension headache?
- A. A heavy feeling over the frontal region and sensitivity to light
- B. Pressure or steady constriction on both sides of the head
- C. Headache and temporary unilateral paralysis
- D. Vague headache, especially peri orbital
Correct Answer: B
Rationale: Tension headaches are commonly described as a sensation of pressure, tightness, or steady constriction around the head. This discomfort is usually felt on both sides of the head, rather than being localized to one specific area. Unlike migraines which may have a pulsating or throbbing quality, tension headaches are characterized by a continuous dull ache. Sensitivity to light (photophobia) and vague headaches are more commonly associated with migraines, not tension headaches. Temporary unilateral paralysis and peri orbital pain are not typical symptoms of tension headaches.
The nurse is discussing development and play activities with the parent of a 2-month-old. Recommendations should include giving a first rattle at about which age?
- A. 2 months
- B. 4 months
- C. 7 months
- D. 9 months
Correct Answer: A
Rationale: At 2 months old, infants start to demonstrate more control over their arm movements and are becoming more aware of objects around them. They may also start to grasp objects intentionally. Giving a first rattle at this age can help stimulate their senses, promote sensory exploration, and encourage their fine motor skills development. This early exposure to different textures, shapes, and sounds can also aid in their cognitive and sensory development, making it an appropriate choice for a parent looking to support their baby's early growth and learning.