Amazingly hard question-I have no idea the answer

Daytonite, BSN, RN · Sep 15, 2008

i know a few more places you can look to find the answers.

what physical finding does an infant of a diabetic mother and an infant with fetal alcohol syndrome have in common?

a. susternal retractions, b. neonatal acrocyanosis, c hypoglycerma or d. respiration 20/30 min.

http://www.merck.com/mmpe/sec19/ch274/ch274i.html - alcohol exposure during pregnancy is discussed
http://www.merck.com/mmpe/sec19/ch272/ch272e.html - large-for-gestational-age (lga) infant
http://www.healthsystem.virginia.edu/uvahealth/peds_hrnewborn/fas.cfm
http://www.emedicine.com/med/topic3237.htm - psychosocial and environmental pregnancy risks

a year after a renal transplant, the clients serum sodium level is 160 meq/l. what is the most likely cause for this client high sodium level.

a. corticosteroid therarpy, b rejection of the kidney, c heart failure, d excessive oral ingestion of sodium

http://www.upmc.com/healthatoz/pages/healthlibrary.aspx?chunkiid=14828 - read the section on the postoperative care and pay particular attention to the information about steroids and weighing themselves. why would the patient be put on long term steroid therapy after a transplant? what are the side effects of these drugs?

which is less frequently used because of neative side effects

a. procainamide b. lidocaine, c. amiodarone

don't know this one--not my field of experience

after craniotomy, how high show the head of the pt bed be?

30-45 deg??

a patient is having a cute anterior mi with third-degree heart block with a ventricular rhythm and rate of 38 bpm. what is the immediate nursing intervention.

a. atropin 1mgiv, diltiazem 15mgiv, digoxin 0.5mg iv, lidocain 50mgiv

http://www.drugs.com/pro/atropine.html

hinakpatel2000 · Sep 16, 2008

Thanks for the info Dayonite. Helpful.

Still didn't find the FAS and diabetes infant common

Regarding a pt with closed head injury. What should be the FIRST nursing diagnosis?

asses neurological function or asses the client's position and elevate head to 40 deg. Basically, I don't know if neuro assesment would come before checking the position!

HK

znov11 · Sep 16, 2008

Regarding a pt with closed head injury. What should be the FIRST nursing diagnosis?
asses neurological function or asses the client's position and elevate head to 40 deg. Basically, I don't know if neuro assesment would come before checking the position!
HK

> I learned in my neuro exposure as discussed by my c.i., a quick neuro assessment comes first if circumstances don't call for immediate or emergency interventions. Through a quick assessment, a nurse may conclude what appropriate position is suitable for the assessment findings. Plus, if a patient is conscious & coherent per assessment, you may collaborate with the patient in positioning, with teachings and explanations why such position is advised(patient compliance). :) :specs:

Jw1724 · Sep 16, 2008

Thanks for the info Dayonite. Helpful.
Still didn't find the FAS and diabetes infant common
Regarding a pt with closed head injury. What should be the FIRST nursing diagnosis?
asses neurological function or asses the client's position and elevate head to 40 deg. Basically, I don't know if neuro assesment would come before checking the position!
HK

Do you mean first nursing INTERVENTION? I would say neuro assessment, especially regarding a quick patient history if possible. I had someone fall in a parking lot and found out through the history that she recently had spinal surgery. Changes your situation.

UM Review RN, ASN, RN · Sep 16, 2008

Look up the drugs in your drug book. The answer will be very apparent if you

google the drug name with "common side effects." Hint: remember your ABCs.

Daytonite, BSN, RN · Sep 16, 2008

still didn't find the fas and diabetes infant common

that one bothered me a lot. i felt it might be the hypoglycemia. i was thinking that the question might have meant that the fas baby was born physically intoxicated and developed a rebound hypoglycemia because of withdrawal once they were born. i couldn't find evidence of this, however, in fas babies. hypoglycemia is definitely a problem of the lga neonates.

regarding a pt with closed head injury. what should be the first nursing diagnosis?

asses neurological function or asses the client's position and elevate head to 40 deg. basically, i don't know if neuro assesment would come before checking the position!

abcs first. the brain controls everything, so assess that it is working. a nicely positioned patient isn't much good if the person is brain dead and not breathing.

UM Review RN, ASN, RN · Sep 16, 2008

still didn't find the fas and diabetes infant common
that one bothered me a lot. i felt it might be the hypoglycemia. i was thinking that the question might have meant that the fas baby was born physically intoxicated and developed a rebound hypoglycemia because of withdrawal once they were born. i couldn't find evidence of this, however, in fas babies. hypoglycemia is definitely a problem of the lga neonates.
regarding a pt with closed head injury. what should be the first nursing diagnosis?
asses neurological function or asses the client's position and elevate head to 40 deg. basically, i don't know if neuro assesment would come before checking the position!
abcs first. the brain controls everything, so assess that it is working. a nicely positioned patient isn't much good if the person is brain dead and not breathing.

we use this assessment tool:

http://en.wikipedia.org/wiki/glasgow_coma_scale

jjjoy, LPN · Sep 19, 2008

A nicely positioned patient isn't much good if the person is brain dead and not breathing.

In reading a question that asks whether to do neuro assessments or check patient positioning first, I'm likely to immediately assume that there are no obvious signs of distress. Otherwise, I wouldn't be considering whether or not to do a specific set of neuro checks before or after adjusting the HOB.

Everytime we see a patient, we should be doing a quick visual assessment for changes in breathing, color, LOC. Thus, I would consider assessing LOC as part of my basic assessment and not a part of the "assess neurological function" in the test question. I'm going to be aware of whether or not the patient looks alert, lethargic or comatose before I even reach the bedside!

If the HOB should be up, I'm going to want to remedy that ASAP. I'm not going to test each extremity for motor function, do reflex checks, and ask a slew of orientation questions before going ahead and raising the HOB.

But that's where knowing how to read test questions is important and to never assume anything. Like if the question doesn't explicitly state it, don't assume it... like assuming that the nurse has already ascertained whether or not a patient is breathing.

llg, PhD, RN · Sep 20, 2008

As for the newborn question, I would answer "D." Neither one of the kids has a reason to have a respiratory problem (unless their conditions are severe and/or they have comorbidities.) So their respirations would be unremarkable.