Test Questions! Need some Advice!

[skygirlhil]

To all of you expereinced OB nurse out there...I have an 11 question essay exam and am stuck on a few of the questions. For each reponse I am supposed to include assessments and teaching interventions....have any advice on these two:

" A new father walks out into the hopital hallway and says to you, please, come quick,it looks like the baby is bleeding." What will you say or do next? What are the possible causes?

In the newborn nursery as you are conducting your admission assessmetn on a newborn and you note the presence of a transverse palmar crease, bilaterally. What else would you look ofor and what is the significance of this finding? what would you say to the mother?........................My question is, is the nurse the one who tells the parents about birth defects...or is it the physician?

THANKS!

[MikeyJ, RN]

To all of you expereinced OB nurse out there...I have an 11 question essay exam and am stuck on a few of the questions. For each reponse I am supposed to include assessments and teaching interventions....have any advice on these two:

" A new father walks out into the hopital hallway and says to you, please, come quick,it looks like the baby is bleeding." What will you say or do next? What are the possible causes?

In the newborn nursery as you are conducting your admission assessmetn on a newborn and you note the presence of a transverse palmar crease, bilaterally. What else would you look ofor and what is the significance of this finding? what would you say to the mother?........................My question is, is the nurse the one who tells the parents about birth defects...or is it the physician?

THANKS!

I am not an OB nurse (still a student myself), but here are some thoughts:

(1) I would immediately enter the patien't room and assess the infant for bleeding. (Remember, ALWAYS assess first before doing any type of intervention or contacting the doctor). I don't know what the common causes of bleeding in infants -- I was thinking the umbilical cord? I have also seen pseudo-mensturation in female infants, and there is minor bleeding from the lady parts.

(2) Transverse palmar creases are usually indicative of Down's Syndrome (but I know it can also be indicative of FAS, but they are probably looking for Down's Syndrome). I would not mention the creases to the mother, because you need the pediatrician to diagnose that. If the mother expressed her concerns about the creases, I would tell her "these type of creases can be indicative of disorders such as Downs Syndrome or FAS; however, you need to speak with your pediatrician about your concerns".

[Elvish, BSN, DNP, RN, NP]

What would your first instincts be, skygirl? I'm not trying to sound snarky, but a lot of times you know the answer or are at least on the right track even when you think you don't/aren't.

So, before we give you what WE would do, what would YOU do?

[jjjoy, LPN]

Without researching anything or having experience in the area and out of school for years...

What would I do??? case one... immediately go and assess the infant... how can I guess at causes without any assessment or even a description of the bleeding?? Case two... I'd have to review what other signs to assess for in relation to the transverse palmar crease. And I wouldn't say anything to the mother about it unless she asked. I'd check any previous documentation in regard to this finding. If the mother had already been told of the finding, I'd engage in teaching in regard to implications of the finding and what to expect at this point. If it appears that it hadn't been addressed already, I'd notify the physician. I'd hope the physician were right there. If not, I'd hope my unit had some policy on how to deal with such situations if it would be awhile before the physician could address it.

[Spidey's mom, ADN, BSN, RN]

1. Assess the infant.

2. Don't say anything to the mother. Assess the baby for other signs of Down's Syndrome and go look up other causes.

http://www.medterms.com/script/main/art.asp?articlekey=40405

steph

[txpixiedust]

Hi skygirlhil,

I'm a PP RN, and we get a lot of parents who think their baby has blood in their diaper, and are quite concerned. Not sure what you had in mind with your scenario, but that's what first came to mind. What the parents think is blood is actually what we call "brick dust" - when the babies are dehydated their urine is so concentrated it looks dark red. This usually occurs when babies are premature and not breastfeeding well. We just encourage the mom to put the baby to breast more, and for her to drink more fluids also. The Pedi's keep an eye on the baby and decide if they want mom to begin supplementing with formula.

Hope that helps you either with school or later on if you work with Women & Children!

Good Luck in School!:wink2:

txpixiedust:nurse:

[LittleLisaLawrence]

What the parents think is blood is actually what we call "brick dust" - when the babies are dehydated their urine is so concentrated it looks dark red. This usually occurs when babies are premature and not breastfeeding well. We just encourage the mom to put the baby to breast more, and for her to drink more fluids also.

Interesting! I didn't know that. Thanks for sharing.