Misc

Question 1

When is physiological jaundice most likely to occur?

Answer 1

Beginning second day of birth, peaking at one week and disappearing by second week.

Question 2

Difference between physiological and pathological jaundice in neonate

Answer 2

Physiological:
Appears after 24 hours.
Max intensity at 3-4 days.
Not detected after 14 days of life.
NO treatment required.

Pathological:
Appears within 24 hours.
Bilirubin rising and is >13.
Jaundice persists after 14 days.
Treatment is required.

Question 3

In postpartum hemorrhage due to uterine atony, what med is used?

Answer 3

Oxytocin
(Oxytocin stimulates uterine contractions.)

(Oxytocin does NOT stimulate breast milk)

Question 4

Best position for mom with abruptio placentae

Answer 4

Left lateral with elevated hob

Question 5

Umbilical cleaning

Answer 5

Clean with alcohol

Question 6

What is polidel?

Answer 6

Lactation suppressant

Question 7

What is tested with alpha fetal protein test?

Answer 7

Neural tube defect

Question 8

Function of estrogen

Answer 8

Stimulates growth of ovaries and Graafian follicles.
Promote retention of fluid during menstrual cycle and pregnancy.
Stimulates prolactin secretion

Question 9

Function of progesterone

Answer 9

Maintain pregnancy by inhibiting motility of Fallopian tubes

Question 10

Side effects of oral bcp

Answer 10

Headache 
Abdominal pain 
Blurred vision
Thrombophlebitis 
Hypertension

Question 11

Antidote for mg so4

Answer 11

Calcium gluconate

Question 12

Action of drug, metagine?

Answer 12

Stimulates uterine contractions

Question 13

What is meatomy

Answer 13

Procedure

Urethra extended to normal position.

Question 14

Test for esophageal atresia

Answer 14

Newborns first fed with few sips of sterile water.

Question 15

What is hypospadias? And what is treatment

Answer 15

Congenital abnormality of penis.
Urethral opening May be anywhere on ventral side of penis.

Tx: avoid circumcision. Not treatment maybe. Or meatomy

Question 16

Digoxin in newborns

Answer 16

Could be used to tx patent ductus arteriosus.

Apical hr for one minute. Hold on infant if HR less than 100.

Question 17

Athetoid

Answer 17

Type of cerebral palsy.
Involuntary, incoordinate motion. 
Facial grimacing
Poor swallowing and tongue movements cause drooling and poor speech.
Normal or better intelligence

Question 18

Cheiloplasty

Answer 18

Cleft lip tx
Done between birth and age 3 months.
Unites lip and gum edges.

Staphylorrhaphy- is cleft palate surgery. Done at 18 months.

Question 19

Early deceleration

Answer 19

The key to remembering if this an early deceleration is to see if the baby’s heart rate mirrors moms contraction and it does here. Plus look to see if the baby’s heart rate is staying within normal limits of 110-160 beats per minutes. The baby’s heart rate dips slightly at the same time the contraction starts and recovers to a normal range after mom’s contraction is over.

Early decelerations are nothing to be alarmed about. The reason the baby’s heart rate starts to slightly decrease is due to head compression (probably from the baby’s head being in the birth canal) causing the vagus nerve to be compressed which in turn decreases the heart rate. So if you see this on NCLEX or HESI the answer to the question will probably be continue to monitor and document the process of the labor or no nursing interventions are required right now but continue to monitor.

Question 20

variable decelerations

Answer 20

dips in the fetal heart tones look like V’s (V for Variable)
Variable decelerations are NOT good! Every time mom has a contraction the baby’s heart rate majorly decreases.
Normal fetal heart rate is 110-160 bpms.

The cause of the decrease fetal heart rate is due to umbilical cord compression. Some of the answers you would need to pick would be change mom’s position (moving her around could help relieve cord compression), administer Oxygen usually 10 L (because cord is being compressed which in turn is causing the baby to not receive enough Oxygen), stop Picotin infusion if running, and contact the doctor.

Plus you may be asked on the exam what is causing this strip to look like this and the answer would be cord compression.

Question 21

late decelerations

Answer 21

Late decelerations are NOT good. When mom has a contraction the baby’s heart rate goes down long after the beginning of mom’s contraction and recovers way after the contraction is over.

This is different from early decelerations because the baby’s heart rate went down at the same time the contractions happened and recovered to normal when the contraction ended.
NCLEX may ask what is causing this type of strip and the answer would be uteroplacental insufficiency. Some nursing interventions include: turn mom onto her side, stop Picotin if infusing, administer 10 L of O2, maintain IV access, determine the Fetal Heart Rate variability, and contact doctor.

Question 22

Effects of methamphetamine on fetus.

Answer 22

The developing fetus appears to be vulnerable to DNA damage from methamphetamine exposure because it hasn’t yet developed the enzymes that protect it against free radicals. Methamphetamines can cause:
neural tube defects such as cleft lip and palate.
skeletal malformations such as clubfoot.
Gastroschisis—when all of the intestines are outside of the body.

When a neonate is withdrawing from methamphetamine, there is an increased incidence of irritability, inability to be consoled, and difficulty sleeping.
Methamphetamine exposure can cause is a common birth defect in methamphetamine- exposed infants.

hyperbilirubinemia is NOT associated with exposure to methamphetamines. Methamphetamines are manufactured with a variety of toxic chemicals that can cause DNA damage in the developing fetus. Many defects can be attributed to methamphetamine exposure in utero.