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SET 2 > New Information > Flashcards

New Information Flashcards

1
Q

Txt of PE

A

Bed rest with affected leg elevated, decrease pain and administer anticoag
vit k
warfarin
thrombin (enoxaparin)
limit leafy green maintain
target INR
bleeding precautions
fibrinolytics like tPA, pulmonary embolectomy may be performed
Inferior vena cava filtration
(Avoid crossing legs, leg pain numbness indicate neurovas impaired) to prevent clots from getting into pulmonary system.

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2
Q

Treatment meds for CHF

A

Ace inhibitors *DOC - RILS
Supress Angiotensin 1 from 2 > Arterial dilation and increase stroke volume.
S/E - Nagging cough

Arbs - Sartans
Block 2 , decrease arterial resistance and BP

Beta
First line therapy to ace
relax , decrease bp, afterload, workload.

Both ace and arbs block aldosterone - we lose sodium and water and retain potassium! *both ARBS AND ACE contraindicated in Pregnancy

Digoxin (0.5-2)
for sinus rythm
in combo with Ace, arbs, beta, diuretics
contraction stronger, hr slower, co up, kidney perfusion up.

Dig tox
- early n/v anorexia 
- late arrythmia vision changes
electrolyte problems
hypokal and dig
  • Dig is held if pulse is <90-100 for infants and for children <70
  • If dose is missed do not give an extra dose or increase dose
  • give water or brush teeth after administration
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3
Q

Filgrastim Med (Onco)

A

Used prophylactically or when theres an infection

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4
Q

meds for ulcerative

A 
abx 
steriods
biologics and immunomodulators (mab)
aminosalicylates (zide and zine)
- ZINE 
	- Drink 8 glasses of water
	- Photosensitivity
	- folic acid - take supplement
	- life threatening - agranulocytosis report fever or sore throat
	- Stevens johnson - client should stop if rash appears
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5
Q

Basal Long acting

A

NPH - immediate acting - 2X a day 18hrs
peak 4-12 hrs
GARGLINE - Once daily 24hrs
no peak

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6
Q

Postprandial short acting

A 
Regular 
- peak 2-4 hrs best used iv dka 
- Sliding scale 
Lispro/aspart/ Glulisine
Peaks - 30 mins - 3 hrs
- 45-75 mins best for postmeal hypergllycemia
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7
Q

Adrenergic blocker S/e (Gastro)

A

Ending in SIN
Relaxes smooth muscle
- causes orthostatic hypotension, esp first dose
- at bedtime, change position slowly and avoid medications that also increase muscle relaxation
- ejaculatory dysfunction

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8
Q

Arrythmias

A

Vtach
- can be pulseless or have a pulse to treat, it is based on pulse so assess pulse. Assess signs of hypotension , altered LOC, signs of shock etc.
Vfib
Asystole

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9
Q

ADHD

A

They have trouble paying attention, experience difficulty organizing tasks

Nursing intervention;

  • calm, structured organized environment
  • Written chart of list of daily activities
  • limit guests to avoid over distraction
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10
Q

Newborn CPR

A
  • neck slightly extended , place blanket or towel roll under newborn shoulder elevate chest 3/4 1 inch
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11
Q

Juvenile Idiopathic Arthritis

A
  • Risk for deconditioned
  • tire quickly
  • low impact , weight bearing, nwb exercises - rom exercises and stretching.
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12
Q

FTT

A
  • <80% OF IDEAL WEIGHT
  • Domestic violence
  • Caregiver -ve attitude towards food
  • Poverty or food security
  • Disordered Feeding (unstructured meal time)
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13
Q

Reye Syndrome

A
  • recent viral infection - varcilla influenza
  • lethary, encep, altered hepatic fx. elevated ammonia
    • Development of this syndrom is increased with the use of aspirin
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14
Q

Ectopic Pregnancy

A

S/s

  • Lower abd pain, pelvic pain
    • spotting, mass on pelvic exam
  • Rupture causing maternal hemorrhage
    • HR elevated
    • dizziness, referred shoulder pain

Txt: Surgery

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15
Q

St. John’s Wort

A

Used to treat depression, it may interact with other medications such as SSRI’s and MAOI. leading to dangers condition called Serotonin Syndrome

Excessive serotonin can be mild to severe

  • mild shivering and diarrhea
  • severe muscle ridgidity , fever and seizures
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16
Q

PKU

A

Can cause intellectual disability

Avoiding high protein foods, help maintain levels in a safe range.

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17
Q

What is the serum alpha fetoprotein test?

A

tests for neural tube defects

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18
Q

What are group b strep testing for ?

A

Routinely 35-37 weeks ges, determining if abx needed to prevent neonatal infx.

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19
Q

DNR

A

Always stop

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20
Q

Jtube management

A

Hand hygiene
Pull plug and pour into urine specimen or plastic cup
empty drain q4-12 hrs unless it is 1/2 full.
compress the bulb side to side
clean spout wit alcohol

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21
Q

VRE AND MRSA, CDIF - CONTACT PRECAUTIONS

A 
Private room, or semi private w/ same infection
dedicated equipment
wear gloves
person hand hygiene 
wear gown 
place notice
essentials inside room
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22
Q

Hawthorn

A

Heartfailure

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23
Q

Black cohosh

A

Hot flashes

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24
Q

Older Adult Women

A

Major health risk Osteo and Heart Disease
Biphosphonates - decrease bone resorption so that loss of bone density is minimized -take with empty stomach 30 min before other drugs full glass upright
calcium and vit d required
HRT improves osteoperosis but increases thrombotic complications such as leg swelling

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25
Q

Endotrach Suctioning

A 
Hand hygiene
Oral care
Preoxygenate with 100% 
advance catheter
Suction only while withdrawing 
Sterile tech
<10 seconds
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26
Q

Urinary Catheter

A

Client with urinary obstruction or retention
perioperative use such as urologic surgery
prolonged immobilization
improve end of life comfort
facilitate healing

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27
Q

Impetigo

A

Highly contagious bacterial skin infection
honey comb crust
from hot weather

s/s burning itching

txt
hand hygiene before and after touching
isolating person's clothing
keeping infected person's nails short
avoiding close contact for 24-48 hrs
cover affected area w/ gauze
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28
Q

Nephrostomy

A

A procedure that removes kidney stones
client experiencing left flank pain requires
- gentle irrigation, aseptic tech

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29
Q

Oliohydraminos

A 
Minimal amniotic fluid, usually declining after 41 weeks
major complications
- pulmonary hypoplasia 
	- possible resuscitation
- umbilical cord compression
	- req' additional personnel

Continuous fetal monitoring and cord compression

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30
Q

Tb Medications

A

Rifampin

  • changes in body fluids, tears can turn red
  • wear eyeglasses instead of soft contact lenses
  • women should use nonhormonal birth control
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31
Q

SSRI’s complications

A
  • tine’s

- causes sexual dysfunction

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32
Q

Bells palsy teaching

A
  • eye care, patch at night, w/ artificial tears

- oral care and chew unaffected side

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33
Q

What is sjogren?

A

Autoimmune exocrine glands wbc attacking
s/s
- dry eyes and mouth
- ulcers
- dental caries, and thrush
txt
- eye drops
- sugarfree or artificial saliva, vag lubricants
- freq dental visits
- mild soap
- avoid decongestants as they further irritate

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34
Q

How to insert enema

A
  • left lateral
  • right knee flexed
  • insert tube tip directed to umbilicus
  • slow rate if abd cramping noted
  • room temperature
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35
Q

Assessment of feedings

A
  • assess for intolerance q4hrs , abd distension
  • tube placement
  • hob >30
  • endotrach cuff 25 cm low cuff increases risk for aspiration
  • suction secretions
  • caution with sedatives
  • avoid bolus tube
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36
Q

What is acute-closure glaucoma?

A
  • Re immediate medication intervention.
    • s/s: sudden onset severe eye pain
    • reduced central vision
    • blurred vision
    • ocular redness
    • halos around lights
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37
Q

Valsalva manuever contraindications

A
  • ICP
  • Stroke
  • Head Injury
  • Heart Disease
  • Glaucoma
  • Eye Surgery
  • Abd surgery
  • liver cirrhosis
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38
Q

In emergency, trach outside hospital

A

Two spare trachs should be carried one same size one smaller.

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39
Q

What is uterine inversion ?

A

Postbirth complication

  • fundus collapses into cavity causing
    • hemorrhage and shock

treatment: oxytocin

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40
Q

How to measure fundal height

A
  • 12 weeks its at symphysis pubis
  • 20-22 weeks at umbilicus
  • 36 xyphoid
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41
Q

Bronchoscopy Procedure

A
  • Mild Sedation
  • Topical anesthetic- to prevent laryngospasm

Complication

  • blood tinged is COMMON but BRIGHT RED indicates hemorrhage
  • hemopytsis, hypoxia, low bp, laryngospasm and brady
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42
Q

How to do a peak flow meter

A
  • Position indicator on flow meter at lowest
  • inhale deeply
  • exhale as quickly
  • repeat procedure 2 more times with a 5 to 10 second rest
  • Record the highest of the three measured
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43
Q

Scabies

A

person to person contact
- intense itching

Txt:

  • all persons in close contact should receive treatment
  • apply to all skin surfaces
  • belongings should be washed in hottest for >3 days
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44
Q

What is Histoplasmosis

A

Opportunistic fungal infx from bird or bat droppings inhaled

- life threatening infx in immunocompromised individuals

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45
Q

How to do a clean catch urine

A
  • Hand Hygiene
  • spread labia
  • cleanse vulva
  • initiate urinary stream before passing container
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46
Q

What to do when status elipticus occurs?

A

Iv rectal benzo

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47
Q

What to remove when person is unconscious and put in a mechanical ventilator

A
  • assess for med alert devices
  • remove personal belongings
  • remove tampons, jewelry, contacts
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48
Q

Working with an interpreter

A
  • address directly
  • short sentences
  • ask one q at a time
  • hold a preconference to review goals
49
Q

Peripheral IV Catheter Infections can be reduced by

A
  • Clean with chlorhexidine friction
  • Secure with sterile, semi permeable dressing
  • access ports cleaned with alcohol swabs
  • replacement is 72-96 hrs unless sign of infx/
50
Q

Influenza is for?

A

Healthy clients 2-49

  • contra: immunocompromised
  • pregnant
  • age <2 years
51
Q

HHNK

A 
Cause:
- Extreme Hyperglycemia 
- osmotic diuresis 
- type 2 diabetes
s/s
- altered mental status 
- gradual onset
- hyperventilation 
- abd pain less common but common in keto
52
Q

What is polycythemia vera

A

Too many RBC CELLS

  • Risk for clots/ dvt
  • Itching

Treatment

  • adequate fluid intake
  • elevate legs
  • wear support stockings
  • avoid iron rich foods
53
Q

Sterile Field

A
  • Hand Hygiene
  • Sterile gauze package ungloved
  • Open Gauze package 15 cm above sterile field
  • Place gauze dressing more than 1” from the edge of the sterile field
  • Use sterile NSS recap that was opened <24hrs ago
54
Q

Broca Aphasia

A
  • Effort sensible speech short, limited sentences and can comprehend speech, frustrated when speaking
55
Q

Ruptured Membrane PH

A

Bluish color or any type of blue

  • BUT, a false positive may be from serum prostatic fluid
    • recent intercourse
56
Q

Separation anxiety alleviation

A
  • encouraging fav toys
  • establish a daily routine
  • provide opportunities to play
  • phone calls
  • providing support when child is upset
57
Q

Herpes medication

A

Teach:

  • use gloves when applying topical medication to avoid spreads
  • complete abstinence when active lesions are present
58
Q

Low sat after general anaesthesia

A

head tilt chin lift to open airway

59
Q

Management of an asthma attack

A
  • high dose of inhaled SABA (albuterol) 20 min
  • ipratropium - 20 min
  • Systemic corticosteroids (solumedrol)
    • Long aging salmeterol is not indicated for emergency use
60
Q

what drug to reverse opiods?

A

naloxone

61
Q

what drug to reverse diazepine?

A

Flumazenil

62
Q

TB Screening

A

1ml Tb , 27 gauge 1/4 inch

  • left forearm face upward
  • 1 inch below insertion pull skin taut
  • insert parallell to skin 10 degree bevel up
  • advance tip into dermis outline of bevel should be visible , small wheal
  • remove do not rub
  • circle area w pen
63
Q

ADHD Meds

A 
Ritalin, Methylphenidate treats narcolepsy and adhd
Common s/e:
- loss of appetite = weightloss
- important to compare weight and height
- increased BP and tachy
64
Q

Rheumatoid Arthritis

A

inflam in synovial joint leading to
- fibrosis which is pain and deformity affective ADL
Symptom management:
- ROM
- Heat packs and stiff joints and ice packs
- Plan frequent rest periods

65
Q

Major Depressive disorder

A 
Experience symptoms everyday for atleast two weeks
SIGECAPS
- Sleep
- Interest deficit
- Guilt
- Energy Deficit
- Concentration Deficit
- appetite
- Psychomotor
- Suicidal
66
Q

CPR Adults and Pregnant

A

Chest compressions 2in or 5 cm
30 compressions followed by 2 rescue breaths
- continuous compressions and 10 breaths/min
- 100-120 min

Pregnant

  • place on sternum slightly higher
  • uterus should be displaced to the left , rolled blanket or wedge under right hip
  • if no circulation after 4 min emerg csection is intitated and should be delivered with in 5 min
67
Q

How to use the cardioversion?

A
  • ensure synchronizer is turned on before they leave the unit
68
Q

What is an important for bed bugs ?

A

Wash clothes in hot water and store in tightly sealed plastic bags

69
Q

What is Necro. entero? and what is an important ns intervention in regards to it.

A

Common with preterm infants, causing inflammation and ischemic tissue. It is important to measure abd girth and assess if it is worsening.

  • place in supine, undiapered
  • avoid rectal temp
70
Q

Growth hormone replacement is for?

A
  • an option for children not growing according to standards

- sub q everyday

71
Q

What is rotavirus?

A

Contagious diarrhea for children less than 5 years old transmitted through fecal-oral route

  • cannot bee treated with abx bc it is viral
    vaccination is important and monitoring dehydration
  • can contaminate through objects
72
Q

What is scarlet fever?

A

Group A strep infex

  • distinctive rash on neck and chest resembling a bad sunburn
    dx: rapid strep antigen test
73
Q

Can warfarin and Heparin be given at the same time?

A

Yes, because warfarin takes 48-72 hrs , overlap is required for 5 days until INR reaches therapeutic level

74
Q

How to do reconstitution ?

A
  • HH
  • withdraw air from the vial
  • inject dilutent into the air
  • roll between palms of hands to mix
  • withdraw reconstituted med
  • label syringe
75
Q

What is west nile and how to prevent it?

A

Mosquito-borne (encephalitis)

  • avoid mos and use a repellent
  • wear long sleeves light colored
  • avoid dawn and dusk
76
Q

How to Z track

A
  • Pull the skin 1-1/2
  • Hold skin taut 90 degree
  • Inject medication slowly while maintaining traction slow injection
  • wait 10 sec after injecting then withdraw
  • release the hold on the skin
  • apply gentle pressure at site but do not massage
77
Q

What are teratogenic meds?

A 
doxycycline
isotrentoin (accutane)
ace inhib
lithium 
warfarin
phenytoin
78
Q

Purse breathing technique

A

Inhale 2 sec through nose with mouth closed

exhale 4 seconds through pursed lips

79
Q

Developmental dysplasia

A
  • Occurs between <2-3 months when a person has extra lingual folds in the leg and laxity hip joint
  • pelvic tilt is noted when the child learns how to walk
80
Q

What must you ensure when it is a forcep/extract delivery

A
  • pt bladder is empty
  • monitor contractions
  • document equipment applied
  • FUNDAL PRESSURE SHOULD NEVER BE DONE
81
Q

Important factors of Long acting controlled release drugs?

A

Dose should be given regularly to maintain therapeutic level for chronic pain, even when pain is not reported.

82
Q

Important factor for immediate release opiods

A

May require break through.

83
Q

What is macular degeneration?

A

Progressive incurable. loss of central vision but can see peripherally

84
Q

What are small flashes of light associated with?

A

Retinal detachment

85
Q

Inability to see close up?

A

Presbyopia

86
Q

Poor peripheral vision?

A

Tunnel vision

87
Q

When a client has >15mm TB

A

Client is positive but was exposed and developed antibodies

88
Q

What is your surgery prep as a nurse?

A
  • be a witness
  • verify client is NPO and voids prior to surgery
  • Informed consent
89
Q

When is a venturi mask utilized?

A

It provides high flow oxygen for
tachpnea is present
hypox
most appropriate for COPD

90
Q

When is a nasal cannaula utilized?

A

for normal vitals not prefferable for COPD

91
Q

When is non-rebreathing mask utilized?

A

To deliver 60-90% oxygen short term, forlow sats.

  • asthma
  • pneumonia
  • trauma
  • sepsis
    NOT copd
92
Q

How to use a fire extingusher?

A 
PASS
pull pin
aim to spray
squeeze handle
sweep the spray
93
Q

What to do when someone has a blood transfusion allergy?

A

stop the infusion
initiate normal saline
maintain IV access
Prevent hypotension and vascular collapse.

All over things like
call doctor, monitor vs, labels, collect urine and return tubing are all after

94
Q

What is priapism?

A

Painful erection related to sickle cell anemia

95
Q

What are your preterm labour meds?

A

administer:

  • im antenatal
    (sones) glucocorticoids
  • abx
  • iv mag sulf
96
Q

Neurological Assessments that are concerning

A
  • Cannot flex the chin toward the chest
  • new onset of right arm drift
  • pupils greater than 8
  • babinski reflex present
97
Q

How to Deal with Syphillis in pregnancy?

A

Syphillis can cross the placenta

  • if the client is allergic to penicillin, desensitization is recommended
  • all clients are screened and rescreened during third trimester
98
Q

What to do when shoulder Dystocia occurs?

A
  • document the event
  • perform mcroberts maneuver
    • legs flexed onto abdomen / supra pubic pressure
  • request additional help
99
Q

what is cranial nerve 1

A

olfactory

100
Q

Cranial nerve iii ?

A

motor of the eye

101
Q

cranial nerve ii?

A

optic nerve and sensory , the persons to see objects in field

102
Q

Cranial nerve vii?

A

facial movements - smile frown etc.

103
Q

ABGs to be taken on mechanical vent pt what should you not do?

A

Avoid suctioning or changing oxygen

104
Q

Intradermal angles

A

5-15 degrees do not massage

105
Q

Sub q angles

A

90 degrees or 45

106
Q

IM angles?

A

client should be positions supine, prone or side lying, knee and hip flexed

107
Q

Pressure injury stages

A

Stage 1 - skin intact
stage 2 - shallow, partial skin loss red or pink
stage 3 - full thickness skin loss fat but not tendon muscle or tunnleing
stage 4 “” but tunneling may have occurred

108
Q

What causes PVCs or Ventricular bigminy

A

Caused by

  • hypokalemia
  • exercise
  • stress
  • hypoxia
  • Fever
  • stimulants
109
Q

Which insulins can be mixed and how to do it first

A

NPH and any regular doses such as aspart or lispro

  • inject clear air first with the NPH
  • inject air into the regular then take the dose from the regular and continue to the NPH
110
Q

What is a synchronized cardioversion defib?

A

Its a low electrical pulse, resets the heart to a more slower regular rhythm. It must be set to ‘sync’ to prevent R on T

111
Q

How often is ostomies changed?

A

every 5-10 days to prevent irritation

112
Q

What is the normal ABG for someone with COPD?

A

Elevated PaCO2 decreased PaO2

Abnormal - PaO2 less than 60.

113
Q

Prevention of DVT

A

Anticoag
Compression stockings
Feet flex - exercises
Ambulation

114
Q

Things to note when administering potassium

A

i/o, lab work
>10 is not acceptable
cardiac monitor
expect burning

115
Q

Which clients pregnant nurses cannot care for due to potential to cause fetal abnormalities ?

A 
Taxoplasmosis
Other [varicella]
Rubella
Cytomegalovirus
Herpes
116
Q

When someone requires CPR near a pool?

A

Dry the area around , move away from large bodies of water

remove transdermal patch

117
Q

What are your restraint rules?

A

Hrly neurovascular checks
brief release every 2 hrs
offering fluids every 2 hrs/ bathroom

118
Q

Fetal Scalp Electrode is contraindicated for:

A

Blood borne disease mothers, because it increases risk for fetus - hep b, hiv

SET 2 (16 decks)

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