NURSING 102 FINAL

Question 1

How is jaundice best assessed in an infant with a dark skin tone?

Answer 1

assess the color of the palate or mucus membranes.

Question 2

What is the Apgar scoring

Answer 2

A- appearance (skin color) 0 if blue gray 1 if the color is pinky body with blue hands and feet 2 if the entire body is pink
P- pulse 0 if no pulse 1 if less than 100 BPM 2 if over 100 BPM
G- reflexes 0 if no response 1 if grimaces 2 If the baby grimaces coughs pulls away or sneezes
A- is for activity (muscle tone) 0 if limp or weak movements 1 is if some movements of arms and legs 2 is active movements
R- respiration 0 if not breathing 1 if slow or irregular breathing, a weak cry 2 normal breathing rate and effort and strong cry

Question 3

what are some safety precautions with sids

Answer 3

nothing in crib but baby, no smoking around baby, no sleeping outside of car in the car seat, baby sleep on back until they can roll themselves, no co-sleeping

Question 4

What is sids

Answer 4

Sudden infant death syndrome

Question 5

what are Signs of respiratory distress in an infant

Answer 5

expiratory grunting, nasal flaring, chest wall retractions, seesaw respirations, generalized cyanosis, HR >150-180, fine crackles, tachypnea (>60) Silverman-anderson score >7, Increases fussiness, decreased feeding ability

Question 6

How is fetal Circulation different from Infant circulation? what changes must occur to transition from intrauterine circulation to extrauterine circulation?

Answer 6

happens with very first breath, increased pulmonary blood flow change from placenta to pulmonary gas exchange,
Instant closure of the foremen ovals, ductus arteriosus, ductus venous, cord clamping of cord arteries and vein.
circulation switches from left to right in utero to right to left after the first breath

Question 7

What causes high bilirubin in an infant? What is happening at cellular level?

Answer 7

results from overproduction of bilirubin chichis the end product of hemoglobin breakdown

levels rise in newborns by 3 ways: increased production, decreased removal and increased reabsorption,
production increased after birth bc of a shortened lifespan of a RBC (70 days infant 90 adult )

Question 8

what are negative effects of heat loss in an infant

Answer 8

Hypoglycemia, hypothermia, causes the baby to burn more calories than they can get in at that time

Question 9

what assessment finding are consistence with a 32week gestation infant

Answer 9

weight under 5.5 scrawny appearance, poor muscle tone, minimal subq fat, undefended testes,plentiful lanugo, poorly formed ear pinna, fused eyelids,
soft spongy skull bones, ,acted scalp hair, absent to few creases in palms and soles, minimal scrotal rugae, prominiate clitoris and labia, thin transparent skin, abundant vernix

Question 10

what assessments are consistent with a 42 week gestation infant

Answer 10

dry cracked skin, possible meconium stained, Long thin extremities, long nails, creases cover entire soles of feet, wide alert expression, abundant hair on scalp, thin umbilical cord, limited vernix and lanugo

Question 11

what is needed to to be classified as small for gestational age

Answer 11

weigh less than 5.8 at term, weight falls below the 10th percentile for length, weight or head circumference on growth chart,
can be preterm or post term

Question 12

what is needed to be classified as small for gestational age

Answer 12

weight > 8.13. lg body, plump, full faced, proportional increase in body size, poor fine motor skills, difficulty regulating behavioral stress that could be caused by fluctuations in glucose

Question 13

What is PKU and when do you screen for it

Answer 13

it is a blood test screening given to newborns 24-3 days after birth,

Question 14

you take care of a 5 hr pp mom and notice a lesion on her mouth that is consistent with herpes lesion what would be used to treat the infant

Answer 14

antiviral medication acyclovir

Question 15

Describe the 4 different degrees of perineal lacerations.

Answer 15

1st- involves only skin and superficial structures above muscle
2nd- extends through perineal muscle
3rd- extends through the anal spinchter muscle
4th- continues through anterior rectal wall.

Question 16

A 5 day post partum women calls the office stating, “I am peeing so much and sweating. Should I be concerned?”. What education would you provide to the patient about the amount of fluid being voided in the first week post partum?

Answer 16

Explain its all completely normal, as she received lots of fluids during labor and her body naturally had additional fluids in it from the pregnancy and its now its time to get rid of the fluids. Its normal but if she feels any burning or urgency to urinate to call the office as she may have a UTI

Question 17

A 6 day post partum patient reports, “I tried for years to have a baby. Now I have the most perfect baby girl in the entire world. I know I should be happy. But I just feel sad. What is wrong with me?”. What education would you provide? What is the term for this condition? What follow up questions would you ask?

Answer 17

Education regarding “baby blues/ postpartum depression. It’s normal to feel like this R/T fluctuating hormones, fatigue, transitioning into a new normal/role. Usually resolves within the first 2 weeks, but if lasts longer reach out to your HCP. Ensure they have a good support system at home

Question 18

Where would you expect to palpate the fundus on a 2 day PP patient?

Answer 18

2cm below umbilicus and should be firm

Question 19

A woman goes to the OB appointment at 32 weeks. Upon review of systems the pt reports feeling “Crampy and I had have some fluid leaking.” Provider examines pt and notes the pt’s cervix is 2 cm dilated. The patient is showing signs of_______________?

Answer 19

PROM, preterm labor

Question 20

What is placenta previa?
What are classic signs and symptoms?

What are causes?

Answer 20

Placenta covering opening of cervix
Classic sign/symptom: bright red painless bleeding from vagina, most common in 3rd trimester
Causes: Advanced maternal age, cocaine use, smoking, previous abdominal surgeries including c-sections.