Union Test Prep Flashcards
Naegele’s rule states….
Add 9 months and 7 days from the Start of LMP (last menstrual cycle) to determine Delivery Date.
Ibuprofen (Advil and Motrin)
Naproxen (Aleve) Naproxen is a stronger
Celecoxib-Celebrex.
Are which type of medication
All NSAIDS
Also, Aspirin - acetylsalicylic acid
When is RhoGAM given?
hint… it’s given twice
Why is it given?
Rh negative mother with a Rh positive father @ 28 weeks & birth
If not given
Mother may produce antibodies that attack her baby’s red blood cells and cross the placenta
What condition can develop in a fetus if the mother is Rh negative & father is Rh positive.
Hydrops fetalis, aka hydrops,
Serious Edema often fatal
Treatment. Deliver baby
What is hydrops fetalis?
How does it happen
Edema in fetus / new born
90% syphilis, B19V infection, metabolic disorders, genetic syndromes, chromosomal abnormalities, and tumoral/mass causes
10% Rh negative mother and Rh positive father
How much weight should be gained during pregnancy?
22 - 27 lbs
A severe headache during the 3rd trimestre is a warning sign of pre-eclampsia.
What 3 health problems are associated with pre-eclampsia, a dangerous medical condition to mother & baby
High BP
Proteinuria
Swelling of hands & feet
When is it normal to feel fetal movement. Between which week’s should it start?
17 - 19
Sometimes as late as 25th week
What is an APGAR score used for?
When is it preformed?
1 and 5 minutes after birth. The 1-minute score = birthing process. The 5-minute = how well the baby is doing outside the mother’s womb
Breathing effort
Heart rate
Muscle tone
Reflexes
Skin color
Each category is scored with 0, 1, or 2, depending on the observed condition.
Breathing effort:
If the infant is not breathing, the respiratory score is 0.
If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
If the infant cries well, the respiratory score is 2.
APGAR score, What is considered a “good” score
score of 7, 8, or 9 is normal and is a sign that the newborn is in good health.
A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.
Nurse ask mom about 1 year old developmental milestones. Which of the answers would be a red flag that there are developmental delays
- Can crawl, pull-up, and stand on own but cannot walk
- Can hold sippy cup but cannot pick up bits of food nor transfer food from his cup to his hands
- He recognizes his name and will look and smile when I call him
- He is able to “coo” but isn’t saying other words
2.Can hold sippy cup but cannot pick up bits of food nor transfer food from his cup to his hands
By 9 months they should be able to transfer objects from hand to hand and use Pincer grasp to pick up small objects
Intimacy vs. Isolation, Integrity vs. Despair, Autonomy vs. Shame, Trust vs. Mistrust, Identity vs. Confusion, Initiative vs. Guilt, Industry vs. Inferiority, Generativity vs. Stagnation
Birth to one
18 months to three years
Three to six years
Six to 11 years
12 to 18 years
18 to 40 years
40 to 65 years
65 and up
Trust vs. Mistrust
Birth to one year Infants learn to trust that their caregivers will meet their needs, but if these needs aren’t consistently met, they may develop mistrust, anxiety, and suspicion.
Autonomy vs. Shame
18 months to three years Children become more interested in their environment and strive for independence.
Initiative vs. Guilt
Three to six years Children gain more autonomy and use their imagination to start forming their identity.
Industry vs. Inferiority
Six to 11 years This stage occurs during childhood.
Identity vs. Confusion
12 to 18 years Adolescents explore their independence and develop a sense of self.
Intimacy vs. Isolation
18 to 40 years Young adults focus on forming loving relationships with others.
Generativity vs. Stagnation
40 to 65 years People may develop their careers or have children, or they may find little meaning in life and become stagnant.
Integrity vs. Despair
65 and up, to death People tend to slow down their productivity and explore life as retirees.
Hormone replacement therapy can decrease the symptoms of menopause (Hot Flashes, insomnia, sweating, mood swings & weight gain)
HRT can also decrease the risk of (1)
And increase the risk of (4)
HRT
Decreases: Risk Osteoporosis
Increases: Risk
Coronary Artery Disease
Breast cancer
DVT
Stroke
Which vaccine should a teenager who is about to move into a college dorm get
- Pneumococcal
- Meningococcal
- Herpes zoster
- Hepatitis B
- Meningococcal (Prevents meningitis)
Herpes zoster >60 yrs (prevents shingles)
Pneumococcal during infancy
Hepatitis B (3 - 4 vaccines starting at birth and ends at 6 months)
Fasting lipid profile
Total cholesterol < ____
Triglycerides or Fatty acid < ____
Total cholesterol <200
Triglyceride or Fatty Acid < 150
Fasting lipid profile
LDL <____
HDL <____
LDL < 100
HDL < 50 Women / 40 Men
Nurse Palpating notices a displaced Point of Maxium Impulse (PMI) & Cardiac thrill
Describe normal location PMI
What disease is a Cardiac Thrill associated with?
PMI Located 5th intercostal space at midclavicular line
Cardiac Thrill is a Palpable Heart Murmur - (Sound or Feel of blood flowing through the heart, due to: healthy heart exertion during exercise, diseased heart valve, or other abnormality)
Both of these can be felt via palpation
Client has 3-day worsening fever, productive cough, and fatigue. Which are most likely during Ausculation
- Hyperresonance with percussion and normal breath sounds with Ausculation
- Hyperresonance with percussion and abnormal breath sounds with Ausculation
- Dullness with percussion and normal breath sounds with Ausculation
- Dullness with percussion and abnormal breath sounds with Ausculation
- Dullness with percussion and abnormal breath sounds with Ausculation
Classic pneumonia symptoms
Will hear dullness with percussion due to consolidation- abnormal breath sounds- wheeze,crackles, rales
Hyperresonance is heard with air presence.
Give examples of a blended family
Give examples of nontraditional family
blended family = Step parent, Step sibling, or half- sibling
Non traditional = Single parent, same- sex, or polygamy
New born male has swollen breast and a clear liquid coming from them.
Which is the most appropriate response from the nurse.
- Your infants needs to be examined
- Swollen breast are normal in a newborn under 2 weeks
- An ultrasound will be needed to assess for an abnormality
- While common in females this finding is abnormal in males
Swollen leaky breast are normal first 2 weeks due to residual estrogen from pregnancy & breastfeeding.
It is referred to as “Witches Milk”
Before surgery a patient is concerned about what will happen to her if something goes wrong. Which is the correct course of action?
- Inform Dr. and delay surgery until after patient seeks legal counsel
- Alert the social worker that patient needs help with advanced directives.
- Inform & educate client about advanced directives, help coordination in their creation, and ensure they are in the medical record
- Inform that the nurse will act as a healthcare proxy for the patient, should they become incapable of making their own decisions
- Inform & educate client about advanced directives, help coordination in their creation, and ensure they are in the medical record
Patient Self Determination: It’s the nurses legal duty to inform educate on advanced directives upon admission to any health care facility.
Assessment of weather Advanced Directives are needed, facilitating creation of documents, ensuring they are part of medical record
The nurse gets a phone call from an unknown caller requesting to know the status of a patient under their care.
Which is the best course of action
- Tell them persons condition
- Take callers information and list it in the patient’s chart prior to sharing information.
- Check patients chart to see if person is listed to recieve confidential information.
- Tell person confidential information cannot be given over the phone.
Check patients chart to see if person is listed to recieve confidential information
HIPAA specifies that only Direct Patient Care, Insurance Reimbursement, Patient Management.
Patients may also list persons in their chart with whom you may share information
When may a health care worker share information in regards to a patient’s current health status to family, friends, or other person? (3)
Patient is Present & has capacity to make health care decisions
Health Status maybe discussed in person, via telephone, or in writing
- Obtains permission
- Give patient opportunity to object but they don’t
- Decides from professional judgement and experience that the patient doesn’t object
When may a healthcare worker release current health information or payment information to Anyone if the patient is not present or incapacitated?
Based on professional judgment that it is in the patient’s best interest.
Must be reasonably sure that the patient has involved them in their health care.
