Nursing Board Review : Maternal And Child Health Nursing Part 2 (Practice Mode)

Mylene is experiencing uneasiness about the curvative of her spine, which will be more evident when she wears a bathing suit. This data suggests a body image disturbance. There is no evidence of anxiety or ineffective coping. The fact that Mylene is planning to attend a pool party dispels a diagnosis of social isolation.

Before coming to any conclusion, the nurse should ask the mother focused questions; however, based on initial information, the analysis of separation anxiety would be most valid. Separation anxiety is a normal toddler response. When the child senses he is being sent away from those who most provide him with love and security. Crying is one way a child expresses a physical need; however, the nurse would be hasty in drawing this as first conclusion based on what the mother has said. Nurturing overdependence or not providing structure for the toddler are inaccurate conclusions based on the information provided.

Using the Nagel’s rule, he use this formula ( -3 calendar months + 7 days).

Anterior fontanel closes at 12-18 months while posterior fontanel closes at birth until 2 months.

Uterine atony, or relaxation of the uterus is the most frequent cause of postpartal hemorrhage. It is the inability to maintain the uterus in contracted state.

RhoGAM is given to Rh-negative mothers within 72 hours after birth of Rh-positive baby to prevent development of antibodies in the maternal blood stream, which will be fata to succeeding Rh-positive offspring.

A loud noise such as a crying baby, or a dropped tray of equipment may be sufficient to trigger a seizure initiating eclampsia, a woman with severe preeclampsia should be admiotted to a private room so she can rest as undisturbed as possible. Darken the room if possible because bright light can trigger seizures.

Alpha-fetoprotein is a substance produces by the fetal liver that is present in amniotic fluid and maternal serum. The level is abnormally high in the maternal serum if the fetus has an open spinal or abdominal defect because the open defect allows more AFP to appear.

With breast feeding, the father’s body is not capable of providing the milk for the newborn, which may interfere with feeding the newborn, providing fewer chances for bonding, or he may be jealous of the infant’s demands on his wife time and body. Breast feeding is advantageous because uterine involution occurs more rapidly, thus minimizing blood loss. The presence of maternal antibodies in breast milk helps decrease the incidence of allergies in the newborn. A greater chance for error is associated with bottle feeding. No preparation required for breast feeding.

Hemophillia A (classic hemophilia) is a deficiency in factor VIII (an alpha globulin that stabilizes fibrin clots).

Non-stress test measures response of the FHR to the fetal movement. With fetal movement, FHR increase by 15 beats and remain for 15 seconds then decrease to average rate. No increase means poor oxygenation perfusion to fetus.

Pregnant woman with preeclampsia should be in a complete bed rest. When body is in recumbent position, sodium tends to be excreted at a faster rate. It is the best method of aiding increased excretion of sodium and encouraging diuresis. Rest should always be in a lateral recumbent position to avoid uterine pressure on the vena cava and prevent supine hypotension.

The client with cystic fibrosis absorbs fat poorly because of the think secretions blocking the pancreatic duct. The lack of natural pancreatic enzyme leads to poor absorption of predominantly fats in the duodenum. Foul-smelling, frothy stool is termed steatorrhea.

The newborn with fetal alcohol syndrome has a number of possible problems at birth. Characteristics that mark the syndrome include pre and postnatal growth retardation; CNS involvement such as cognitive challenge, microcephally and cerebral palsy; and a distinctive facial feature of a short palpebral fissure and thin upper lip.

The predominant perception of death by preschool age children is that death is temporary separation. Because that child is losing someone significant and will not see that person again, it’s inaccurate to infer death is insignificant, regardless of the child’s response.

The infant with cleft lip is unable to create an adequate seal for sucking. The child is at risk for inadequate nutritional intake as well as aspiration.

Clients under class I has no physical activity limitation. There is a slight limitation of physical activity in class II, ordinary activity causes fatigue, palpitation, dyspnea or angina. Class III is moderate limitation of physical activity; less than ordinary activity causes fatigue. Unable to carry on any activity without experiencing discomfort is under class IV.

A rubella titer should be 1:8 or greater. Thus, a finding of a titer less than 1:8 is significant, indicating that the client may not possess immunity to rubella. A hematocrit of 33.5%, WBC of 8,000/mm3, and a 1 hour glucose challenge test of 110 g/dL are within normal parameters.

The FHR can be auscultated with a fetoscope at about 20 weeks of gestation. FHR is usually auscultated at the midline suprapubic region with Doppler ultrasound at 10 to 12 weeks of gestation. FHR cannot be heard any earlier than 10 weeks of gestation.

Stress stimulates the adrenal cortex to increase the release of aldosterone. Aldosterone promotes the resorption of sodium, the retention of water and the loss of potassium.

IQ= mental age/chronological age x 100. Mental age refers to the typical intelligence level found for people at a give chronological age. OQ of 140 and above is considered genius.

Heart rate of 99 bpm-1; weak cry-1; irregular respiration-1; moving all extremities-2; extremities are slightly blue-1; with a total score of 6.

Pressure of the growing fetus on blood vessels results in an increase risk for venous stasis in the lower extremities. Subsequently, edema and varicose vein formation may occur.

Lymphedema, webbed neck and low posterior hairline, these are the 3 key assessment features in Turner’s syndrome. If the child is diagnosed early in age, proper treatment can be offered to the family. All newborns should be screened for possible congenital defects.

The 6 cardinal movements of labor are descent, flexion, internal rotation, extension, external rotation and expulsion.