The mother of a 2-day-old infant newly diagnosed with sepsis asks why she could not detect the symptoms. What should the nurse reply to this mother?
1. "Your mothering skills will improve with time. You should take the newborn class."
2. "Newborns have immature immune function at birth, and illness is very hard to detect."
3. "Your baby did not get enough active acquired immunity from you during the pregnancy."
4. "The immunity your baby gets in utero does not start to function until 4 to 8 weeks of age."
2
Explanation:
1. This response does not address the physiology of neonatal infection and is not therapeutic because it is blaming.
2. The immune system of a newborn lacks response to pyrogens and presents a limited inflammatory response; thus, the signs and symptoms of infection are often subtle and nonspecific in the newborn.
3. The mother develops active acquired immunity, which is passed to the newborn transplacentally as passive acquired immunity. This immunity is to the illnesses and infections she has had or been immunized against.
4. The passive acquired immunity a newborn receives from its mother is effective at birth and lasts from 4 weeks to 8 months, depending on the specific antibody.
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A nurse cares for a client who is prescribed patient-controlled analgesia (PCA) after a cholecystectomy. The client states, "When I wake up I am in pain." Which action should the nurse take?
a. Administer intravenous morphine while the client sleeps. b. Encourage the client to use the PCA pump upon awakening. c. Contact the provider and request a different analgesic. d. Ask a family member to initiate the PCA pump for the client.
A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings?
a. They indicate that a drug should not be given except in life-threatening circums-tances. b. They provide detailed information about the adverse effects of the drug. c. They alert prescribers to measures to mi-tigate potential harm from side effects. d. They provide information about antidotes in the event that toxicity occurs.
The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the nurse expect the patient to experience?
a. Inadequate drug effects b. Increased risk for superinfection c. Minimal adverse effects d. Slowed onset of action
To promote healing it is wise to have a diet that is high in:
a. protein, sodium and adequate fats. b. carbohydrates, iron and adequate fluid. c. protein, zinc and adequate fluid. d. carbohydrate, calcium and adequate fluid.