The nurse is caring for a newborn who was born 24 hours ago to a mother who received no prenatal care. The newborn is a poor feeder but sucks avidly on his hands
Clinical manifestations also include loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating. Which should the nurse suspect?
a. Seizure disorder
b. Narcotic withdrawal
c. Placental insufficiency
d. Meconium aspiration syndrome
ANS: B
Newborns exposed to drugs in utero usually show no untoward effects until 12 to 24 hours for heroin or much longer for methadone. The newborn usually has nonspecific signs that may coexist with other conditions such as hypocalcemia and hypoglycemia. In addition, these newborns may have loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating, which is uncommon in newborns. Loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are manifestations not descriptive of seizure activity. Placental insufficiency usually results in a child who is small for gestational age. Meconium aspiration syndrome usually has manifestations of respiratory distress.
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A client who experienced a pulmonary embolus is receiving heparin therapy. The client will now also start receiving sodium warfarin (Coumadin). When the client asks the nurse why both me-dications are being given, the best response by the nurse is
a. "It takes several days for the warfarin to become therapeutic." b. "Most clients go home on both drugs for maximal treatment." c. "The heparin is not working to dissolve the blood clot, so we are adding warfa-rin." d. "You are right to ask. You are at increased risk of bleeding with both drugs."
The client with adrenocortical insufficiency has an irregular pulse. What is the nurse's best first action?
A. Document the finding as the only action. B. Assess blood pressure in both arms. C. Measure oxygen saturation. D. Notify the physician.
A nurse of Hispanic descent is assigned to provide care to patients of the same culture. The patients would benefit because:
1. The nurse is culturally competent. 2. The nurse will provide expert care. 3. The nurse will not make any errors. 4. The nurse will make sure the patients have a timely discharge.
The nurse is working with a group of caregivers of chronically ill, school-age children
In discussing ways to promote self-care among this group of children, which of the following suggestions might be the most appropriate to suggest to this group of caregivers? The caregivers could: A) make a chart of goals the child could do successfully; add a sticker to the chart each time a goal is reached. B) write a contract with the child, with the reward being a certain privilege when specific self-care tasks are completed a certain number of times. C) model the task for the child each day until he or she begins to perform the task. D) encourage the child to socialize with the well children every day so that he or she is motivated to become as independent as those peers.