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The fetus with hydrops fetalis may exhibit effusions

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The fetus with hydrops fetalis may exhibit effusions into the peritoneal, pericardial, and pleuralspaces, as well as demonstrate signs of ascites.DIF: Cognitive Level: Understand REF:IM:883TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity6.Which statement regarding congenital anomalies of the cardiovascular and respiratory systemsiscorrect?a.Cardiac disease may demonstrate signs and symptoms of respiratory illness.
b.Screening for congenital anomalies of the respiratory system need only beperformed for infants experiencing respiratory distress.c.Choanal atresia can be corrected with the use of a suction catheter to remove theblockage.d.Congenital diaphragmatic hernias are diagnosed and treated after birth.ANS: AThe cardiac and respiratory systems function together; therefore, initial findings will be related torespiratory illness. Screening for congenital respiratory system anomalies is necessary, even forinfants who appear normal at birth. All newborns should have critical congenital heart disease(CCHD) screening performed before discharge. Choanal atresia requires emergency surgery.Congenital diaphragmatic hernias are prenatally discovered on ultrasound.DIF: Cognitive Level: Understand REF:IM:889TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity7.When attempting to screen and educate parents regarding the treatment of developmentaldysplasia of the hip (DDH), which intervention should the nurse perform?a.Be able to perform the Ortolani and Barlow tests.b.Teach double or triple diapering for added support.c.Explain to the parents the need for serial casting.d.Carefully monitor infants for DDH at follow-up visits.ANS: DBecause DDH often is not detected at birth, infants should be carefully monitored at follow-upvisits. The Ortolani and Barlow tests must be performed by experienced clinicians to preventfracture or other damage to the hip. Double or triple diapering is not recommended because itpromotes hip extension, thus worsening the problem. Serial casting is recommended for clubfoot,not DDH.DIF: Cognitive Level: Apply REF:IM:899 TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance8. The nurse is assigned a home care visit of a 5-day-old infant for the treatment of jaundice. Athorough assessment is completed, and a health history is obtained. Which sign or symptomindicates that the infant may be displaying the initial phase of encephalopathy?a.High-pitched cryb.Severe muscle spasms (opisthotonos)c.Fever and seizuresd.Hypotonia, lethargy, and poor suckANS: DThe early and most subtle symptoms of bilirubin encephalopathy include hypotonia, lethargy,poor suck, and a depressed or absent Moro reflex. Should the infant display symptoms such as ahigh-pitched cry, severe muscle spasms, hyperreflexia, or an arching of the back, the nurseshould be aware that the baby has progressed beyond the more subtle signs of the first phase ofencephalopathy. Medical attention is immediately necessary. Symptoms may progress from thesubtle indications of the first phase to fever and seizures in as few as 24 hours. Onlyapproximately one half of these infants survive, and those that do will have permanent sequelae,including auditory deficiencies, intellectual deficits, and movement abnormalities.

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