Family Health Exam 2 Flashcards

Terms Definitions
oral defamation
What increases itching?
absence of entire extremity
partial absence of extremity
- Abnormally increased convex angulation in the curvature of the thoracic spine - Most common form is postural - Can result from TB, arthritis, osteodystrophy, or compression fracture
What is NAS?
Neonatal abstinence syndrome
extremely low birth weight <1000g
greater than 42 weeks gestation
The presence and growth of endometrial tissue outside of the uterus. The major symptoms are dysmenorrhea and deep pelvic dyspareunia (painful intercourse). The treatment is drug therapy and surgical intervention.
a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus.Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrhea.
Hypogonadotropic amenorrhea
Problem in the central hypothalamic-pituitary axis. Results from hypothalamic suppression.
Large for gestational age, greater than 90th percentile
Primary Syphilis
Primary syphilis begins after infection. Usually, it takes between two and six weeks for symptoms to manifest. During this stage, a painless sore called a chancre will appear somewhere on your body, generally at the point of infection. Typically, these chancres will grow on your genitals, anus, lips, or tongue, but they can appear on other body parts too. Sometimes the chancres grow inside the genitals, making the infection hard to diagnose. The chancre will disappear within a few weeks of their appearance. If left untreated, your syphilis may become chronic.
True or false:Abdominal movements are counted when determining the respiratory rate of newborns
Unilateral termination of care and treatment by the health care provider without patient consent and/or adequate notice. Charges of abandonment are usually made against physicians. Failure to adequately monitor patients on inpatient units can lead to charges of abandonment.
Supervisor Liability
usually involves triage, delegation, supervision, reporting performance deficits, chain of command as well as inadequate training, failure to periodically evaluate staff, failure to discipline or terminate unsafe staff and negligence in developing appropriate policies and procedures. Liability for negligent supervision may be based on improper delegation, improper supervision, negligent judgement.
What's the neurotransmitter known for its involvement in pain modulation?
Phenylketonuria is a type of birth defect a child inherits from both parents, who pass along the abnormal gene. A person who has phenylketonuria is missing or deficient in a specific enzyme needed to process an essential amino acid called phenylalanine. Amino acids are the building blocks for protein. For babies or adults with phenylketonuria, too much of this amino acid can be dangerous. An affected newborn needs special low-phenylalanine formula to meet its nutritional needs. Older children and adults must continue to follow a strict diet low in this amino acid.a disease of metabolism inherited as an autosomal recessive trait.Test is not reliable until the newborn has ingested amino acid phenylalanine found in human and breast milk.Undiagnosed and untreated can cause intellectual impairment.
Absence of menstrual flow, most often the result of pregnancy.
After birth, the ductus arteriosus is supposed to close within a few days as part of the normal changes occurring in the baby's circulation. In some babies, however, the ductus arteriosus remains open (patent). This opening allows blood to flow directly from the aorta into the pulmonary artery, which can put a strain on the heart and increase the blood pressure in the lung arteries.
Legg-Calvé-Perthes Disease
- Self-limited, idiopathic, occurs in juveniles ages 3 to 12, more common in males ages 4 to 8 - Avascular necrosis of femoral head - 10% to 15% cases have bilateral hip involvement - Most have delayed bone age- Pathophysiology: cause is unknown but involves disturbed circulation to the femoral head with ischemic aseptic necrosis - After resolving may have normal femoral head or may have severe alteration
ABO test
The ABO test classifies people's blood into one of four types: A, B, AB, or O.
- Process of separating opposing bone to encourage regeneration of new bone in created space - Can be used when limbs are unequal in length and new bone is needed to elongate shorter limb
is painful sexual intercourse, due to medical or psychological causes. The term is used almost exclusively in women, although the problem may occur in men.
Urates in infant urine
orange/red uric acid crystals
Preterm or premature
before completion of 37 weeks
swelling of one or more lymph nodes
True or false:The thermistor probe of a radiant heat panel should be taped to the upper quadrant of the abdomen just below the intercostal margin (ribs) on the right or left side.
How many periods of reactivity are there?
What is a generalized, easily identifiable edematous area of the scalp usually over the occiput area?
Caput succedaneum
Viral infections
- Human Papillomavirus (HPV) - Herpes Simplex Virus (HSV) - Human Immunodeficiency Virus (HIV)
Cervical Traction
- Crutchfield or Barton tongs - Inserted through burr holes in skull with weights attached to the hyperextended head - As neck muscles fatigue, vertebral bodies gradually separate so the spinal cord is no longer pinched between vertebrae - Halo traction can be applied in some cases
Group B strep
It's a bacterium that causes life-threatening infections in newborns. Many people carry group B strep bacteria in their bodies without developing infection or illness. However, the bacteria can become deadly to people with weakened immune systems. Pregnant women can transmit group B strep to their newborns at birth. It's the most common cause of blood infections and meningitis in newborns.Most cases of group B strep disease in newborns can be prevented by giving certain pregnant women antibiotics during labor.In newborns, group B strep is the most common cause of sepsis (infection of the bloodstream) and meningitis (infection of the lining and fluid surrounding the brain) and a common cause of pneumonia. Group B strep disease in newborns usually occurs in the first week of life ("early- onset"). Babies can also get a slightly less serious "late-onset" form of group B strep disease that develops a week to a few months after birth.
Subarachnoid hemorrhage
Bleeding into the space that lies between the arachnoid membrane and the pia mater and contains cerebrospinal fluid (CSF) Most common ICH.
Premenstrual syndrome (PMS)
Cyclic symptoms occurring in luteal phase of menstrual cycle. It's a cluster of physical, psychologic, and behavioral symptoms.
Systemic Lupus Erythematosus (SLE)
- Chronic, multisystem, autoimmune disease of connective tissues and blood vessels - Characterized by inflammation - Symptoms variable and unpredictable - Symptoms mild to life threatening
What is endometriosis characterized by?
Secondary amenorrhea, dyspareunia, abnormal uterine bleeding, and infertility.
Live Birth
Birth in which the neonate manifest any heartbeat, breathes, or displays voluntary movement, regardless of gestational age
Personal Liability
the nurse is always accountable for the outcome of his or her actions in carrying out nursing duties. The rule of personal liability requires the professional nurse to assume resp for patient harm that is a result of a nurse's negligent acts.
What is a collection of blood between the skull bone and its periosteum as a result of pressure during birth?
Ostensible Authority
The facility is liable for negligence of independent contractor if patient had rational basis to believe that the independent contractor was a facility employee.
What do you watch for after a circumcision that isn't related to bleeding?
Scarlet Fever
- AGENT: Group A streptococcus - SOURCE: Nasopharyngeal secretions - TRANSMISSION: Direct contact - INCUBATION PERIOD: 2-5 days - PERIOD OF COMMUNICABILITY: During incubation and period of illness, approximately 10 days.Fever, headaches, malaise and lymphadenopathy
Why is vitamin K given?
To help with clotting
Initiative vs Guilt
Preschooler. Begins to initiate, not imitate, activities; developsconscience and sexual identity.
physiological adaptations: hepatic system
- iron storage- carbohydrate metabolism - conjugation of bilirubin - physiologic jaundice- breastfeeding and jaundice - coagulation - signs of risk for hepatic system problems
A 3 year-old is admitted with respiratory distress and started on albuterol nebulizer treatment every 2 hours. The mechanism of action for albuterol is:a. suppress inflammation in the lungsb. decrease viscosity of secretions
promote bronchodilation
compound or open fracture
fractured bone protrudes through the skin
Nursing implications when using survanta
- suction infant before administration - assess infant's resp rate, rhythm, ABGs, and color prior to admin. - ensure proper ET tube placement - change position during admin to encourage drug to flow to both lungs - assess infant's resp rate, rhythm, ABGs, and color after admin - do not suction ET tube for 1 hour after admin to avoid removing the drug
S/s of CLD
- Tachypnea - Retraction - Nasal flaring - Increased work of breathing - Exercise intolerance (feeding and handling) - Tachycardia
What is exanthem?
a widespread rash, usually viral, and usually occurring in children. It represents either a reaction to a toxin produced by the organism, damage to the skin by the organism or an immune response. Exanthems may also be due to a drug, most commonly antibiotics.
What is subgaleal hemorrhage?
Bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.
What happens to a baby's heat when there is a problem?
It decreases
Respondeat Superior
A legal rule that the principal or employer is liable for harms done by agents or employees while acting within the scope of their agency or employment.
Why is Eye prophylaxis ointment given?
To kill bacteria (gonorrhea)
A 7 year-old child is brought to the ER for acute asthma attack. He's wheezing, takipnic?, diaphoretic, and looks frightened. The nurse should prepare to administer:a. IV methoprednisoneb. epinephrinec. oral prednisone
What is RSD (respiratory distress syndrome) caused by?
A lack of pulmonary surfactant.
Types of Fractures
- Compound or open - Complicated - Comminuted - Greenstick
Bell's Palsy (Facial Palsy)
Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.
What is ICES?
- Ice - Compression - Elevate - Support No heat before examination
What is RICE?
- Rest - Ice - Compression - Elevation
congenital bacterial neonatal infections
- manifests within 24-48 hours - progresses rapidly - usually caused by microorganism from the normal flora of the maternal vaginal tract.
How often do breastfed babies need to be fed?
every 2 hours
Exceptions to Respondeat Superior
- "Borrowed Servant" or "Captain of the Ship"
What children are immunodeficient?
- Receiving steroid therapy - Other immunosuppressive therapies (chemo) - Generalized malignancies (leukemia) - Immunologic disorder (HIV)
3 ways that breathing is initiated
1. Chemically2. Cold3. Chest expands
Violation of a controlled substance act
drugs obtained illicitly through work
A 15 year-old with a history of cystic fibrosis is admitted to pediatrics with the following assessment findings - crackles, increased cough, and green sputum. A 2 week hospitalization is anticipated. Which of the following nursing interventions hold the
gaining IV access
Persistent Pulmonary Hypertension (PPH)
In a baby with PPHN, the fetal circulatory system doesn't "switch over." The ductus arteriosus remains open, and the baby's blood flow continues to bypass the lungs. Even though the baby is breathing, oxygen in the breathed air will not reach the bloodstream. Because the blood returning from the body is unable to enter the lungs properly - and instead flows through the still-open ductus arteriosus - it returns to the heart in an oxygen-poor state.
What is a clinical symptom of RDS?
Respiratory or mixed acidosis, increased CO2. RDS usually presents itself immediately or within 6 hours.
What may a deficiency in surfactant be caused by?
- Insufficient surfactant production - Abnormal composition and function - Disruption of surfactant - A combination of any of the above
What intervention is necessary for a fever and uncontrolled rash?
Isolation until diagnosis is confirmed.
What is given for pain during a circumcision?
Tylenol, lidocaine, or emla.
The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should...
Cleanse eyes from inner to outer canthus prior to administration. It should be applied into the conjunctival sac to avoid accidental injury to the eye. It should not be flushed out.
Physiologic Adaptations: Thermogenic system
- Thermogenesis - Heat Loss - Temp regulation
What is often given for severe itching?
Antipruritic medication such as diphenhydramine (Benadryl) or hydroxyzine (Atarax).
Which description is most descriptive of bronchiole asthma?a. heightened airway reactivityb. decreased resistance in the airwayc. the single cause of asthma is an allergic hypersensitivityd. inherited
It's not inherited. It's heightened airway reactivity.
Preterm infants prior to 32 weeks...
do not have adequate amounts of pulmonary surfactant to survive extrauterine life .
Signs of a clavical fracture
Limited use of the arm, absence of Moro reflex on affected side, crepitus over the bone.
Signs and symptoms of subarachnoid hemorrhage and subdural hematoma
- asymptomatic - CNS depression or irritability and/or seizure - poor feeding - apnea - unequal pupils - Infant may appear normal until seizing starts on the 2nd - 3rd day
Herpes Simplex Virus (HSV)
Two types: I and II. There is pain and recurrent genital ulcers. Neonatal herpes is fatal. Risk is highest with a primary infection of HSV-II. There is no cure.
Maternal risk factors for neonatal sepsis
- low socioeconomic status - poor perineal care - poor nutrition - susbstance abuse
What are some reasons for IUGR?
The baby didn't get the necessary nutrients and oxygen for proper growth and development of the organs. This is related to blood flow.
When is an apgar test done?
At 1 and 5 minutes after birth.
NURSING DIAGNOSIS: Pain related to skin lesions, malaise
- Use comfort measures such as vaporizer, gargling, lozenges to keep membranes moist - Use nonpharmacologic techniques for pain reduction - Adminster analgesics, antipyretics, and antipuritics. - DO NOT USE SALICYLATES
A mother of a neonate hospitalized with a URI asks why her baby won't take the bottle. The nurse's best answer would be:a. she's probably not hungryb. it's okay because we're giving her IV fluids therefore she's not hungry
newborns breathe through their nose, congestion may be interfering with her breathing and eating at the same time
A 5 year-old is admitted to the unit following a tonsilechtomy. Of the assessments below, which of the following would be the most important:a. assess for any pain in the earsb. observe for frequent swallowingc. assess
observe for frequent swallowing
Signs and symptoms of respiratory distress in newborn
- Flaring of the nares - Expiratory grunting - Retractions of the chest - Increasing resp effort: paradoxical breathing patterns, tachypnea, apnea, cyanosis.
Neonatal risk factors for neonatal sepsis
- Multiple gestation - male - birth asphyxia - MAS - congenital abnormalities of skin or mucous membranes - Galactosemia - Absence of spleen - LBW - Prematurity/post mature - IUGR - Prolonged hospitalization
How Do you Prevent Spread of Disease?
1. Primary prevention of the disease: Immunization 2. Control spread of disease to others: - Reduce risk of cross-transmission of organisms - Infection control policies - Handwashing
How do you keep the glans from sticking to the diaper?
By applying petrolatum around the glans after each diaper change and by changing the diaper at least every 4 hours.
What is usually given for a sore throat?
With lozenges, saltine rinses, and analgesics.
A high school experiences an outbreak of hepatitis B. In teaching the high school students about hep B, the nurse would explain:a. hep-B cannot exist in the carrier stateb. hep-b is primarily transmitted via the fecal-oral route
hep-B can be prevented by receiving the hep-b vaccine
Incidence of SLE (systemic lupus erythematosus)
- More common in females ages 10 to 19 years - More common in African-American, Asian, and Hispanic children - Familiar tendency - Cause unknown - Possible triggers: hormonal imbalance, immune disorders, environmental exposure to drugs, infection, stress, chemical agents
Communicable Disease Plan of Care & Implementation
- Child will not spread infection - Child will not experience complications - Child will have minimal discomfort - Child and family will receive adequate emotional support/education
What does cold do to a newborn?
Cold stress increases the need for O2 and may deplete glucose stores.
What can a sore throat signify?
It's most often a symptom of a minor viral infection, although it can signal diphtheria or a strep infection, such as scarlet fever.
A 9 month-old is receiving O2 in a mist tent, it is most important for the nurse to:a. provide fluids every three hours to maintain hydrationb. remove the child from the mist tent for a few minutes every hour for warming
change the child's clothes frequently so the child remains dry
A child has surgery for pyloric stenosis. The child has his/her first feeding postoperatively. After feeding the child should be placed in which position:a. prone to encourage digestionb. trendelenburg to prevent pressure on the s
on the right side to encourage flow through the pyloris
What is the most crucial time for Soft Tissue Injuries?
The first 12 hours are the most crucial.
What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn prior to discharge?
Apical heart rate of 90 BPM, slightly irregular, when awake and active. The heart rate of a newborn should range between 120 to 140 beats per minute especially when active. The rate should be regular with sharp, strong sounds.
When caring for a 10-month old infant with RSV, an important nursing consideration would be:a. encouraging infant to drink 8oz of formula every 4 hours.b. administering antibioticsc. administer cough syrupd
Place in a mist tent.Has moist cool air and O2. Let them breathe.
What else do you check for in an initial newborn assessment?
- Physical injury r/t the birth - Check skin for erythema, ecchymosis, petechiae, abrasions, lacerations, edema
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