Exam (elaborations) NUR 405 Maternity and Peds Hesi Final Fall 2019 latest
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Course
NUR 405
Institution
Chamberlain College Of Nursing
MP Hesi.1
• Mastitis: antibiotic therapy, wear a supportive bra, warm compress
• Pyloric stenosis: olive size obstruction on abdomen
• Anchor the lower part of the uterus - then massaging the fundus
• High bp maybe with preeclampsia: check for protein in the urine (proteinuria)
• Boy...
exam elaborations nur 405 maternity and peds hesi final fall 2019
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Chamberlain College Of Nursing
NUR 405
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NUR 405 Maternity and Peds Hesi Final Fall 2019
something a C --wasn’t this the amniocentesis-
MP Hesi.1 testing the rh for rhogam? Yes testing maternal
• Mastitis: antibiotic therapy, wear a supportive
bra, warm compress
• Pyloric stenosis: olive size obstruction on abdomen
• Anchor the lower part of the uterus -
then massaging the fundus
• High bp maybe with preeclampsia: check for
protein in the urine (proteinuria)
• Boy child frequent visits to the school nurse
headache, irritable for few weeks: ask how
daily school day is
• BMI 6 -year old: physical activity at the school, girls
physical activity at home, and diet
• Saturated 2 pads in 30 mins: massage the fundus
• Tick bite: test for Lyme disease
• HIV AZT is given to slow down the transmission
to the fetus
• Clear water to clean for diaper change
• APGAR = 9, acrocyanotic only gets 1 point for
color
• Mom says baby not sleeping through night, nurse
should assess severe skin breakdown on the baby to
plan family care
• Blind child with traction - bring familiar objects
or stuff animals from home
• Drooling, temp - epiglottitis need to notify
the provider
• Muscular irritability from hemorrhaging
• Osteomyelitis - give milkshake as snack-
high protein, high fiber
• Hypoglycemic: give milk
• Croup- barking sound, high pitch on breathing -
bring in shower with warm mist
• Transillumination through scrotal sac to test
if testes are present
• Earache if meningitis
• Hypothyroidism: D- TSH is high so T4 is low by
thyroid gland
• Tetralogy of Fallot - cyanotic limbs crying
• Cephalohematoma noticed near occiptal
sutures- notify Dr
• Increase AFP- need to do an sonogram
• 30 week gestation age 38 inches fundal height - do
an ultrasound, bc should’ve been equal
• Inguinal Hernia - palpate to get it back in
• Breastfeeding 5 day with yellow stools - this
is normal
• Spontaneous rupture of membranes - ask the
color and consistency
• 3+ pitting edema with GERD- normal during
pregnancy??
• Postpartum depression - may need to be evaluated
** Know the length of PPD
• Afebrile seizures - will eventually go away
• MD - wobble legs at this stage
• Tonsillitis-signs of bleeding - need to inspect the
oral cavity
• Movements caused from rh??? they temporary
1
, NUR 405 Maternity and Peds Hesi Final Fall 2019
• Fetal heart pattern in V form - priority is • Tonic clonic seizure and heart issue - monitor
change mother’s position calcium
• Braxton Hicks will go away with walking it • Amniocentesis priority - something with to get Rh
is not true labor factor for rhogam
• Placenta Previa - check fetal HR *Breasts- need supportive bra, antibiotics,
• I’m having pain in my stitches - look cold compress
at the episiotomy *infant vital signs- normal
• Use breathing techniques after giving pain *DMD- weak muscles and gait - I remember
meds 30 mins ago something with DMD & serum Ca+
• Female - parenteral antibiotics *preeclampsia- check urine for protein
administration is most effective
• Introducing solid foods - 1 food at a time MP Hesi 2017
for 4-7 days 1. dosage : 700. 77 lb baby.
• Digoxin - missed dose can give if it’s been less 2. 20 units of oxytocin+1L LR→ 125 .
than 4hrs /if more than 4 hrs wait until next 3. Gerd: sugar cookies
dose/If miss 2 doses, call HCP 4. Mom is Rh-: check Rh immunoglobulin or check FHR
• Dilantin - check the serum levels 5. Cystic fibrosis: infertility
• UTI child - return for another urine sample 6. Tetanus questions: clean and antibiotic!!!
• 3 hour newborn with irregular 7. folic acid, doesn’t like green lefy veggies: strawberrie
respirations and small/soft murmur - put 8. Diaper rash: zinc oxide
pulse ox on the foot 9. young parents, 24hrs birth: evaluate feeding 1
• Mag toxicity possibility: mag was 8? 0. mom forcing kid to eat means and veggie(requires
With hypoactive reflexes further.
• Gonorrhea infection tell other partners to 11. sickle cell: hot and thirsty
seek treatment 12. pyloric stenosis: olive-shaped
• Adolescent gets a rubella vaccine at 13.Pyloric stenosis, hungry and irritable after feelings,
maternal bearing age - use another form of first intervention→ crying or weight
birth control for 28 days 14. turn to side and suction
• Diaphragm – use same as before giving birth 15. fractured clavicle
- get resized? Use another form of bc? 16. jitteriness: check glucose
blood to see if they need to administer RhoGam 17. Normal primipara finding: 2 saturated pads for 1st h
put pulse 56.
2
,18. Dad called few days post-partum - hormonal swings a•reMedication to prevent respiratory issues in the
normal. baby - betamethasone IM
19. MgSO4 priority: calcium gluconate • 15 mo breastfeeding & now 6 mos prego - get
20. HIV: AZT nutrition history
21. Assess FHR and coombs • Postpartum hemorrhage even after finishing
22. check for after amniocentesis: monitor for labor oxytocin infusion - check maternal BP
23. Post-partum mood swings vs. depression: fatigue & n•otMath questions were 10 and 10
making decisions? • Baby got otitis media after an acute respiratory
24. eye ointment: prevent eye infection infection, why do infants get otitis media - shorter
25. intussuception: brown stool notify HCP eustachian tubes
26. girl SATA: 27. girl who druinks: atta boy • Boy with spine injury after driving accident
28. ADHD: refer or help with HW?? - maintain alignment
29. transitional phase: monitor contractions, help mantai•nObese question SATA - find out what physical
control activities she does & if school has PE class, 3 day
30. AFP: Sonogram diet history from mother
31. Priority pt: ARF and hyperkalemia!!! • Iron supplement - take with meal
32. mastitis: antibiotics, bra support, warm support • Preeclamptic women received Pitocin IV and is
33. Open heart surgery: demonstration of splintintg, deep having contractions 1 to 2 minutes apart -
breathing etc discontinue Pitocin
34. rupture membranes 12hrs ago--: temperature • Lyme disease - if rash, then test
35. C-section priority: uterine atony or positive homans??•?Esophageal atresia, highest priority - body
36. AGN: Sore throat temperature
37. hemophilia: NOT motrin(elevate and immobilize. • Baby regurgitation and vomiting - suction
38. Resp distress: nasal flaring the mouth and nose
39. Leopolds: anchoring fundus • An adolescent received an above the knee
40. Drooling, s/o epiglotitis→ emergency response!!! amputation. Would do you tell them to do everyday
41. flick the sole - inspect the stump daily
42. RF: Chorea • Women says about 6 mos pregnant & smokes
43. after c section lacerated. trickle of blood: BP a pack of cigs/day, how to check for estimated
44. +2 edema: MgSO4 gestation age: ultrasonography
45. position on stomach • 8 month old development, you would notice -
46. HPV: C “immunization is a must to prevent it” sitting unassisted
47. scoliosis: girls 10-14 • Glucose was 800 mg - give IV normal saline and
48. metabolic alkalosis-vomiting or pyloric insulin
49. MDI: spacer or cold??? • Rubella - give after delivery within 72 hours
50. position on stomach • Newborn has swollen, tender, testicles. Suspect
51. sesnse of security hydrocele. What do you do? Use
52. IUGR: sonogrm transillumination to check for fluid
53. Flaring of the nare • Fetal heart rate dropped abruptly to a V - change
54. Developmental delay: maximum potential mom’s position
55. 8 mos expected: sitting up unassisted • Pregnant had a temp of 101 – chorioamnionitis
• Epidural anesthesia - check maternal HR and BP
MP Hesi 2017 • Teenagers who are pregnant, be sure to include -
• Protruding cord - knees to chest nutrition requirement during pregnancy
• Child who had Slipped Capital Femoral Epiphysis • Patient who was 9 cm and 80% effacement - ?
(SCFE. - pin and something • Transitional phase - assess uterine contractions
• 4-month old what to do to prevent diaper rash - use • Infertile couple - allow them to control if they
a barrier cream, such as zinc oxide want to stop or support group before another IVF
• Mother with mastitis, what would you advise - start cycle
on the unaffected breast first • 4 neonates, who to see first – Tet
• Adolescent turns 18 and mother calls for lab results • 9yr old (school age. – industry
- must get permission from daughter • Child with pneumonia - assess lung sounds
• Different acid base levels - normal acid base • Child is dehydrated. What to check for? Weak cry
• A breastfeeding mother wants to avoid having but no tears
another pregnancy. What do you do? use • Pyloric stenosis - metabolic alkalosis
condoms and gel • Assess for cryptorchidism - warm the room
• Infant getting phototherapy - Cover the infant’s • “He doesn’t feed himself, I make him eat vegetables
eyes and meat”
• 6 month baby goes in for routine vaccine and flu • A newborn infant is crying, temperature is 96.5, has
shot - give all immunization and influenza but elevated bp and is cyanotic. What do you do? Warm
alternate site and injection that baby up (answer)
, MP Hesi 2017 • When do you have to notify the HCP? When the
• What put kid at risk for bacterial meningitis?? deceleration is after the peak of the
Earache NOT VARICELLA IT’S A VIRUS contraction.
• Tree bark flies in eyes Put on patches & call • Pt has a hard, rigid abdomen, is bleeding profusely
ophthalmologist what do you do next? Stay with Pt & call the
• Kid is 2 years old drinking with bottle drinking health care provider
sweetened soda, what should Nurse discuss? Don’t • Administering prostaglandins. What is the
drink out of a cup, soda leads to obesity, & finding you make the doctor aware of?Fetal HR
soda lead to dental caries of 50
• Kid with type I Diabetes & Blood sugar 180 wants • Woman is 3 cm dilated & she wants to pee? Check
to play in his soccer game what does Nurse her cervix
recommend? The kid can play soccer w/o eating • C8 injury looses bladder control doesn’t have
a snack or taking insulin reflex?
• Mom depressed how does she feel? Tired, sad, • How do you know the baby is in distress? Nasal
dec. appetite Flaring
• Mag toxicity DTR +1, UO was 25, Mag was • Temp was 97.7 Pulse of 140, 42 breaths per
8, Respiration 14 Closely follow up minute but irregular Put in EMR
• Intussusception & now has brown poop • What would you do when the newborn nurse
Notify HCP comes in the nursery put the thermal regulator
• Kid sees the school nurse with stomach ache Notify in line with the abdomen
HCP • She was 30 wks & edema was +3, Ask
• Cleft Lip/Cleft Palate See genetic counselor about blurred vision
• Hx of syphilis & chicken pox urine sample/blood • The little kid has abdominal pain, fever & is
sample vomiting what do you ask him? Ask him the
• Salt wasting Check the Perineum quality & location of his pain
• What do you report to Dr first with an • Mother DM. What is most important about
epidural? Blood Pressure, her care? Strict glucose control
• She has excessive bleeding, what do you let the dr • Amniocentesis at 36wks Mother has 8 1/2 lb
know Report BP or Apical HR baby what do you assess in her? Fetal lung
• Administering Epidural slows the labor process status
• Palpate with one hand & the other hand is there to • Muscle dystrophy X linked recessive
do what? Anchor the uterus • Teen has Pelvic inflammatory disease & finished
• The uterus was firm midline & in place she felt like with a 14 day antibiotics & flagyl orally. She wants
she had vag pressure check perineum to know if she can be treated at home. Why not?
• Episitomy visualize the perineum Monitor parental antibiotics IV
• The person is oozing blood & has muscle • The girl has a fractured ulnar & her wrist is in
irritability, what electrolyte level are you most splints. What do you do next Check wrist pulses
concerned about? Calcium • Digoxin: Can administer a first missed dose
• Budding breasts & Tanner II within 4 hours
• A 7 year old girl has a UTI & discharged what do • A child has liver disease & the parents are aware
you tell her to check? check urine odor that they are dying.
• 4 year old girl what is a normal finding? imaginary • What is the priority for the nurse? Reassure the
friend parents
• 10 year old had rheumatic fever & is on strict bed • 5 day old newborn yellow sticky poop that smells
rest. What is an appropriate form of play? checkers like sour milkThis was normal
• Rubella vaccine don’t get pregnant for 1 month • What to do for cryptochism Ask parent if they felt
• Pitocin after labor to stimulate uterine it before?
contractions • Dosage Calculation: 2.5
• MOM has HIV & is administered AZT during birth • Dosage Calculation: 25
what do you need to do with the newborn after? • Kid is drooling Notify HCP & trach kit by
Administer AZT bedside
• What is most likely a sign of pregnancy Hegars • Lyme Disease/tetracycline Don’t take with milk
• 5 month with hypothyroidism laughs & rolls to or antacids
side • The point of an ultrasound Growth & age
• Immunization question Need Consent for Hep B • What’s the intervention when the kid has
• Mom is 36 wks pregnant, nonreactive nonstress puss filled vesicles Prevent transmission
test then has contraction Stress Test with an • The kid has a tonsillectomy & is swallowing a lot.
infusion of Pitocin. What is the priority to let What do you do first? Look in their throat with a
the doctor know? Fetal Late decelerations flashlight
• Afebrile Seizures The kid will grow out of them
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