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NURS 629 Exam 4 With Questions And Answers @ 2023
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NURS 629 Exam 4 With Questions And Answers @ 2023...
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NURS 629 Exam 4 With Questions And Answers @ 2023 What is physiological jaundice? - Answer -occurs when baby accumulates bilirubin -secondary to immature liver in newborns -Risk factor is prematurity What level is conjugated hyperbilirubinemia? - Answer serum conjugated bilirubin concentration greater than 1 mg/dL if the total bilirubin is less than 5.0 mg/dL or more than 20% of the total bilirubin if the the total bilirubin is greater than 5 mg/dL (p. 862 AAP book) What is breastfeeding jaundice? - Answer -due to poor intake that causes la ck of stools and urine output -common in first week and resolves once milk comes in and infant is feeding w ell-more stools and urinary output -peaks around 2-3 weeks How do you diagnose jaundice? - Answer -dx with a bili level of 5 mg/dL -12 mg/dL threshold for all newborns having jaundiced appearance -direct/indirect bili levels -CBC -reticulocyte count -use of bilitool.org How do you treat jaundice? - Answer increased intake, longer feeding indirect sunlight phototherapy IV fluids Bili lights Biliblanket What are other causes of jaundice? - Answer abnormal blood cell shapes (like sickle cell) Rh incompatibility cephalohematoma polycythemia (increased RBCs, SGA infants, twins) infection specific enzyme disorders What is biliary atresia? - Answer -life-threatening condition causing a blockage of bile ducts inside or outside of liver -leads to build-up of toxins (like bilirubin) -malabsorption of fat-soluble vitamins A,D,E,K -scaring of the liver, loss of tissue, cirrhosis -not inherited What are the two types of biliary atresia? - Answer fetal- noted in womb (other de fects like heart, spleed, intestines) perinatal- appears 2-4 weeks after birth What causes biliary atresia? - Answer -infection after birth (cytomegalovirus or rotavirus) -autoimmune disorder -developmental issue in womb -exposure to toxic substances What are symptoms of biliary atresia? - Answer jaundice dark urine light to white stools poor wt gain and growth How do you diagnose biliary atresia? - Answer any infant with jaundice present 2- 3 weeks after birth -direct and indirect serum bilirubin -LFTs -abdominal x-ray -abdominal US -liver bx How do you treat biliary atresia? - Answer -surgery (Kasai procedure), small intestine is attached directly to the liver to allow bile to flow into the small intestine bypa ssing the cystic, hepatic, and common bile duct. -liver transplant What are risk factors for dehydration? - Answer GI virus NVD What are s/sx of dehydration? - Answer -sunken fontanels -tachycardia and decrease cap refill >2-3 seconds -decrease urine output is sensitive but nonspecific -increase in urine specific gravity -decrease BP- late finding=more than 10% fluid loss How do you treat dehydration? - Answer -if minimal, mild, moderate- oral rehydration -if severe (drowsy, cold extremities, lethargic, sunken/dry eyes, very depressed anterior fontanel, no tears, dry mouth/tongue, very decreased skin turgor, rapid/sometimes impalpable pulse, decreased/unrecordable pulse, deep/rapid respiratory rate, markedly reduced urine output) - IV fluids What is emesis? - Answer vomiting=symptom must distinguish from regurgitation in infants integrated response to noxious stimuli-coordinated by CNS What is acute emesis? - Answer short-term abrupt onset episodic What is recurrent emesis? - Answer -at least 3 episodes over 3 months -chronic -relatively mild but occurs frequently What is cyclic emesis? - Answer -recurrent, intense episodes -periods of being asymptomatic How do you treat emesis? - Answer NPO for 1-2 hrs **rehydrate with small/frequent amounts of clear liquids avoid dairy and solids for 4-6 hrs and then add bland foods slowly What are causes of diarrhea? - Answer -primarily viral (most common) or bac terial -bacterial pathogens are usually C. difficile, salmonella, Giardia, Campylobacter **always serious in infancy due to small ECF reserve, and can dehydrate quickly Patho of diarrhea - Answer 1. retention of water w/in the intestine (malabsorptive syndrome, lactose intolerance) 2. excessive secretion of water and electrolytes into the intestinal lumen (cholera, e. coli, chrohn's, laxatives) 3. release of protein and fluid into the intestinal mucosa (ulcerative colitis, Crohn's. infections) 4. altered intestinal motility resulting in rapid transport through the colon (IBS, scleroderma) What is acute diarrhea? - Answer most likely to be an infectious agent sudden onset frequent, loose, watery stools bloody stools abdominal cramping thirst decreased urination dizziness fatigueThe benefits of buying summaries with Stuvia:
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