HESI maternity & pediatric review

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HESI maternity & pediatric review
2011-12-07 22:46:24

HESI review for OB/PEDS
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  1. The LPN is talking with a couple about ovulation and conception. whish statement by the LPN gives the most likely time for conception to occur?
    2 weeks before menstration; should avoid sex several days before the anticipated ovulation and for 3 days after ovulation
  2. Embryo & Fetus
    • embryo-15 days to 8weeks
    • fetus-9 weeks to term (38+weeks)
  3. Goodell's sign
    softening of cervix
  4. Gravida-# of times pregnant regardless of outcome
    Para-# of deliveries (not kids), after 20 weeks
    ex: gravida 1 para 2
  5. EDB using Nagele's rule
    count back 3 mths from the first day of last normal menstrual period and add 7 days
  6. it is recommended that pregnant pts drink a quart of milk a day . this will insure that the daily CA+ needs are met and will help alleviate leg cramps
    Bilirubin levels= 6-12
  7. early decels
    caused by head compression, usually occur b/t 4-7 cm and in 2nd stage of labor
  8. accelerations
    caused by sympathetic fetal response, occur in response to fetal movement, reactive healthy baby , occur with contracions
  9. variable decels
    caused by cord compression
  10. late decels
    non-reassuring sign, uteroplacental insufficiency, assoc with preeclampsia, DM, cardiac disease, and abruptio placentae
  11. Non stress test
    used to determine fetal well being, if fetus responds with the 15/15 acceleration its considered reactive and healthy
  12. the most important determinate of fetal maturity for extrauterine survival is the L:S ratio ( higher then 2:1)
  13. True Labor
    • pain in lower back
    • contractions that intensify with ambulation
    • progressive cervical dialtion and effacement
  14. Hyperventilation
    • caused by blowing off too much CO2
    • dizziness
    • stiff mouth
    • tingling fingers
  15. full bladder is one the most common reasons for uterin atony and or hemorrhage in the first 24hrs after delivery
    • if the nurse finds the fundus soft, boggy, and deviated to right of umbulicus..
    • give fundal massage then have her empty bladder recheck fundus q15mins
  16. when does the child sit unsupported? 8 mths
    when does achild throw a ball overhand? 18 mths
    when does a child tie their shoe? 5 yrs
    when does a child speak 2-3 word sentences? 2 yrs
    when does a child use scissors? 4 yrs
  17. What behavior would indicate that thyroid hormone therapy for a 4-month-old is effective?”
    One correct answer would be “has steady control” which is an expected milestonefor a 4-month-old and indicates that replacement therapy is adequate for growth
  18. “What task could a 5-year-old diabetic boy be expected to accomplish by himself?”
    pick injection sites
  19. immunization given at birth
    Hep B
  20. DTaP, Hib, PCV, IPV immuinizations
    given at 2 months
  21. MMR, Varicella
    given at 12-15 mths
  22. The common cold is not contraindication for immunization.
    Following immunization, what teaching should the nurse provide to the parents?Irritability, fever (<102 degrees F), redness and soreness at injection site for 2-3days are normal side effects of DPT and IPV administration.Call health care provider if seizures, high fever, or high -pitched crying occur.A warm washcloth on the thigh injection site and “bicycling” the legs w/each diaperchange will decrease soreness.Acetaminophen (Tylenol) is administered orally every 4-6 hours (10-15 mg/Kg).
  23. The nurses should be sure a PT and PTT have been determined prior to atonsillectomy.
    Polycythemia is common in children w/cyanotic defects.
    • Basic difference between cyanotic and acyanotic defects:Acyanotic: Has abnormal circulation, however, all blood entering the systemiccirculation is oxygenated.Cyanotic: Has abnormal circulation w/unoxygenated blood entering systemiccirculation.
    • CHF: Congestive heart failure is more often associated w/acyanotic defects
  24. Feed infants or child w/cerebral palsy using nursing interventions aimed atpreventing aspiration. Position child upright and support the lower jaw
    The signs of increased ICP are the opposite of those of shock.Shock: Increased pulse, Decreased blood pressure.Increased ICP: Decreased pulse, Increased blood pressure.