40 Questions
What happens to the airways during an acute asthma attack?
They narrow further due to bronchospasm, leading to increased airway resistance.
What is the main difference between otitis media and otitis externa?
Otitis media involves the middle ear, while otitis externa involves the outer canal.
What typically precedes an acute otitis media infection?
A common cold
Why is a radiographic examination performed on a newborn with Imperforate anus?
To determine the distance between the anal dimple and the closed end of the rectum.
What is the primary cause of otitis media?
Bacterial and viral infections
What is a common symptom of otitis externa?
Radiating pain
What is the role of the trigeminal and facial nerve in otitis externa?
Responsible for sensation and movement
Why is otitis media more common in children than in adults?
Because the Eustachian tube in children is shorter and more horizontal.
What is the purpose of radiography in assessment of imperforate anus?
To determine the distance of the close end of the rectum from the anal dimple
What is the nurse's highest priority while the neonate is in the nursery, besides maintaining a patent airway?
Maintain neutral thermal environment
What is the primary function of brown fat in newborns?
Regulation of body temperature
What is the benefit of maintaining neutral thermal environment in neonates?
Reduced morbidities associated with hyperthermia and hypothermia
Why is placing the crib close to the nursery window least effective in maintaining a neutral thermal environment?
Heat loss by radiation
What is the purpose of covering the scale with a warmed blanket prior to weighing?
To maintain neutral thermal environment
What is the function of glycogen in newborns?
Regulation of glucose levels
Why is maintaining a neutral thermal environment crucial for neonates?
To prevent morbidities associated with hyperthermia and hypothermia
What is a common symptom of Hirschsprung's disease?
Abdominal distention
What is the ideal time for an infant to pass their first meconium stool?
Within 24 hours
What is an expected finding when performing a rectal exam on children with Hirschsprung's disease?
Presence of hard caked stool
What is a common cause of abdominal distention in Hirschsprung's disease?
Ribbon-like or hard caked stool
What is a possible indication of an early sign of megacolon in a newborn?
Delayed passage of meconium stool
Why may an infant need further evaluation?
If they take longer than 48 hours to pass meconium stool
What is a characteristic of stool in Hirschsprung's disease?
Ribbon-like or hard caked
What is a common diagnosis made in an infant with undernutrition and ribbon-like stools?
Hirschsprung's disease
What is the primary reason for immediate drying of the neonate after birth?
To remove wetness that could lead to evaporative heat loss
What is the recommended frequency for taking a woman's vital signs in the immediate postpartum period?
Every 15 minutes during the first hour and then every 30 minutes for the next two hours
What is the normal size of clots found in lochia during the first 1 to 2 days after birth?
Smaller than 1 cm
What is the priority action when clots larger than 1 cm are found in lochia?
Notify the physician
What is the primary purpose of placing the neonate on a warm, dry towel after birth?
To remove wetness that could lead to evaporative heat loss
What is the time frame referred to as the initial or acute period in the postpartum woman?
First 6-12 hours
Why is vitamin K routinely administered to newborns?
To prevent faulty blood clotting
What is a potential complication that may occur during the initial or acute period in the postpartum woman?
Both A and B
What is the primary focus of the postpartum assessment?
Evaluating overall maternal and neonatal well-being
What is the primary reason for administering silver nitrate drops in a newborn's eyes?
To prevent ophthalmia neonatorum
Where would you expect to administer a vitamin K injection to a newborn?
Vastus lateralis
What is the most effective way to prevent evaporative heat loss in a neonate immediately after birth?
Immediately drying the neonate
What is the consequence of a newborn having low levels of vitamin K?
Abnormal bleeding
Why is the vastus lateralis muscle ideal for vitamin K injection in newborns?
It has a large muscle mass
What is ophthalmia neonatorum caused by?
Neisseria gonorrhoeae
What is the primary function of vitamin K in newborns?
Proper blood clotting
Study Notes
Acute Asthma Attack
- During an acute asthma attack, the airways narrow further due to bronchospasm, leading to increased airway resistance.
Otitis Media and Otitis Externa
- Otitis media involves the middle ear, whereas otitis externa involves the outer canal.
- Otitis media typically follows a common cold, while otitis externa occurs from swimming.
- Otitis media can cause pain, while otitis externa produces radiating pain.
Acute Otitis Media
- Acute otitis media usually occurs after an upper respiratory infection.
- This type of ear infection typically follows a common cold.
Imperforate Anus
- Radiographic examination is done to determine the distance between the anal dimple and the closed end of the rectum.
Hirschsprung's Disease
- Hirschsprung's disease is a condition that affects the large intestine (colon) and causes problems with passing of ribbon-like or hard caked stool.
- Abdominal distention is a key symptom of Hirschsprung's disease.
- Meconium should be passed ideally within the first 24 hours and less frequently within the first 48 hours.
- A rectal exam on children with Hirschsprung's disease may reveal an empty rectum.
- A provisional diagnosis of Hirschsprung's disease may be made based on the presence of ribbon-like stools and undernutrition.
Newborn Care
- Maintaining a neutral thermal environment is the nurse's highest priority while the newborn is in the nursery.
- Brown fat helps to keep the newborn's body temperature regulated.
- Heat loss by radiation can occur when an infant's crib is positioned too close to cold walls or windows.
- Vitamin K is routinely administered to newborns to prevent faulty blood clotting.
- Silver nitrate drops are used to prevent ophthalmia neonatorum, a type of conjunctivitis caused by exposure to Neisseria gonorrhoeae during birth.
- The vastus lateralis muscle in the thigh is the ideal site for injection in newborns due to its large muscle mass and lower risk of nerve injury.
- Immediate drying of the neonate after birth removes the wetness that could lead to evaporative heat loss.
- Postpartum vital signs should be taken every 15 minutes during the first hour and then every 30 minutes for the next two hours.
Postpartum Assessment
- Clots larger than 1 cm in the lochia are considered abnormal and require notification of the physician.
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