A baby is born with bladder exstrophy. Immediate care for this ...

[B]

A baby is born with bladder exstrophy. Immediate care for this infant will include which intervention?
 
  1. Measuring intake and output
  2. Inserting a Foley catheter
  3. Covering the defect with sterile plastic wrap
  4. Palpating the bladder mass to ensure urine is expelled

Question 2

A nurse is taking care of a patient in the ICU who has been on opioids for an extended period of time. The nurse understands that the child has to slowly wean from the medication over a period of time.
 
  While weaning, the nurse will observe the child for symptoms of too rapid withdrawal, including: 1. Hyperactive deep tendon reflexes, vomiting, and abdominal cramps.
  2. Bradycardia and pallor.
  3. Decreased blood pressure and drowsiness.
  4. Voracious appetite and hypotonicity.

[perkiness]

Answer to Question 1

3
Rationale 1: Because the bladder constantly drains onto the skin of the abdomen, measuring output is not possible.
Rationale 2: The bladder is open to the abdomen. A Foley catheter cannot be inserted.
Rationale 3: This reduces the contamination of the bladder, which should be sterile.
Rationale 4: The bladder is very sensitive and palpation would cause unnecessary pain.
Global

Answer to Question 2

1
Rationale 1: These are symptoms of withdrawal resulting from reducing the dose too quickly.
Rationale 2: A child who is being withdrawn from opioids too quickly will be tachycardic and have hot flashes and sweating.
Rationale 3: The child who is being withdrawn from opioids too quickly will be hypertensive and wakeful.
Rationale 4: Nausea, abdominal pain, diarrhea, and hypertonicity would be symptoms of withdrawal.
Global Rationale: