Concerning congenital anomalies involving the central nervous ...

[daltonest1984]

Concerning congenital anomalies involving the central nervous system, nurses should be aware that:
 
  1. although the death rate for most congenital anomalies has decreased over the past several decades, neural tube defects (NTDs) have gone up in the past few years.
  2. spina bifida cystica is usually asymptomatic and may not be diagnosed unless there are associated problems.
  3. a major preoperative nursing intervention for a neonate with myelomeningocele is to protect the protruding sac from injury.
  4. microcephaly can be corrected with timely surgery.

Question 2

Concerning hemolytic diseases of the newborn, nurses should be aware that:
 
  1. Rh incompatibility only matters when an Rh-negative offspring is born to an Rh-positive mother.
  2. ABO incompatibility is more likely than Rh incompatibility to precipitate signif-icant anemia.
  3. exchange transfusions are frequently required in treatment of hemolytic disorders.
  4. the indirect Coombs' test is performed on the mother before birth; direct Coombs' test is performed on the cord blood after birth.

[brittrenee]

Answer to Question 1

3
1. Incorrect. Most congenital anomalies have a stable neonatal death rate since the 1930s; NTDs are declining because of mandatory food fortification with folic acid.
2. Incorrect. Spina bifida occulta is often asymptomatic; spina bifida cystica has a visible sac.
3. Correct. The nurse protects the infant by laying it on its side.
4. Incorrect. Microcephaly is a tiny head; there is no treatment.

Answer to Question 2

4
1. Incorrect. Only the Rh-positive offspring of an Rh-negative mother is at risk.
2. Incorrect. ABO incompatibility is more common than Rh incompatibility but causes less severe problems; significant anemia, for instance, is rare with ABO.
3. Incorrect. Exchange transfers are needed infrequently because of the decrease in the in-cidence of severe hemolytic disease in newborns from Rh incompatibility.
4. Correct. An indirect Coombs' test may be performed on the mother a few times during pregnancy.