Of all the clients who have been scheduled to have a biophysical ...

[ETearle]

Of all the clients who have been scheduled to have a biophysical profile, the nurse would clarify the order for which client?
 
  1. A gravida with intrauterine growth restriction
  2. A gravida with mild hypertension of pregnancy
  3. A gravida who is post-term
  4. A gravida who complains of decreased fetal movement for 2 days

Question 2

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem ap-proach. The first step in the provision of this care is:
 
  a. Pharmacologic treatment.
  b. Reduction of environmental stimuli.
  c. Neonatal abstinence syndrome scoring.
  d. Adequate nutrition and maintenance of fluid and electrolyte balance.

[dantucker]

Answer to Question 1

2
Rationale:
1. The gravida who has intrauterine growth problems might be compromised due to placental insufficiency.
2. The biophysical profile is used when there is a risk of placental and/or fetal compromise. The gravida with mild hypertension will need to be monitored more closely throughout the pregnancy, but is not a candidate at present for a biophysical profile.
3. The gravida who is post-term might be compromised due to placental insufficiency.
4. The gravida who is experiencing decreased fetal movement for 2 days needs assessment of the placenta and the fetus.

Answer to Question 2

C

Feedback
A Pharmacologic treatment is based on the severity of withdrawal symptoms. Symptoms are determined by using a standard assessment tool. Medications of choice are morphine, phenobarbital, diazepam, or diluted tincture of opium.
B Swaddling, holding, and reducing environmental stimuli are essential in provid-ing care to the infant who is experiencing withdrawal. These nursing interven-tions are appropriate for the infant who displays central nervous system (CNS) disturbances.
C Neonatal abstinence syndrome (NAS) is the term used to describe the cohort of symptoms associated with drug withdrawal in the neonate. The Neonatal Absti-nence Scoring System evaluates CNS, metabolic, vasomotor, respiratory, and gastrointestinal disturbances. This evaluation tool enables the care team to de-velop an appropriate plan of care. The infant is scored throughout the length of stay, and the treatment plan is adjusted accordingly.
D Poor feeding is one of the gastrointestinal symptoms common to this patient population. Fluid and electrolyte balance must be maintained, and adequate nu-trition provided. These infants often have a poor suck reflex and may need to be fed via gavage.

[ETearle]

TYSM

[emsimon14]

Excellent