A woman comes into the emergency department and states that her ...

[corkyiscool3328]

A woman comes into the emergency department and states that her husband has abused her physically. She has a number of bruises, and is obviously pregnant. She states she is 7 months pregnant.
 
  She states that her husband arrived home drunk and just started hitting her. She states that her main concern at this time is her three young children, who are still in the home with her husband. She had a neighbor bring her in to emergency department. What can the nurse do to assist with this situation? 1. The nurse can ask the neighbor to go and get the children.
  2. The nurse can call the authorities to go with social service workers to get the children, with the patient's permission.
  3. The nurse can call the husband at home to bring the children into the emergency department, with the patient's permission.
  4. The nurse can call social services and have them go pick up the children, with the patient's permission.

Question 2

The nurse is caring for a 28-hour-old newborn, and notes a yellow coloring of the skin.
 
  Which factors would the nurse consider as potential causes of the infant's physiologic jaundice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Vacuum extraction delivery
  2. Adequate calorie intake
  3. Neonatal asphyxia
  4. Congenital heart disease
  5. Frequent bowel movements

[jharrington11]

Answer to Question 1

2
Rationale 1: Asking the neighbor to go to the home to get the children would not be appropriate in view of the state the husband is in at this time.
Rationale 2: The nurse should call authorities to accompany the social service workers to the home to get the children. This action is appropriate, given the husband's condition.
Rationale 3: Calling the husband and asking him to bring the children to the hospital would not be appropriate, especially since he is drunk.
Rationale 4: It would not be appropriate for social services to go out to the house alone.

Answer to Question 2

1,3,4
Rationale 1: The use of forceps or vacuum extraction that sometimes causes facial bruising or cephalhematoma can increase the amount of bilirubin to be handled by the liver.
Rationale 2: If the newborn does not ingest adequate calories, the formation of hepatic intracellular binding proteins diminishes, resulting in higher levels of bilirubin.
Rationale 3: Decreased oxygen supplies to the liver associated with neonatal hypoxia lead to a rise in bilirubin level.
Rationale 4: Decreased oxygen supplies to the liver associated with congenital heart disease lead to a rise in bilirubin level.
Rationale 5: Frequent bowel movements increase elimination of bilirubin and subsequently decrease the risk of jaundice.

[corkyiscool3328]

Thanks for the timely response, appreciate it

[Dominic]

Excellent