Author Question: The nurse is caring for a newborn in the special care nursery. The infant has hydrocephalus, and is ... (Read 60 times)

panfilo · **on:** Jun 27, 2018

The nurse is caring for a newborn in the special care nursery. The infant has hydrocephalus, and is positioned in a prone position. The nurse is especially careful to cleanse all stool after bowel movements.

This care is most appropriate for an infant born with: 1. Oomphalocele.
2. Gastroschisis.
3. Diaphragmatic hernia.
4. Myelomeningocele.

Question 2

The nurse is taking a history of a new patient in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the patient. The nurse should use what technique to make it easier for the patient?

1. Let the patient fill out a paper copy, so she does not have to talk about intimate matters.
2. Skip the sexual part until the next time the patient comes into the clinic.
3. Start with the easier medical and surgical questions, and develop a feeling of trust with the patient.
4. Leave the sexual part of the history for the doctor to ask about.

jonathanballen97 · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

4
Rationale 1: Oomphalocele is a herniation of abdominal contents into the base of the umbilical cord. Positioning on the abdomen would be detrimental.
Rationale 2: Gastroschisis is a full-thickness defect of the abdominal wall, resulting in the abdominal organs' being located on the outside of the body. Positioning on the abdomen would be detrimental.
Rationale 3: Diaphragmatic hernia is incomplete formation of the diaphragm, resulting in the bowel and sometimes the stomach's extending upward through the defect and into the chest cavity.
Rationale 4: Myelomeningocele is a neural tube defect in which the meninges and spinal cord are exposed. Meticulous cleaning of the perineum helps prevent infection. The infant is positioned prone to prevent pressure on the defect. Hydrocephalus often is present.

Answer to Question 2

3
Rationale 1: This is not always possible due to the increasing reliance on electronic records, and it does not facilitate a therapeutic relationship.
Rationale 2: This is not correct, as a complete history needs to be done so that appropriate care can be accomplished.
Rationale 3: Starting with easy-to-answer questions and then going to the sexual ones helps, as hopefully patient is at ease by then.
Rationale 4: It is not the doctor's job to get the history. That is needed by the time patient sees the doctor.