The nurse is assessing a 36-week gestational age newborn. Upon ...

[Kikoku]

The nurse is assessing a 36-week gestational age newborn. Upon auscultation, she hears a late systolic murmur in the left intrascapular area with no femoral pulse but increased brachial pulses. What treatment should this infant receive?
 
  1. Indomethacin with surgical ligation.
  2. Lanoxin with surgical closure with a Dacron patch.
  3. Prostaglandin E1 and surgical resection of the aorta.
  4. Palliative surgery to increase blood flow to the lungs followed by corrective surgery.

Question 2

The pregnant patient at 41 weeks is scheduled for labor induction. She asks the nurse if induction is really necessary. What response by the nurse is best?
 
  1. Babies can develop postmaturity syndrome, which increases their chances of having complications after birth.
  2. When infants are born two or more weeks after their due date, they have meconium in the amniotic fluid.
  3. Sometimes the placenta ages excessively, and we want to take care of that problem before it happens.
  4. The doctor wants to be proactive in preventing any problems with your baby if he gets any bigger.

[angrybirds13579]

Answer to Question 1

Correct Answer: 3
Rationale 1: This treatment is used with patent ductus arteriosus. This infant has coarctation of aorta, which should be treated with prostaglandin E1 and surgical resection of the aorta.
Rationale 2: This treatment is used for ventricular septal defect. This infant has coarctation of aorta, which should be treated with prostaglandin E1 and surgical resection of the aorta.
Rationale 3: This is the correct treatment for an infant with coartation of aorta.
Rationale 4: This treatment is used for tetralogy of Fallot. This infant has coarctation of aorta, which should be treated with prostaglandin E1 and surgical resection of the aorta.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: This statement is correct.
Rationale 2: Although this statement is partially true, meconium-stained amniotic fluid is not always present or the only complication of postmaturity syndrome.
Rationale 3: Although this statement is true, it is too vague. It is better to be specific and call postmaturity syndrome by its name.
Rationale 4: Although this is true, the answer is incomplete. The risk of postmaturity syndrome is also an issue.

[Kikoku]

Excellent

[isabelt_18]

TYSM