NURS 299 Exam #3: Study Resource

Recall the formula for infant compared to birthweight 5 months?

Double their birth weight (x2)

Recall the formula for infant compared to birthweight 12 months?

Triple their birth weight (x3)

Recall the formula for infant compared to birthweight 2.5 years?

Quadruple their birth weight (x4)

Nursing Application: The baby was 6 pounds at birth. What is their expected weight at 5 months?

12 lbs

Nursing Application: The baby was 6 pounds at birth. What is their expected weight at 12 months?

18 lbs

What are Erikson's Theory of Human Development?

- Infancy

- Toddler

- Preschool

- School age

- Adolescence

- Young adulthood

- Middle adulthood

- Older adult (maturity)

0 - 1 years (Trust vs. mistrust)?

Infancy

1 - 3 years (Autonomy vs. shame & doubt)?

Toddler

3 - 6 years (Preschool)?

Initiative vs. guilt

6 - 11 years (Industry vs. inferiority)?

School age

11 - 17 years (Identity vs. role confusion)?

Adolescence

18 - 35 years (Intimacy vs. isolation)?

Young adulthood

35 - 65 years (Generativity vs. stagnation)?

Middle adulthood

65 + years (Ego integrity vs. despair)?

Older adult (maturity)

What are the stages of Kohlberg's Theory of Moral Development?

- Pre conventional

- Conventional

- Post Conventional

What is obedience and punishment, individualism and exchange?

Pre-conventional

What is good interpersonal relationships, maintaining social order?

Conventional

What is social contract and individual rights, universal principles?

Post Conventional

School age (younger than six)?

Pre-Conventional (Level 1)

School age/adolescence (7 to 11 years)?

Conventional (Level 2)

Adolescence/young adult (11 years on)

Post-Conventional (Level 3)

What level is avoiding punishment and gaining a reward?

Pre-Conventional (Level 1)

What level is gaining approval and avoiding disapproval?

Conventional (Level 2)

What level is establishing personal moral standards/individual rights, achieving justice, and agreeing upon rights?

Post-Conventional (Level 3)

What does it mean when there is an Rh incompatibility?

If the mother is Rh negative (-) and the fetus is Rh positive (+)

If there is an Rh incompatibility what will the mother need?

Mother needs RhoGAM shot at 28 weeks of gestation AND 72 hours after delivery of baby

Recall caloric needs during pregnancy?

Calorie needs increase by 300 calories during pregnancy

What problems arise during the mother's elimination pattern during pregnancy?

Because of the enlarging uterus and hormonal influences

When does urinary frequency occur?

First and third trimesters, constipation, and hemorrhoids cause normal discomfort

What is Anticipatory guidance?

To help pregnant women cope with these changes and prevent complications during elimination

What usually correlates with preterm labor?

UTIs

Describe how culture influences pregnancy and how to incorporate this in plan of care?

- Culture can impact childbearing practices

- Important to avoid stereotyping

What are the levels of culture?

- Primary level

- Secondary level

- Tertiary level

What is the level of culture rules known and obeyed by everyone?

Primary level

What is the level of culture rules not related to outsiders (taboos, rituals)?

Secondary level

What is the level of culture visible to outsider (dress, foods, religion)?

Tertiary level

(T/F): It's okay to incorporate cultural influences as long as it is safe for the baby?

True

____ask about cultural practices first, ask more questions?

ALWAYS!

Some cultures may not seek care for their pregnancy or might use a healer and want to provide resources such as?

Women, Infants, and Children (Under Five) - WIC

What are other things you ask a pregnant mother?

- Ask if there's family support and if she feels at home

- Evaluate her happiness with pregnancy

What are some ways to help prepare a preschool child for a new sibling?

Allow the child to help out with the baby

What is an example of strategies to prepare a preschool child for their new sibling?

Let them help pick out baby's clothes, or let them help decorate the baby's room

What ways are appropriate for infant-mother bonding?

- Recommend at least 6 months of breast feeding

- Influence by previous life experiences

- Skin-to-skin is a good way to bond with the baby

- Assess mom for any complications

What are safe over the counter (OTC) drugs okay in recommended dose during pregnancy?

- Acetaminophen (Tyenol)

- Antihistamines (Benadryl)

- Antacids (Tums)

- Sleep aids (Melatonin)

- Stool softeners (Colace)

- Cool remedies (Mucinex)

- Vitamin B6

What are unsafe over the counter (OTC) drugs okay in recommended dose during pregnancy?

- NSAIDS - Ibuprofen (Advil)

- Bismuth Subsalicylate (Pepto Bismol)

- Ephedrine (Nasal decongestants)

- Antiepileptics

What is a parasite found in cat feces and undercooked/contaminated meat?

Toxoplasmosis

What are the symptoms of toxoplasmosis?

- Muscle pain

- Fever

- Headache

- Abdominal pain

- Seizures

- Confusion

- Breathing problems

What will happen to the baby if affected with toxoplasmosis?

- Eye damage

- Miscarriage

- Damage to baby's brain

- Other organs damaged

(T/F): Pregnant women should change litter boxes?

False

If a pregnant absolutely has to change a cat's litter box what must she do to prevent toxoplasmosis?

She should wear gloves and masks

If a pregnant women gets toxoplasmosis it can get passed to the baby? (T/F)

True

As a nurse educating a pregnant women with a cat litter box what can we suggest to her?

Do not clean the litter box, she should wear gloves and masks

What will happen to the placental function if infants are born early or after 42 weeks?

Decrease in placental function (placenta is wearing down, not functioning well and this can cause complications)

What can also happen if infants are born early or after 42 weeks?

Increases the risk of stillborn babies (major concern)

What do we call when a pregnant women craves non edible items such as (dirt, chalk, tide pods, and rocks)?

Pica

As a nurse what will we do to treat pica?

Treat the underlying cause, stress the importance of an appropriate diet

What can we also educate the patient with pica?

Encourage a healthy diet and don't be judgmental

What deficiency is pica associated with?

Mineral deficiency

(T/F): There is higher risk of abuse in pregnancy?

True

What will happen if the woman gets all the attention and that the baby is getting more attention than the partner?

This causes the partner to get jealous, risk for added stress during pregnancy

There is a possible resentment, financial stress, concerns about roles during pregnancy? (T/F)

True

As a nurse assessing a pregnant women and there is frequent arguing with spouse?

Need to follow up signs of abuse and ask further questions!

What are the risks for women who experience domestic violence during pregnancy, the baby has a greater risk of what?

Being born premature and having low birth weight

What can help prevent birth defects?

Folic acid (folate)

What is the recommended amount of folic acid for pregnant women?

400 mcg

What are the sources of folic acid?

- Fortified cereals

- Dark leafy vegetables

- Some citrus fruits

What are the appropriate toys for a 2 month old?

Colorful mobile with music

What are the appropriate toys for a 3-4 month old?

Rattles

When a baby reaches 9 months we can have?

Supervised time outside of playpen

Infant Developmental Stage: 1 month?

Lifts head when prone

Infant Developmental Stage: 2 months?

Has social smile

Infant Developmental Stage: 5 months?

Rolls from back to front

Infant Developmental Stage: 6-7 months?

Sits alone, leaning on hands

Infant Developmental Stage: 7-9 months?

Crawls

Infant Developmental Stage: 8-9 months?

Use pincer grasp to feed self

Infant Developmental Stage: 10 months?

Pulls self to standing position

Infant Developmental Stage: 11-12 months?

Initiates vocalization

Infant Developmental Stage: 12-15 months?

Walks

How much fluid does a mother need to increase during breastfeeding?

1 quart in addition to their recommended minimum daily fluid intake. (9-13 cups + 1 quart)

What will happen to infants stools during breastfeeding?

- Softer consistency

- Clean smell

- Initially several stools daily progresses to one daily or over several day

- More frequent bowel movements than bottle fed babies

What will happen to infants diet during breastfeeding?

- Fewer infections

- Antibody and germ fighting factors pass from mom to baby

- Strengthens immune system

- Provides well-rounded nutrition

- Creates a mother baby bond

- May need Vitamin D supplements

What will happen to stools during bottle-fed infants?

- Harder consistency

- Smellier

- Similar to an infant on solid food

What will happen to diets of infants during bottle-feeding?

- Digested slower than breast milk

- No antibody protection

- More prone to infections

What does the acronym SID mean?

Sudden Infant Death Syndrome

What is the leading cause of death among infants 28-365 days? (1 month to 1 year)

SIDS - Sudden Infant Death Syndrome

What is the cause of SIDS?

Unknown

What are risk factors associated with SIDS?

- Prone/side sleeping

- Smoke exposure

- Soft bedding

- Bed sharing

- Not breastfeeding

- Overheating

- Preterm/low birthweights

Describe home visits and referrals such as signs and symptoms of child abuse. Differentiate between when to provide resources versus report to child protective services (CPS)?

- Report when child abuse is suspected

- Most common under age 3

- Signs of child abuse bruises in abnormal areas and abnormal fractures

- Sexual abuse

What do the round bruises on the back mean for a child is a sign of abuse?

This may not be child abuse because this could be a cultural practice called cupping, but still ask parents

List car seat recommendations?

- Rear facing for infants to 20 lb in backseat, preferably the middle seat

- Shield-type of "infant only" seat to 30 lb

- Never sit an infant on the lap in the car

How old should an infant be when we supervise them outside the playpen?

9 months old

What do we need to do for our homes for infant safety?

Babyproof the home and remove all small choking hazards

Always supervise! Never leave the baby unattended! (T/F)

True

What are the ABCs of safe infant sleeping?

Alone on their Back in a Crib

When babies are sleeping what precautions should we take?

Babies should never sleep on their belly or their side. They should always sleep alone without any small items in their crib

Why babies should never co-sleep with their parents in their parents bed?

Risk of suffocation

Avoid soft bedding for babies because of?

Risk of suffocation

List common accidents in infants?

- Most accidents occur in the home

- During sleep

- Falls

- Burns

- Poison

- Swallowing

- Choking

- Motor vehicle accidents

- Heat stroke

Where do the most accidents happen for infants?

Occur in the home

What position should babies sleep in?

Supine laying on their back