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NUR 254 MATERNAL AND PEDIATRICS 2025 ACTUAL NEWEST EXAM WITH DETAILED QUESTIONS AND ACCURATE ANSWERS.pdf
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Question-what is primary nursing? - answer-RN "primary" nurse assumes 24-hour responsibility for all of the pts, or long term nurse for a pt in the ICU or nursing home This only works in a setting where pts are there for a long time Likely to happen in a nursing home Question-what is team nursing? - answer-total client care for assigned group of patients Pct, lpn and rn are all working collaboratively and that is team nursing Question-What does empowerment look like? - answer-when one person rises, we all rise Question-What is formal leadership? - answer-legit authority Position of power Question-What is informal leadership? - answer-their influence is their personality
Status Personal skills Question-What are different types of power? - answer-legitimate power Coercive power Reward power Expert power Connection Informational What are different nursing care delivery systems? - answer-total pt care Functional nursing Primary nursing Team nursing Question-what is total pt care? - answer-one nurse has one team of pt, no tech Primary team Likely to happen in the ICU Question-what is functional nursing? - answer-task oriented nursing Needed tasks are divided up by charge, based on skill of staff working Likely to happen as a wound nurse
Question-What does cortisol do? - answer-increased bone resorption Question-What does estrogen do? - answer-stimulates osteoblast Inhibits osteoclasts Question-what does testosterone do? - answer-stimulates musculoskeletal growth Question-What is the difference between isometric and isotonic movement? - answer- Question-What is isotonic movement? - answer-ROM movements Walking Any movement with muscles contracting Question-What is isometric movement? - answer-no movement, but you are engaging muscles Kegels Planks Wall sits Question-What are the 6 P's of neurovascular status? - answer-Pain Polar (temp of skin)
Pulse Paresthesia (decreased sensation) Pallor Paralysis Question-What are important assessments for musculoskeletal? - answer- 6 p's Alignment Make sure both sides are equal (R v L) Question-What is the nursing role for arthroscopy? - answer-administer analgesic Question-What is the nursing role for the bone density test? - answer-no Ca supp prior This is done to test for bone density Question-What is nursing care for arthrosentesis? - answer-contraindicated for bleeding risk Analgesic and ABX Question-How do we identify a potential pelvic Fx? - answer-Ecchymosis Tenderness
Pillow between legs Question-How do we recognize a femoral Fx? - answer-inability to move hip and knee Deformed and painful thigh Edema Question-What is nursing management for femoral Fx? - answer-monitor NV status Pain control Fx reduction Skeletal traction Early mobilization Question-What are complications for femoral Fx? - answer-shock (lots of bleeding, big vessels in thighs) Knee effusion (ligament damage) (instability of knee joint) Question-What does emergency nursing management include? - answer-OPEN: Covering with sterile dressings ABX (if open) Traction Ice
Immobilization CLOSED: Control pain/edema Maintain traction Question-What do we do after reduction? - answer-immobilization after reduction Internal or external fixation Ice!! Elevate Question-What are Fx early complications? - answer-hypovolemic shock r/t hemorrhage Must stabilize Fx and restore circulation VTE, DVT, PE DIC Infection ABX Fat embolism Compartment syndrome
Sluggish cap refill Pallor distal to injury Cyanotic nail beds Decrease in blood flow, ischemic necrosis of nerves and muscles Question-What is treatment for compartment syndrome? - answer-frequent assessment NV function Elevation of extremity at level OF the heart DR will open or bivalve cast/splint Extreme cases: Fasciotomy (tissue literally cut open) Question-What is avascular necrosis? - answer-death of bone tissue due to lack of blood supply Tx: Bone grafts Decompression Question-What is heterotopic ossification? - answer-Bone formation in location other than bone (muscle)
Bone cells become dispersed S/s: Painful Swelling Edema Question-What is complex regional pain syndrome? - answer-brain registers touch, or everything as pain S/s: Severe burning pain Local edema Stiffness Vasomotor skin changes Trophic changes Question-What is rhabdomyolysis? - answer-breakdown of muscle tissue after injury Severe muscle aching VERY DARK URINE High serum kinase Urine myoglobin Complications: High K+ Renal failure
Question-what is nursing management of scoliosis? - answer-encourage compliance w brace (23/24 hours) Shower during 1 hour break from brace Pain management postop Question-What are clinical manifestations of developmental dysplasia of Hip? (DDH) - answer- dislocated hip joint Shortening of limb Positive barlow (does hip go out of joint?)You go OUT to the bar Positive ortolani (do hips go back into socket?) Go home Question-What do we do for DDH? - answer-harness hips into place Traction or reduction spica casting Question-What is nursing management for DDH? - answer-recognize it early Educate the parents Maintain skin integrity in the cast Maintain 180 degrees in spica cast
Watch growth and development Question-What are clinical manifestations slipped capital femoral epiphysis? - answer-hip pain, maybe into the knee Limp Decreased ROM Question-What do we do for slipped capital femoral epiphysis? - answer-surgery Traction w/ pins before surgery Question-Who is at risk for club foot? (talipes deformites) - answer-family Hx Breech position Baby boys Question-what is nursing management for clubbed foot? Talipes deformites - answer-cast care Passive ROM Question-What do we do for clubbed foot? Talipes deformites - answer-serial casting Corrective shoes/braces Question-How to take a calcium supplement? - answer-with meals, orange juice, split doses
Promote exercise within limits of traction Medicate for pain!! Monitor for complications Question-what is nursing management for SKELETAL traction? - answer-monitor infection!!! 6 p's Monitor skin breakdow Assess skin before and after applying traction Promote exercise Monitor for xomplications Medicate Question-What is open reduction internal fixation? - answer-fixed from the INSIDE (can't see how we fixed it) Question-What is closed reduction external fixation? - answer-fixed from the OUTSIDE (hardware is on the OUTSIDE!! You can see how we fixed it) Question-What is arthroplasty nursing care? - answer-pain Blood loss (plan for it)
Prevent and monitor infection (ABX) Ambulation Question-hip replacement nursing management? - answer-proper positioning Drainage monitor Skin breakdown Mobilization Prevent infection Question-What is arthritis? - answer-inflammation of a joint Question-What is septic arthritis? - answer-bac, viral or fungal infection from the blood that travels to the joint Question-What is Rheumatoid arthritis? - answer-autoimmune process Inflammation comes FIRST, then THAT leads to injury Exacerbations occur during times of stress SYSTEMIC effect, connective tissue disorder Question-what are key differences between rheumatoid arthritis and osteoarthritis? - answer-RA:
Question-What are nursing goals for RA? - answer-keep lots of ROM Encourage activity when in remission Splint usage when in acute inflammation HOT YOGA Question-What are meds for RA? - answer-non biologic dmards:disease-modifying antirheumatic drugs: Methotrexate, antimalarial, leflunomide, sulfasalazine Biologic DMARD Abatacept, adalimumab, anakinra Question-What is Juvenial Idiopathic Arthritis? - answer-inflammation and destruction of articular cartilage, with pannus formation Flare ups with healthy periods Usually affects one side more than the other (RA affects both sides at the same time) Question-Does JIA have systemic symptoms? - answer-yes Visual changes Fever, lethargy Weight loss, anorexia
Question-What are meds fir JIA? - answer-non biologic dmards:disease-modifying antirheumatic drugs: Methotrexate, antimalarial, leflunomide, sulfasalazine Biologic DMARD Abatacept, adalimumab, anakinra Question-What is nursing management for JIA? - answer-keep them moving!!!! Keep. Them. Moving. Question-What is osteoarthritis? - answer-degenerative joint disease Due to "wear and tear" or aging Nodules INSIDE of the joint Question-What is the difference between pain and stiffness? - answer-pain: after overuse (OA) Stiffness: in the morning (OA) Must rest with pain! Walk out the stiffness with OA Question-Spondyloarthropathies include? - answer-Ankylosing Spondylitis Psoriatic Arthritis Reactive Arthritis