A nurse is caring for a newborn who has myelomeningocele. Which of the following nursing goals has the priority in the care of this infant?
Promote maternal-infant bonding.
Maintain the integrity of the sac.
Provide age-appropriate stimulation.
Educate the parents about the defect.
The Correct Answer is B
Rationale:
A. Promoting maternal-infant bonding is important but is secondary to addressing immediate physical concerns.
B. Maintaining the integrity of the sac is the priority in managing myelomeningocele. The sac should be protected from rupture or infection to prevent damage to the spinal cord and nerves.
C. Providing age-appropriate stimulation is important for development but is not as urgent as protecting the physical integrity of the sac.
D. Educating the parents about the defect is crucial for long-term care but does not take precedence over immediate physical needs.
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Correct Answer is B
Explanation
Rationale:
A. Isosorbide dinitrate is a nitrate that helps to dilate blood vessels and reduce the workload on the heart. It is generally safe for clients with asthma.
B. Carvedilol is a beta-blocker used to manage heart failure, but it can also cause bronchoconstriction, which is dangerous for clients with asthma. Beta-blockers can exacerbate asthma symptoms, so clarification is needed before administration.
C. Fluticasone is a corticosteroid commonly used to manage asthma and other respiratory conditions; it is not contraindicated for this client.
D. Captopril is an ACE inhibitor used to treat heart failure and does not pose a risk for clients with asthma.
Correct Answer is C
Explanation
Rationale:
A. Hypertension is not typical for nephrotic syndrome; instead, nephrotic syndrome often presents with low blood pressure or normal blood pressure.
B. Polyuria is more commonly associated with conditions like diabetes mellitus rather than nephrotic syndrome, which typically presents with reduced urine output.
C. Facial edema is a common finding in nephrotic syndrome due to fluid retention and is often noticeable in the periorbital area.
D. Smokey brown urine is indicative of hematuria or glomerulonephritis, not nephrotic syndrome.