Maternal and Child Health Nurse Test Part 2

Ampicillin is the drug of choice if the meningitis is caused by a H. Influenzae. If other organisms are detected as the causative agent (such as E. COLI and GROUP B STREP) , a third-generation cephalosporin is prescribed such as cefotaxime and ceftriaxone, that’s why the correct answer is B. Mannitol and Dexamethasone are not antibiotics.

Station refers to the descent of the fetal presenting part in relation to the pelvic structures. The mark is the ischial spines. Once the presenting part descended at the level of the ischial spines the station is zero and engagement has occurred. If it is above the ischial spines the station is negative and if below the mark the station is positive. Therefore, -1 is 1 cm above the ischial spines and +1 is one cm below the ischial spines. Centimeter not inch is used in interpreting a station.

Estrogen stimulate the growth of long bones however, it also causes closure of the epiphysis (end of a long bone), thereby limiting bone growth.

An MRI, CT scan and ultrasound study may be ordered to examine for abscesses.

Vulva is a collective term that refers to the external female reproductive organ. Only letter B enumerates all external female structures.

A- Zygote: 12-14 days B- Embryo: 15th day – 8 weeks C- Fetus: 8 weeks until delivery D- Neonate: delivery to 1 month

The external genitals differentiates internally at about 7-8 weeks intrauterine life. XY produces a genetically male zygote directing the primitive cells to become testes with the influence of testosterone. At about 10 week’s AOG, if no testosterone is present the primitive cells develop to become ovary. Thus, it is the absence of testosterone not the presence of estrogen that causes the development of female reproductive systems.

Meningitis is caused by an infection. It is not genetically determined. Children with splenectomy are susceptible to pneumococcal infections unless they receive a pneumococcal vaccine.

The fourth maneuver is only done if the presentation is in cephalic. The nurse assesses the degree of flexion in this maneuver. Maneuver 1 would assess the fetal part found at the fundus. To know what the presenting part is and assess if engagement occurred Maneuver 3 is done.

CSF indicative of meningitis include increase WBC and protein levels and a decrease of glucose level because the bacteria fed on the glucose. Platelet count is not affected in meningitis.

The primitive tissue that differentiates to become male reproductive organs is called a mesonephric duct or wolffian duct. Internal sexual organ differentiation starts at about 7-8 weeks intrauterine life. Both external and internal reproductive organ differentiation is completed at about 12 week’s age of gestation.

In calculating the EDD or exact date of delivery, the first day of LMP should be used. In the case, January 24, 2010 was the last day of LMP. Since the client said that her last menses has 4 day duration, meaning to say, the first day of LMP was January 20, 2010. In Nagele’s rule, you count back three months from the first day of the LMP and add 7 days. You cannot substitute the year for months like January, February and March. Therefore, January 20, 2010 – 3 months + 7 days = October 27, 2010. If you used 2010, the pregnancy will last more than 9 months.

Cranial nerve paralysis may occur in children with meningitis. Most typically, the third and sixth cranial nerves are damaged causing a child to unable to follow a light through a full visual field.

Seizure or shock in most children with meningitis is the first noticeable sign. Headache leading to irritability will not be immediately noticed or interpreted as infection of the meninges. Nuchal rigidity develops later on. A bulging fontanel (if open) develops later than the seizures.

If the part palpated at the fundus is round and soft it is the fetal buttocks. Fetal head feels round and firm.

If the causative agent is H. Influenzae, septic arthritis may develop. If it is caused by N. Meningitidis papula or purple petechial rash may develop. Papilledema develop if the fontanels are closed already. Photophobia is seen in children with meningitis regardless of what the causative factor is.

Birthweight doubles at 6 months triples at 1 year. If at 2 years she weighs 30 lbs, then 30 / 4 = 7.5 lbs. Thus, D is the correct answer.

A positive Brudzinski’s sign causes bilateral flexion of the hip, knee and ankle as the nurse flexed the patient’s neck. A positive Kernig’s sign is the pain, resistance and spasm as the leg is extended. Opisthothonus is characterized by an arched back and hyperextension of the neck.

Having the pregnant woman drink plenty of fluids would lead to uncomfortable feeling during the procedure once the woman feels the need to void. Before starting the maneuver, allow the woman to void, warm the hands of the nurse to prevent discomfort to the client and provide privacy.

Cold stress is prevented in newborns as an immature body system is incapable of shivering to produce heat. If a newborn is exposed to cold, the neonate’s body metabolizes the brown fats and the process is call non-shivering thermogenesis. Hypoglycemia occurs within 24 hours if the mother has diabetes.

To prevent the transmission of disease is the top priority in this case. Respiratory precautions should be observed.

The main reason in obtaining weight in children is to provide data that will be used in calculating drug dosages (e.g. Clark’s Rule). Tracking the growth or physical progress is just secondary to that reason. Developmental delay is assessed through Denver Developmental Screening Test (DDST).

Erik Erikson’s psychosocial theory states that 1 year old infants are under Trust vs Mistrust. Oral is the psychosexual development of infants according to Freud.

Keep in mind M comes before N in the alphabet. In suctioning the M (mouth) first before N (nose). Mouth is suctioned first to prevent aspiration.

Ampicillin is the drug of choice if the meningitis is caused by a H. Influenzae. If other organisms are detected as the causative agent, a third-generation cephalosporin is prescribed such as cefotaxime and ceftriaxone. Mannitol is given to relieve or reduce increase ICP.