Mood + Affect
This is a six-part model that can be used to guide de-escalation and crisis intervention efforts.
SAFER-R
Other than oxygen saturation, what vital sign is important to monitor in a patient receiving remdesivir?
Heart rate - potential for severe bradycardia
True or false: you cannot be considered infertile if you have already had a child
False. Secondary infertility is the inability to conceive after a previous pregnancy.
Define hyperbilirubinemia
total serum bilirubin (TSB) level above 5 mg/dL, resulting in jaundice
True or false: infants of mothers with diabetes frequently display hyperglycemia after birth due to maternal hyperglycemia
False - IMDs experience fetal hyperinsulinism and increased peripheral glucose utilization, placing them at risk for hypoglycemia in the immediate postnatal period
To meet the definition of rapid cycling in bipolar, how many mood episodes (manic, mixed, hypomanic, or depressive) in a year must the patient experience?
Four or more
Because oseltamivir can decrease the effect of the live attenuated influenza virus vaccine, how much time is suggested to wait before and after the vaccine before utilizing this drug?
Avoid giving vaccination within 2 weeks before or 48 hours after oseltamivir.
Name the reversal agent for magnesium sulfate
Calcium gluconate
When diagnosing NOWS, the gold standard to ID substances newborn was exposed to is toxicology screening of what?
Newborn's meconium (but can also test urine or umbilical cord blood)
This condition involves soft tissue swelling caused by pressure of head against dilating cervix during birth process, is not limited by suture lines, and usually resolves over the first few days without treatment.
Caput succedaneum
What is the nurse's priority in crisis management?
Safety! Consider if the individual is in danger of self-harm or harm from others, whether the person in crisis is a danger to others, and environmental safety. Once any immediate safety concerns addressed, can engage in appropriate crisis-management techniques
List 5 manifestations of influenza - think "FACTS"
Fever, aches, cough, tired/fatigue, sudden onset
What is the difference between PROM and PPROM?
Both refer to spontaneous rupture of amniotic sac before onset of true labor, but PPROM occurs before 37 weeks
Describe the difference between the direct and indirect Coombs test.
Direct: done on newborn's blood - to identify hemolytic disease of the newborn; positive results indicate that the newborn’s red blood cells have been coated with antibodies
Indirect: done on mother's blood - antibody screen to determine whether they have developed isoimmunity to the Rh antigen. If test is positive, isoimmunization has occurred and fetus is carefully monitored for hemolytic disease. If negative, then patient is a candidate for RhIG
This intervention may be performed if phototherapy is not effective in hyperbilirubinemia or if hemolytic disease is present.
Exchange transfusion
A patient with bipolar disorder presents with symptoms of lethargy, slurred speech, weakness, and nausea. What is a lab the nurse might expect to see checked?
Lithium levels - concern for toxicity
"If body fluid decreases significantly because of hot weather, strenuous exercise, vomiting, diarrhea, or drastic reduction in fluid intake for any reason, then lithium levels can rise sharply, causing an increase in side effects, progressing to lethal lithium toxicity."
What would a nurse look for when assessing therapeutic effects of tocilizumab given to a COVID-19 patient?
improvement in pulmonary function and diminished inflammation (assessment may include include chest x-rays and testing of pulmonary function)
Describe DIC.
Disseminated intravascular coagulation (DIC) is a bleeding disorder characterized by an abnormal reduction in the elements involved in blood clotting resulting from their widespread intravascular clotting. Small clots form throughout the body, and eventually, the blood clotting factors are used up, rendering them unavailable to form clots at sites of tissue injury. Clot-dissolving mechanisms are also increased, resulting in potentially severe bleeding.
Define the criteria for low birth weight, very LBW, extremely LBW
<2500 g, <1500 g, <1000 g
Management of the infant experiencing RDS may include...
Administration of exogenous surfactant, CPAP/PEEP, mechanical ventilation
Describe nursing actions related to suicide prevention.
Identification of suicidal ideation (screening - can use tool like Columbia-Suicide Severity Rating Scale), Assessment (evaluation of thoughts/plans/intentions/behaviors to gauge current risk/severity + note protective and risk factors), Identifying in-room hazards (ligature points, other hazards), Documentation (current level of risk, mitigation and safety plans in place - ex 1:1 sitter, removal of high-risk items from room, collaboration with provider/mental health team)
You are caring for an infant with RSV. List some potential signs that may indicate impending respiratory failure.
Severe increase in respiratory effort (including severe retractions or grunting, decreased chest movement), cyanosis, tachycardia or bradycardia, tachypnea or bradypnea, agitation, fatigue
List at least three interventions a nurse might expect to perform when caring for a patient with placental abruption.
Place them on strict bed rest and in a left lateral position. Administer oxygen therapy. Monitor oxygen saturation levels via pulse ox. Obtain the patient’s vital signs frequently, as often as every 15 minutes as indicated, depending on the patient’s status and amount of blood loss. Observe + report changes in vital signs suggesting hypovolemic shock. Insert an indwelling urinary (Foley) catheter to assess hourly urine output. Initiate an IV infusion for fluid replacement. Assess fundal height for changes (an increase in size would indicate bleeding). Monitor the amount and characteristics of any vaginal bleeding as frequently as every 15 to 30 minutes. Be alert for signs and symptoms of DIC. Institute continuous electronic fetal monitoring. Assess uterine contractions, and report any increased uterine tenseness or rigidity. Also observe the tracing for tetanic uterine contractions or changes in fetal heart rate patterns suggesting that the fetus has been compromised.
In a pre-term infant, respiratory distress, central cyanosis, hypoglycemia, lethargy, weak cry, abdominal distention, apnea, bradycardia, acidosis can all serve as cues for...
Cold stress
You are caring for an infant who is LGA. List at least three potential signs of hypoglycemia.
listlessness, hypotonia, apathy, poor feeding, apneic episodes with a drop in oxygen saturation, weak or high-pitched cry, cyanosis, temperature instability, pallor and sweating, tremors, irritability, and seizures