A neonate, 16 hours old, is in the NICU for respiratory distress. A chest X-Ray reveals heart failure. Lab results indicate: AB positive blood type, a positive Coomb’s test, serum bilirubin 16mg/dl, and severe anemia. The vital signs are 98.6 (F), HR 166, R 70. The infant is jaundiced from face to sole of feet and has generalized edema. What condition does the infant have?
Kernicterus.
Severe cardiac anomaly.
Respiratory distress syndrome.
Hydrops fetalis.
The Correct Answer is D
Choice A rationale
Kernicterus is a rare type of brain damage that occurs in a newborn with severe jaundice. It happens when a substance in the blood, bilirubin, builds up to very high levels and spreads into the brain tissues. This condition can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities. However, the symptoms provided do not align with this condition.
Choice B rationale
A severe cardiac anomaly could cause heart failure and respiratory distress, but it would not explain the positive Coomb’s test, high bilirubin levels, severe anemia, jaundice, and generalized edema.
Choice C rationale
Respiratory distress syndrome (RDS) is a common problem in premature babies. It causes babies to need extra oxygen and help with breathing. RDS occurs most often in babies born before the 28th week of pregnancy and can be a problem for babies born before 37 weeks of pregnancy. It’s caused by a lack of a slippery substance called surfactant, which helps the lungs inflate with air and keeps them from collapsing. However, the symptoms provided do not align with this condition.
Choice D rationale
Hydrops fetalis is a severe, life-threatening problem of severe edema (swelling) in the fetus and newborn. It is also called hydrops. There are two types of hydrops fetalis: immune and nonimmune. Immune hydrops fetalis is a complication of a severe form of Rh incompatibility, which can be prevented. Nonimmune hydrops fetalis occurs as a result of other diseases, such as infections, heart or lung defects, liver disease, or genetic disorders, which aligns with the symptoms provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
In the Gamete Intrafallopian Transfer (GIFT) procedure, fertilization occurs within the woman’s body. The eggs and sperm are collected, mixed together, and then injected into the fallopian tubes. This allows fertilization to occur naturally within the woman’s body. Choice B rationale
Zygotes are not positioned in the fallopian tubes in the GIFT procedure. This is a characteristic of the Zygote Intrafallopian Transfer (ZIFT) procedure, not GIFT.
Choice C rationale
Donor sperm are not placed in a medium with donor eggs in the GIFT procedure. In GIFT, the woman’s eggs and the man’s sperm are mixed together and then injected into the woman’s fallopian tubes.
Choice D rationale
A surrogate does not carry the infertile woman’s fetus in the GIFT procedure. In GIFT, the fertilized egg implants and develops in the woman’s own uterus.
Correct Answer is D
Explanation
Choice A rationale
Informing the obstetrician is important, but it is not the first action to take. The nurse should first try to address the issue at hand, which is a displaced and boggy uterus.
Choice B rationale
Straight catheterization of the patient could be necessary if the patient is unable to void. However, the first step should be to ask the patient to void.
Choice C rationale
Preparing the patient for manual removal of uterine clots is a more invasive procedure that should be considered if other measures, such as asking the patient to void or massaging the fundus, are not effective.
Choice D rationale
A full bladder can displace the uterus and prevent it from contracting properly. Asking the patient to void can help the uterus contract and reduce bleeding.
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