A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

Large ears

Protruding tongue

Transverse palmar creases

Muscular hypertonicity

Low birth weight

Answer and Explanation

Correct Answer : B,C

B. A protruding tongue, often due to a small mouth and poor muscle tone (hypotonia), is a common feature of Down syndrome. This tongue appearance can contribute to difficulties with feeding and speech development.

C. Instead of a single palmar crease (known as a simian crease), individuals with Down syndrome often have transverse palmar creases. This occurs in about 45-50% of cases and is considered a characteristic feature.

A. While large ears are not typically listed as a common feature, individuals with Down's Syndrome may have unusually shaped or small ears.

D. Hypertonicity refers to increased muscle tone or stiffness. In Down syndrome, however, hypotonia (reduced muscle tone) is more common, especially in infancy. Therefore, muscular hypertonicity is not typically associated with Down syndrome.

E While low birth weight can occur in some infants with Down syndrome, it is not a universal characteristic. In fact, some infants with Down syndrome may be born at average or even slightly higher birth weights.

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Correct Answer is ["A","C","E"]

Explanation

A. Resuming prenatal vitamins after cesarean birth is important for replenishing essential nutrients and supporting recovery. This statement indicates that the client understands the importance of nutritional supplementation postoperatively.

C. It is important for the client to understand that while some discomfort is expected after a cesarean birth, pain should be managed effectively with prescribed pain medications. Unrelieved pain can indicate inadequate pain management or a complication that requires medical attention.

E This statement demonstrates understanding of the importance of monitoring the incision for signs of infection. Discharge from the incision, especially if it is increasing, foul-smelling, or accompanied by fever, could indicate infection and should prompt the client to seek medical evaluation.

B. Fever is not a normal occurrence after a cesarean birth and can indicate infection. Therefore, this statement would indicate a misunderstanding and should be clarified. The client should be informed to contact their healthcare provider if they experience fever, as it could signify a complication such as endometritis.

D. Resting in a recliner is not typically recommended for healing after a cesarean birth. The client should be educated that rest should ideally be in a bed with proper support and positioning to promote healing and prevent complications such as thrombosis.

A. Monitor vital signs every 5 min. B. Notify the provider. C. Place the client in a lateral position D. Elevate the client's legs.

Correct Answer is C

Explanation

C. Positioning the client on her left side (lateral position) can help improve venous return to the heart and subsequently increase blood pressure. This position is beneficial in managing hypotension caused by epidural anesthesia and should be implemented promptly.

A. While monitoring vital signs is important, including blood pressure, heart rate, and oxygen saturation, doing so every 5 minutes might not be sufficient if the client's blood pressure remains low. Continuous monitoring is crucial in this situation, but it is not the priority action.

B. Notifying the provider is essential because hypotension during epidural anesthesia can affect placental perfusion, leading to fetal distress. The provider may order interventions such as administering intravenous fluids, adjusting the epidural anesthesia infusion rate, or administering medications to increase blood pressure. However, this should delay other necessary interventions.

D. Elevating the client's legs is not recommended in this situation because it can further compromise venous return and exacerbate hypotension. This action is contraindicated when managing hypotension related to epidural anesthesia.

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A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who is 3 days postoperative following a cesarean birth. Which of the following client statements should indicate to the nurse the teaching is effective? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is C

Explanation

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