ATI RN
Nursing Interventions for Pediatric Respiratory Distress Questions
Question 1 of 5
A postpartum patient calls the clinic and reports to the nurse feelings of fatigue, tearfulness, and anxiety. What is the nurse's most appropriate response at this time?
Correct Answer: D
Rationale: The correct answer is D because the nurse needs to differentiate between postpartum blues and more serious conditions like postpartum depression. By asking if the patient is able to care for her baby, the nurse is assessing the severity of the symptoms and determining if the patient needs further evaluation or support. This response shows a proactive approach to addressing the patient's concerns and ensuring proper care.
Question 2 of 5
Following a difficult vaginal birth of a singleton pregnancy, the patient starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline. Vital signs are 37.6°C (99.8°F), pulse 90 beats/minute, respirations 20 breaths per minute, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?
Correct Answer: C
Rationale: The correct answer is C because prostaglandin analogs can be administered intramuscularly to stop uterine bleeding in this scenario. Oxytocin may be considered, but it is not administered in a piggyback solution. Methylergonovine is contraindicated in the presence of hypertension, which the patient has. Increasing parenteral fluids will not directly address the uterine bleeding issue.
Question 3 of 5
To evaluate the desired response of methylergonovine (Methergine), the nurse would assess the patient's
Correct Answer: A
Rationale: In the context of pediatric respiratory distress, understanding the use of methylergonovine (Methergine) is crucial for nurses. Methylergonovine is a medication primarily used to manage postpartum hemorrhage by stimulating uterine contractions, thereby improving uterine tone. Therefore, the correct answer is A) uterine tone. Option B) pain level is incorrect because methylergonovine is not used to assess or manage pain. Option C) blood pressure is incorrect as monitoring blood pressure is not the primary purpose of administering methylergonovine. Option D) last voiding is also incorrect as it is unrelated to the desired response of this medication. In an educational context, nurses must be knowledgeable about the actions and expected outcomes of medications they administer. Understanding the specific effects of methylergonovine, such as assessing uterine tone, is essential to ensure safe and effective patient care. By selecting the correct answer, nurses can monitor and evaluate the therapeutic response of the medication accurately, promoting positive patient outcomes in scenarios where methylergonovine is utilized.
Question 4 of 5
Which method of heat loss may occur if a newborn is placed on a cold scale or touched with cold hands?
Correct Answer: B
Rationale: In understanding the nursing interventions for pediatric respiratory distress, it is crucial to comprehend the mechanisms of heat loss in newborns, as they are particularly vulnerable to temperature regulation issues. When a newborn is placed on a cold scale or touched with cold hands, heat loss occurs primarily through conduction. Conduction is the direct transfer of heat from one object to another when they come into contact. In this scenario, the cold surface of the scale or the cold hands of the caregiver directly draw heat away from the newborn's body, leading to potential heat loss and subsequent risk of hypothermia. The other options, radiation, convection, and evaporation, are not the primary mechanisms at play in this specific situation. Radiation refers to the transfer of heat through electromagnetic waves and would not be the dominant factor in direct contact with a cold surface. Convection involves the transfer of heat through air or fluid movement, which is not the case here. Evaporation pertains to the loss of heat through the conversion of a liquid to a gas, such as sweating, and is not applicable in the given context. Educationally, understanding how different modes of heat loss impact newborns is essential for nurses caring for pediatric patients, especially those at risk for respiratory distress. By recognizing the significance of conduction in situations of direct contact with cold surfaces, healthcare providers can implement targeted interventions to maintain the infant's thermal stability and overall well-being.
Question 5 of 5
The nurse is planning to conduct the initial assessment of a full-term newborn. Included in the plan is providing a neutral thermal environment. To accomplish this plan, what is the desired environmental temperature to conduct the assessment?
Correct Answer: C
Rationale: A neutral thermal environment for a full-term newborn is one in which the infant can maintain a stable body temperature with minimal oxygen need. The desired environmental temperature to conduct the assessment and provide a thermoneutral zone is 32 to 33.5°C (89.6 to 92.3°F). This range allows the infant to maintain stability without an increase in metabolic rate.