A nurse is caring for a neonate in the neonatal intensive care unit. Q122

Exhibits

Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.

Abdominal circumference

Gestational age

Respiratory distress

UAC

Feeding method

5-minute Apgar score

Answer and Explanation

Correct Answer : A,B,C,D

A. Abdominal circumference: The increase in abdominal circumference by 1 cm (0.4 in) since the prior assessment is concerning and may indicate a complication such as abdominal distension, which could be a sign of necrotizing enterocolitis (NEC) or other gastrointestinal issues. NEC is a serious condition that is common in preterm infants, especially those receiving enteral feedings.

B. Gestational age: Being born at 34 weeks gestation is a significant risk factor. Prematurity increases the risk for complications like respiratory distress syndrome (RDS), infections, and feeding difficulties. Preterm infants are also at risk for problems with thermoregulation, which is why the neonate is on a radiant warmer.

C. Respiratory distress: The presence of substernal retractions, nasal flaring, and an elevated respiratory rate (70/min) indicates respiratory distress. Preterm neonates, especially those born at 34 weeks, are at risk for RDS due to insufficient surfactant production, which can lead to difficulty breathing and hypoxemia.

D. UAC: The umbilical arterial catheter (UAC) is commonly used for monitoring blood pressure and obtaining blood samples in neonates. However, it carries a risk for complications such as infection, thrombosis, and injury to blood vessels. This is an invasive device that could contribute to complications.

E. Feeding method (Continuous breast milk feedings via OG tube): Although feeding via an orogastric tube is a standard method for preterm neonates, it does not pose an immediate risk factor in this case. The method of feeding itself is not a complication risk. However, complications like feeding intolerance or aspiration can arise, which would require further monitoring.

G. 5-minute Apgar score: A 5-minute Apgar score of 7 is considered an acceptable score for a neonate. Although it indicates some initial difficulty, this score does not present a significant risk factor for complications by itself. A lower score would be more concerning, but a score of 7 typically suggests the neonate is transitioning well.

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Correct Answer is D

Explanation

A. Keeping a promise to visit a housebound client reflects fidelity, not distributive justice.

B. Being honest with the parents about reporting suspected abuse demonstrates veracity.

C. Accepting a client's decision to live alone represents autonomy.

D. Ensuring equitable access to healthcare for a homeless client aligns with distributive justice, which focuses on the fair allocation of resources to all individuals, especially vulnerable populations.

A. COPD B. Hypertension C. Dermatitis D. Smoking history E. Type 2 diabetes mellitus F. Hypothyroidism

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

Explanation

A. COPD: Clients with chronic obstructive pulmonary disease (COPD) are at increased risk for pneumonia due to compromised lung function, chronic inflammation, and decreased mucociliary clearance, making it easier for pathogens to infect the lungs.

B. Hypertension: While hypertension is a significant cardiovascular risk factor, it does not directly increase the risk of pneumonia. Therefore, it is not a relevant factor in this case.

C. Dermatitis: Dermatitis is a skin condition and does not affect lung function or immunity in a way that would increase the risk of pneumonia.

D. Smoking history: Smoking damages the respiratory epithelium and impairs the immune defenses of the lungs, making smokers more susceptible to respiratory infections such as pneumonia.

E. Type 2 diabetes mellitus: Diabetes compromises immune function and increases the risk of infections, including pneumonia, due to hyperglycemia impairing neutrophil function and other immune responses.

F. Hypothyroidism: While hypothyroidism may cause some general symptoms such as fatigue, it does not directly compromise respiratory function or immunity in a way that increases the risk of pneumonia.

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A nurse is caring for a neonate in the neonatal intensive care unit. Q122 Exhibits Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.

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A community health nurse is working with a group of clients. The nurse practices the ethical principle of distributive justice by performing which of the following tasks?

Correct Answer is D

Explanation

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A nurse is caring for a neonate in the neonatal intensive care unit. Q122

Exhibits

Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.