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A client with recurrent headaches has been told by the physician that the cause is likely psychosomatic. The client reports this conversation to the nurse and says, “That just can’t be true! My head hurts so bad sometimes that it makes me sick to my stomach.” The nurse’s best response is?

Case Study  A woman diagnosed with gestational diabetes delivered a 7-pound 2-ounce male at 36 weeks after spontaneous rupture of membranes without complications at 0532.  APGARS were 8/8. The mother states that the neonate successfully breastfed for thirty minutes right after birth. Nurses’ Notes 0500: A woman vaginally delivered a 7-pound 2-ounce baby girl at 36 weeks after spontaneous rupture of membranes without complications.  APGARS were 8/8. The mother states that the neonate successfully breastfed for thirty minutes right after birth. 0900: Upon rounding with the pediatrician on the perinatal unit, a nurse notes the newborn is demonstrating fast and shallow breathing, grunting, nasal flaring, chest retracting, and skin color dusky.  The mother states she tried to breastfeed, but the baby did not seem to be interested and is sleeping soundly. The neonate has yet to void or stool.  0910. Blood glucose 34 mg/dl. Newborn is lethargic with poor muscle tone. Passed meconium.  Auscultation of the lungs reveal inspiratory crackle and expiratory grunt. 0940- Transferred to neonatal intensive care unit 1000- Intubated with 3.0 ET tube and placed on mechanical ventilation. Surfactant administered via endotracheal tube. Peripheral IV placed and patent. Repeat blood glucose 44mg/dL. Vital Signs Time 0900 0910 0920 0940 1015 Temp 97 F 97F 97.5 F 97.5 98F HR 156 156 170 170 156 RR 76 76 80 78 58 B/P 70/35 N/A N/A N/A 80/40 Pulse oximeter 91% on RA 90% on RA 93% on 100% 93% on 100% 98% on 60% Pain 0 0 0 grimace 0   Laboratory Results     Lab Results Reference range ABG pH 7.25 7.35-7.45 ABG P02 58 60 -70 mm Hg ABG PC02 52 35-45 mmHg ABG SaP02 88 95-100% ABG HC03 17 22-26 mEq/L Glucose 34 40-60 mg/dl Hematocrit 53 Newborn 46-68% Hemoglobin 18 g/dl Newborn 15.2-23.6 g/dl WBC 10 9.1 – 30.1 x 103 cells/mm3 Blood type O+   Diagnostic Reports   Echocardiogram no congenital heart defect noted. Chest x-ray hypo aeration- ground glass pattern After the intubation and initial dose of surfactant What would you expect to note if the newborn’s respiratory distress syndrome is improving. Select all that apply.

For the infant experiencing acute neonatal abstinence syndrome (NAS), the nurse would anticipate which of the following assessments:  Select all that apply:

Which of the following statements about the treatment of clients with panic disorder is FALSE?

A young woman is newly married and is seeking advice on contraception. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of PID. Which method should the nurse recommend?  

A client has sought treatment for a specific phobia: fear of cats. The nurse in the anxiety disorders clinic has established the nursing diagnosis: Anxiety related to exposure to phobic object (cats). Which of the following is a realistic short-term goal for this client?

Which finding by the nurse is consistent with an infant born at 42-weeks’ gestation?

A client tells the nurse at the anxiety disorders clinic that he experiences palpitations, difficulty breathing, and a sense of overwhelming dread whenever he goes out of his home. This problem began after he was beaten and robbed on his way to work. He has been unable to go to his office for over a month. He asks the nurse: Don’t you agree that not being able to go out is pretty stupid? The most therapeutic reply from among those listed below is:

All of the following activities are important in the immediate care of the premature neonate in the delivery room. Which one should have the greatest priority?

Case Study   A woman diagnosed with gestational diabetes delivered a 7-pound 2-ounce male at 36 weeks after spontaneous rupture of membranes without complications at 0532.  APGARS were 8/8. The mother states that the neonate successfully breastfed for thirty minutes right after birth. Nurses’ Notes 0900: Upon rounding with the pediatrician on the perinatal unit, a nurse notes the newborn is demonstrating fast and shallow breathing, grunting, nasal flaring, chest retracting, and skin color dusky.  The mother states she tried to breastfeed, but the baby did not seem to be interested and is sleeping soundly. The neonate has yet to void or stool.   0910. Blood glucose 34 mg/dl. Newborn is lethargic with poor muscle tone. Passed meconium.  Auscultation of the lungs reveal inspiratory crackle and expiratory grunting. Vital Signs Time 0900 0910 Temp 97F 97F HR 156 160 RR 76 76 B/P 70/35 N/A Pulse oximeter 91% on RA 90% on RA Pain 0 0 Orders: CBC with differential Metabolic panel Arterial blood gases Blood cultures  Meconium for toxicology Chest x-ray  Oxygen via hood   Laboratory Results     Lab Results Reference range ABG pH 7.25 7.35-7.45 ABG P02 58 60 -70 mm Hg ABG PC02 52 35-45 mmHg ABG SaP02 88 95-100% ABG HC03 17 22-26 mEq/L Glucose 34 40-60 mg/dl Hematocrit 53 Newborn 46-68% Hemoglobin 18 g/dl Newborn 15.2-23.6 g/dl WBC 10 9.1 – 30.1 x 103 cells/mm3 Blood type O+   Diagnostic Reports   Echocardiogram no congenital heart defect noted. Chest x-ray hypo aeration- ground glass pattern Fill in the blanks  Make sure to use the exact wording of the choices below The condition the newborn is most likely experiencing is_______________ and the focus of nursing management is ____________. Choices for 1st blank are:  Neonatal abstinence syndrome Neonatal septic shock Respiratory distress syndrome _______ Make sure to use the exact wording of the choices below Choices for 2nd blank are: supportive care early surfactant administration early identification of infection  _______