Procedures and Care - NCLEX-PN

While vitamin deficiencies, lack of sleep, and social stresses can all contribute to depressed mood after giving birth, the primary cause of postpartum depression is an extreme drop in hormones (primarily estrogen and progesterone) that occurs after delivery of the placenta.

Molding, or the elongation of the infants head during labor and delivery, is a normal adaptation allowing the relatively large skull to traverse the narrow space of the birth canal. It generally resolves in 1-5 days.

Meconium is a sticky, dark-green to black stool that is the first stool passed by neonates after birth. It is composed of the content of the infant's digestive tract before it has begun drinking milk - primarily water, mucus, bile, lanugo, and intestinal epithelial cells. A newborn that has begun to feed on breastmilk or formula should pass a normal stool (yellow to mustard-green and creamy rather than sticky) within 24 hours.

A nurse should expect to see an approximately 3% increase in the recipient's hemoglobin 4-6 hours after the administration of one unit of packed red blood cells.

Washed red blood cells are the product of blood that has been stripped of plasma, leukocytes, antibodies, cytokines, and platelets, in addition to any other blood proteins.

Washed red blood cells are generally prepared for patients with a history of severe allergic reaction to blood transfusion. Washed red blood cells are not generally required in patients with kidney disease, patient who are immunocompromised, or patients with metastatic disease.

Before administration, plasma products must be checked for ABO compatibility and Rh compatibility.

ABO blood type does not have to be an exact match, but blood types must be compatible. An Rh positive individual, for example, is compatible with either Rh negative blood or positive blood, while an Rh negative individual is only compatible with Rh negative blood.

Whenever possible, fresh frozen plasma should be transfused immediately (or as soon as possible) after thawing. However, if this is not possible, it may be refrigerated for as long as 24 hours after thawing.

Common signs of transfusion reaction include urticaria, itching, or swelling, pallor or cyanosis, anxiety, and myalgia, tingling, or numbness, in addition to diaphoresis, tachycardia, headache, and gastrointestinal distress.

Normal heart rate for a child aged 6-12 is 70-120 bpm. This is moderately higher than normal heart rate for an adult, which is 60-100 bpm.

Tachycardia is the term used to describe a faster than normal heart rate. A heart rate of more than 100 beats per minute is considered tachycardic. Bradycardia is used to describe a slower than normal heart rate. Less than 60 beats per minute is considered bradycardia.

When a patient has an infection and is prescribed antibiotics, the patient should always take the full course of the medication and never discontinue the medication. It is easy for patients to believe they can stop taking the medication when the symptoms are resolved, but the nurse needs to educate the patient to continue the full regimen. The rest of the statements are accurate; the patient must get adequate rest, eat well, use the incentive spirometer, and stay away from others who are sick until he is well.

The most likely cause of his symptoms is hypoglycemia, which is defined as a blood glucose below in a non-diabetic patient. The symptoms of hypoglycemia include altered consciousness, tremors, weakness, vertigo, headaches, heart palpitations, and a bounding pulse.

A temperature of is not considered abnormal as it may reflect a normal variation in body temperature.

His blood pressure is slightly elevated, but it is unclear whether this is typical for him or whether this represents a significant change from his normal blood pressure. Regardless it would not likely be sufficiently elevated to cause his symptoms.

It is also possible he may be experiencing a panic attack, but in the presence of his depressed blood sugar (and absence of signs of anxiety), hypoglycemia is the most likely cause of his symptoms.

Abdominal rigidity and decreased bowel sounds are classic signs of peritontis. In addition, the patient will often want to lie very still, as any motion often increases pain. Cystitis, ulcerative colitis, and cholecystitis all may cause significant abdominal tenderness but would not generally result in rigidity or decreased bowel sounds.

Blind finger sweeps are not recommended in an infant with airway restriction due to a foreign object because they may inadvertently force the object deeper into the airway. A finger sweep should only be used if the object can be visualized. Injury to the oral cavity would not be a primary concern in the case of airway restriction, and a finger sweep would not be expected to trigger either gasping or vomiting in an infant.

The four main categories of shock are as follows:

• Cardiogenic: Sudden inability of the heart to pump sufficient blood to the body, most commonly due to acute myocardial infarction.
• Hypovolemic: Due to loss of fluids or hemorrhage.
• Septic: Also known as endotoxic shock. Dangerously low blood pressure as the result of systemic inflammatory response to infection.
• Anaphylactic: Systemic inflammatory response to an allergen.

Varicella requires airborne precautions. Staff caring for patients with varicella should be immune. One's immunity to varicella can be confirmed by a blood test.

Standard precautions should be utilized in the care of every patient. Hand hygiene before and after patient contact is always required. Clean, functioning, equipment should always be available. The use of personal protective gear when there is potential to blood or bodily fluid exposure is critical. This includes the proper disposal of soiled materials such as linens. However, it is not necessary for patients to be housed in private rooms unless they are affected by an infectious disease. If private rooms for infectious individuals are unavailable, it is acceptable to place patients in cohorts of the same infectious disease.

Red yeast rice contains monacolins, which block the production of cholesterol. Monacolin K has the same structure as lovastatin and functions similarly to reduce cholesterol. Nettle is best used as a painkiller, and to treat disorders of the excretory system. Kava is a sedative and anesthetic, and may also be used to treat social anxiety. Lavender has a calming effect, and is effective in inducing sleep.

The normal range for hemoglobin in an adult female is . Hemoglobin levels above that range may be indicative of chronic low blood oxygen, while lower levels of hemoglobin are seen in anemia.