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Maternal Child & Core Concepts Exam Blueprint, Study Guides, Projects, Research of Nursing

A comprehensive overview of key concepts and test blueprint for nurs 2710 exam #4, covering topics such as fluid and electrolytes, nutrition, elimination, sleep and rest, and maternal child health. It includes detailed explanations of physiological processes, common imbalances, prevention measures, and assessment techniques. The document also highlights important aspects of maternal and child care, including family planning, prenatal care, labor and delivery, and postpartum care. It is a valuable resource for nursing students preparing for their exam.

Typology: Study Guides, Projects, Research

2023/2024

Uploaded on 10/30/2024

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NURS 2710 Concept Outcomes & Test Blueprint – Exam #4
Concepts: Fluid & Electrolytes, Nutrition, Elimination, Sleep & Rest, & Maternal Child (Weeks 12
– 16)
Concept: Fluid & Electrolytes = 15 questions
1. Differentiate between the various body fluid compartments
Intracellular (ICF)
Fluid within cells
2/3 of total body water
Potassium major intracellular ion
Found inside cells and are made up of protein, water,0electrolytes, and solutes. The
most abundant electrolyte in intracellular fluid is0potassium. Intracellular fluids are
crucial to the body’s functioning.0
Extracellular (EFC)
Fluid outside of cells
1/3 of total body water – sodium major extracellular ion
Three divisions:
Interstitial – between cells outside blood vessels
Intravascular – within vessels, blood, or plasma
Transcellular – such as CSF, pleura, synovial, etc.
Fluids found outside of cells. The most abundant0electrolyte in ECF is sodium. The
body regulates sodium levels to control the0movement of water into and out of the
extracellular space due to osmosis.0
2. Fluid can move between compartments (through selectively permeable membranes) by a
variety of methods:
Active transport – requires energy (ATP)
Diffusion – DOWN the gradient
Electrolytes & particles move from a higher concentration to a lesser concentration
(opposite Osmosis below).
Passive process that is Seeking equalization.
Osmosis – Movement of H20 only across cell membranes.
Pulls fluid into compartment that has the higher concentration (osmotic pressure)
until equalization occurs.
Isotonic, hypotonic, and hypertonic IV solutions
Filtration – hydrostatic pressure
Movement of fluid between interstitial and vascular compartments – may result in
edema
3. Describe the processes involved in regulating extracellular fluid volume, osmolarity, and fluid
distribution
Regulating extracellular fluid
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NURS 2710 Concept Outcomes & Test Blueprint – Exam # Concepts: Fluid & Electrolytes, Nutrition, Elimination, Sleep & Rest, & Maternal Child (Weeks 12

Concept: Fluid & Electrolytes = 15 questions

1. Differentiate between the various body fluid compartments

 Intracellular (ICF)

  • Fluid within cells
  • 2/3 of total body water
  • Potassium major intracellular ion
  • Found inside cells and are made up of protein, water, electrolytes, and solutes. The most abundant electrolyte in intracellular fluid is potassium. Intracellular fluids are crucial to the body’s functioning.  Extracellular (EFC)
  • Fluid outside of cells
  • 1/3 of total body water – sodium major extracellular ion
  • Three divisions:  Interstitial – between cells outside blood vessels  Intravascular – within vessels, blood, or plasma  Transcellular – such as CSF, pleura, synovial, etc.  Fluids found outside of cells. The most abundant electrolyte in ECF is sodium. The body regulates sodium levels to control the movement of water into and out of the extracellular space due to osmosis.
  1. Fluid can move between compartments (through selectively permeable membranes) by a variety of methods:  Active transport – requires energy (ATP)  Diffusion – DOWN the gradient
  • Electrolytes & particles move from a higher concentration to a lesser concentration (opposite Osmosis below).
  • Passive process that is Seeking equalization.  Osmosis – Movement of H20 only across cell membranes.
  • Pulls fluid into compartment that has the higher concentration (osmotic pressure) until equalization occurs.
  • Isotonic, hypotonic, and hypertonic IV solutions  Filtration – hydrostatic pressure
  • Movement of fluid between interstitial and vascular compartments – may result in edema
  1. Describe the processes involved in regulating extracellular fluid volume, osmolarity, and fluid distribution  Regulating extracellular fluid
  • The kidneys, in concert with neural and endocrine input, regulate the volume and osmolality of the extracellular fluid by altering the amount of sodium and water excreted. This is accomplished primarily though alterations in sodium and water reabsorption, the mechanisms of which differ within each nephron segment  Osmolarity
  • When osmolality increases, it triggers your body to make antidiuretic hormone (ADH). It's also called arginine vasopressin (AVP). This hormone tells your kidneys to keep more water inside your blood vessels and your urine becomes more concentrated. When osmolality decreases, your body doesn't make as much ADH  Fluid distribution
  • Fluid is moved by a combination of osmotic and hydrostatic pressures. The osmotic pressure results from differences in solute concentrations across cell membranes. Hydrostatic pressure results from the pressure of blood as it enters a capillary system, forcing some fluid out of the vessel into the surrounding tissues
  1. Describe common electrolyte imbalances (Sodium, Potassium, and Calcium)  Sodium (Na+)
  • Increased level  HypernatremiaCauses. Excessive salt intake  Symptoms. Lethargy, irritability, seizures, and weakness  Treatments. Rehydrate w/ D5W and increase water intake
  • Decreased level  HyponatremiaCauses. Excessive water intake and diuretics  Symptoms. Headache, confusion, coma  Treatments. 3% NS and fluid restriction  Potassium (K+) (intracellular)
  • Increased levels  HyperkalemiaCauses. Kidney dysfunction, excessive potassium intake, and ACE inhibitors  Symptoms. Cardiac arrhythmias, cramping, diarrhea, and irritability  Treatments. Limit potassium in diet, loop diuretic, insulin, dialysis, and kayexalate
  • Decreased levels  HypokalemiaCauses. Loop and thiazide diuretics and IV administration of insulin  Symptoms. Weakness, arrhythmias, lethargy, and thready pulse (WALT)  Treatments. PO/IV potassium and increase K+ in diet  Calcium (Ca++)
  • Increased levels  HypercalcemiaCauses. Overactive parathyroid glands and cancer  Symptoms. Nausea, vomiting, constipation, and thirst  Treatments. Decrease calcium in diet, increase mobility, and administer phosphorous

 Tremors  Diaphoresis  Weakness  Hunger  Headache  Irritability  Seizures  Hyperglycemia

  • State of elevated blood glucose levels, defined as more than 100 mg/dL in a fasting state or 140 mg/dL when not fasting (Severe >180)
  • Signs and symptoms  Polyuria  Polydipsia  Fatigue  Fruity odor to breath  Kussmaul breathing  Weight loss  Hunger  Poor wound healing
  1. Describe the impact of fluctuations in blood glucose  Blood glucose monitoring is performed on patients with diabetes mellitus and other conditions that cause elevated blood sugar levels.  Diabetic patients require frequent blood glucose monitoring to administer customized medication therapy to prevent long-term complications from occurring. 10.Implement intervention strategies to maintain optimal glucose control  Specimen collections from a patient’s anterior nasal cavity and nasopharynx are used to test for multiple viral illnesses such as influenza & COVID-19.  The oropharynx is the part of the throat at the back of the mouth behind the oral cavity. It includes the back third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils. When obtaining a specimen from this area, it is important to avoid the tongue and teeth 11.Identify primary and secondary prevention measures associated with optimal glucose control  Primary
  • Diet
  • Exercise
  • Weight control  Secondary
  • Screening  Laboratory tests  Hemoglobin A1c  Cholesterol  Microalbuminuria
  • Screening to detect complications  Blood pressure  Dental, foot, and eye examinations Concept: Elimination, Sleep & Rest = 7 questions
  1. Identify factors related to alterations in elimination across the lifespan

 Infants

  • Incontance  Toddles
  • Starting potty training
  • Occasional accidents  Child – Adolescent
  • Totally potty trained with no accidents  Adults
  • Might have accidents when coughing/sneezing to heard (especially women who have children)  Elderly
  • Will begin to lose their function for their bladder
  • Bowels are usually in check but will have the occasional accident due to not being about to move quick enough to get to the bathroom
  1. Detail the nonpharmacologic measures to promote urinary and bowel elimination  Urinate
  • Catheterization
  • Bladder training therapy  Bowel
  • Prunes
  • Fruits & vegetables
  • Whole grains
  • Drinking plenty of water
  • Exercise
  1. Identify factors related to sleep and rest across the lifespan  Newborn 16 hours a day  Baby 8-10 hours at night, for a total of 15 hours per day  Toddler 12 hours all together  Preschoolers 12 hours at night  Child 9-  Adolescence 7 ½  Adult 6-8 ½  Older adult total number of hours declines
  2. Recognize characteristics of sleep deprivation  Physiological disorders  Current life events  Emotional stress or mental illness  Diet  Exercise  Fatigue  Sleep environment  Medications  Substance use
  3. Consider the use of nonpharmacological measures to promote sleep and rest  Lavender oil diffuser  Low Zen music  Warm blankets

 Heart rate ◦ Accelerations ◦ Early decelerations ◦ Variable decelerations ◦ Late decelerations  Intermittent auscultation

  • MECHANISM OF LABOR  Descent – Engagement – Flexion – Internal rotation – External rotation – Expulsion
  • Labor and Birth: Four Stages & Phases  FIRST STAGE - Dilation ◦ Onset labor to complete cervix dilation ◦ Three stages: Latent, Active, Transition  SECOND STAGE - Pushing ◦ From complete dilation of cervix to birth  THIRD STAGE - Placenta ◦ Birth to delivery of placenta  FOURTH Stage - Recovery ◦ First 4 hours after childbirth; physiological and psychological adjustments ◦ Evaluating and intervening for hemorrhage & pain ◦ Observing bladder function and urine output ◦ Evaluating recovery from anesthesia ◦ Providing initial care to the newborn infant ◦ Promoting bonding and attachment between the infant and family ◦ Massage the fundus

• Passenger – Presentation

  • Assessing for postpartum depression  85% of women will experience some type of mood disturbance ◦ Postpartum blues ◦ PPD- Postpartum Depression (10-15%) ◦ Postpartum Psychosis (0.1-0.2%)  Suicide  Infanticide  Risk factors ◦ Stress, fatigue, relationship, support, pre-term, low birth weight infant, young maternal age  Child Assessment & Care
  • Initial care  Maintaining thermoregulation  Assessment (Major anomalies)  Observe the infant ◦ Cardio-respiratory ◦ Urinary ◦ Passage of meconium (stool)  Vital signs ◦ Respirations (30-60 belly breathers) ◦ Heart rate (110-160 Apical) ◦ Temperature (Temporal)

complications and deterioration. Interventions encourage maximum functioning, resource utilization, rehabilitation, and referral.

  1. Patient teaching (PP Week 6 Health Promotion)  Defined as “a process of assisting people to learn health related behaviors so that they can incorporate these behaviors into everyday life.” Giddens  Cognitive – enhances understanding
    • Includes all intellectual behaviors and requires thinking  Psychomotor – requires the patient have opportunity to touch, manipulate equipment, and practice skills
      • Integration of mental and muscular activity  Affective – intended to change attitudes
    • Deals with expression of feelings and acceptance of attitudes, opinions, or values  Major attributes of patient education
    • Identified learning needs
    • Patient motivation to learn is assessed
    • Planning is involved
    • Outcomes are directed to achieving goals
  2. Communication  TeamSTEPP
    • Is a teamwork program designed for health care professionals
    • Is an evidence-based teamwork system to improve communication and teamwork skills
    • Integrates teamwork principles into all areas of practice
    • developed by US Department of Defense’s Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality
    • Resulted in:  Observed improvement in the quality of communication/clinical handover  Improved structure of clinical handover/multidisciplinary team meetings (right person, right time, right information)  Improvement in teamwork and relationships  Improvement in patient safety culture  Role definition and clarity  Reduction in incident reports in the areas of falls, documentation, and aggression
    • Provides higher quality, safer patient care by:  Producing highly effective medical teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for patients  Increasing team awareness and clarifying team roles and Responsibilities  Resolving conflicts and improving information sharing  Eliminating barriers to quality and safety  ISBARR
    • Introduction  Who you are and what is your role? Patient identifiers (at least 3)
    • Situation  What is going on with the patient?
    • Background  What is the clinical background/context?
    • Assessment  What do I think the problem is?
    • Recommendation  What would you recommend? Risk patient/occupational health and safety? Assign and accept responsibility/accountability
    • Read back

 Read back orders when obtaining medical orders  CALL OUT

  • Used to communicate important or critical information out loud
  • Used in emergent situations
  • Helps team members anticipate next steps  CALL BACK or READ BACK
  • Closed-loop communication to ensure the information conveyed by the sender is understood by the receiver as intended  HAND OFF (I PASS THE BATON)
  • One on one conversation, it includes an opportunity to ask questions, clarify, and confirm what was said.
  • Introduction
  • Patient
  • Assessment 24. Ethics
  • Situation
  • Safety 25. Physical Health Assessment
  • THE
  • Background
  • Actions
  • Timing
  • Ownership
  • Next  Open ending question
  • Will get the patient to talk more  Close ending question
  • Answers will be “yes/no”