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Friday, March 20, 2009

NCLEX PASS Board Preparation for Nurses

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Parental anxiety is expected related to the care of the infant with erythroblastosis fetalis. This anxiety is caused by a lack of knowledge regarding the disease process, treatments, and expected outcomes. Parents need to be encouraged to verbalize concerns and participate in care as appropriate. The nurse would not tell the parents “not to worry” or “not to be concerned.”

Diabetic teenagers are at risk for depression and suicide (self-destructive thoughts), which is frequently manifested by changing insulin and eating patterns. Social isolation is another indicator.

Intrauterine Fetal Death Demise (IUFD) is the death of a fetus that occurs for no apparent reason in a normal, uncomplicated pregnancy.

Reflection is the therapeutic communication technique that redirects the client’s feelings back in order to validate what the client is saying.

The therapeutic statement is the one that facilitates the client to explore his situation and to express his feelings. Reflection, by verbalizing to the client that the nurse feels he is experiencing a troubled or difficult time, is empathic and will assist the client to begin to ventilate. As the client begins to ventilate, the nurse can assist the client to discuss the reasons behind alienation from his only child.

chalasia - relaxation of a bodily opening, such as the cardiac sphincter (a cause of vomiting in infants).

One of the nursing diagnoses for the parents of a high-risk neonate, such as a preterm SGA infant, is risk for impaired parenting. Parent-infant bonding is affected if the infant does not exhibit normal newborn characteristics.

The mother of an LGA infant with facial bruising may be reluctant to interact with the infant because of concern about causing additional pain to the infant. The bruising is temporary.

The developmental task of the school-aged child is industry versus inferiority. The child achieves success by mastering skills and knowledge. Maintaining school work provides for accomplishment and prevents feelings of inferiority from lagging behind the class.

The definition of Ineffective Coping is the “state in which an individual demonstrates impaired adaptive behaviors and problem-solving abilities in meeting life’s demands and roles.” By displacing feelings onto the environment instead of in a constructive fashion, this nursing diagnosis clearly applies in this situation.

Parents’ involvement through touch and voice establishes and initiates the bonding process in the parent-infant relationship.

The temporary or permanent thinning or loss of hair, known as alopecia, is common in clients with cancer receiving chemotherapy. This often causes a body image disturbance that can be easily addressed by the use of wigs, hats, or scarves.

Permanent TPN is indicated for clients who can no longer absorb nutrients via the enteral route. These clients will no longer take nutrition orally.

Anticipatory grieving is the intellectual and emotional responses and behaviors by which individuals and families work through the process of modifying self-concept based on the perception of potential loss. Defining characteristics include expressions of sorrow and distress at potential loss. Dysfunctional grieving or impaired adjustment are abnormal responses to changes in health status. The nursing diagnosis of disabled family coping is used when a usually supportive person is providing insufficient, ineffective, or compromised support, comfort, assistance, or encouragement.

Mutism is the absence of verbal speech. The client does not communicate verbally, despite an intact physical structural ability to speak. Pressured speech refers to rapidity of speech reflecting the client’s racing thoughts. Verbigeration is the purposeless repetition of words or phrases. Poverty of speech means diminished amounts of speech or monotonic replies.

Repetition of words or phrases that are similar in sound and in no other way (rhyming) is one altered thought and language pattern seen in schizophrenia. Clang associations often take the form of rhyming. Loosened associations occur when the individual speaks with frequent changes of subject, and the content is only obliquely related. Echolalia is the involuntary parrot-like repetition of words spoken by others. Word salad is the use of words with no apparent meaning attached to them or to their relationship to one another.

A client with Graves’ disease may become irritable, nervous, or depressed. The signs and symptoms in the question support the nursing diagnosis of ineffective coping.

It is normal for clients who experience thyroid storm (hyperthyroidism) to continue to be anxious and emotionally labile at the time of discharge.

When a client has a central line placed in the subclavian area, the client is able to move as tolerated with no restriction of movement. The client may have pain when the catheter is placed, but the pain will not last continuously. The client may, however, be self-conscious about the intravenous line, disturbing body image.

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