pg. 1 NURS 643 Final Exam/ Nurs 643 Exam Questions with Correct Verified Answers/ Latest Version 2024.
What is the most common craniofacial abnormality? - Correct Answer - Cleft lip
What is a cleft lip and palate? - Correct Answer - Incomplete fusion of embryonic soft tissue and/or palatal arch
What environmental factors can cause cleft lip/palate? - Correct Answer - smoking phenytoin (Dilantin)
Cheiloplasty - Correct Answer - Cleft lip repair: 10 week old infant or when patient is 10lb (4 kg)
Staphylorrhaphy - Correct Answer - Cleft palate repair: closed within 1 year to avoid speech difficulties.Appliances, surgeries plus long-term therapies
Cleft Complications - Correct Answer - Failure to gain weight feeding problems misaligned teeth poor growth recurrent ear infections speech difficulties
Cleft: feeding difficulties - Correct Answer - flow of milk through the nasal passages
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pg. 2 tracheoesophageal fistula - Correct Answer - abnormal passageway pertaining to the trachea and esophagus
tracheoesophageal atresia - Correct Answer - Failure of the esophagus to connect to the stomach
TEF / EA History - Correct Answer - Polyhydramnios (increase amniotic fluid) Inability to pass NG tube during resuscitation
TEF /EA Physical Exam - Correct Answer - •Frothy saliva, drooling •Coughing, choking, reflux through nose, cyanosis during feedings •Spitting and vomiting
What is a concern with TEF /EA? - Correct Answer - •aspiration of feedings •aspiration pneumonia
TEF / EA Diagnostic studies - Correct Answer - Chest and abdominal films Water soluble films NG tube
What would you expect to happen if you placed an NG tube in an infant with TEF /EA? - Correct Answer - The tube will be coiled in the thoracic region
What is a water soluble film? - Correct Answer - evaluates the upper esophagus showing the exact location of the atresia and rules out TEF
TEF / EA Differential diagnosis - Correct Answer - > RDS > Meconium Aspiration > Congenital Heart Disease > VACTERL Syndrome: Vertebral/ Anal/ Cardiac/ Tracheal/ Esophageal/ Renal / Limb
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pg. 3 What is the most common cause of GI bleeding in children? - Correct Answer - Meckel's Diverticulum - bright red and rectal bleeding, no pain
Meckel's Diverticulum: Diagnosis - Correct Answer - Hemoccult positive, CBC (anemia), plain films not helpful, Scintigraphy(radioactive tracer) will show a "hot spot", Nuclear scan will detect gastric tissue
Meckel's Diverticulum: Treatment - Correct Answer - Stabilization, surgical referral, administration of broad-spectrum antibiotics both prior to surgery and perioperatively.
Meckel's Diverticulum: Rule of two - Correct Answer - estimated to be present in 2% of the population About 2% of the affected population presents with clinical findings typically before age 2 years The condition is two times more common in males than females.
Meckel's Diverticulum: Complications - Correct Answer - Inflammation ->
Obstruction (intussusception or volvulus) -> Painless hematochezia -> stools can be dark maroon, right red, or tarry -> occasional infacrtion ->
What is an Intussusception? - Correct Answer - intestinal obstruction: a portion of the intestine sleeves over another portion (telescoping) - cuts off circulation to tissue
Reducible intusseception - Correct Answer - Often ileum into cecum into colon
Non-reducible intussception - Correct Answer - colon into cecum into ileum
Intussusception manifestation: when does it most often occur? - Correct Answer - •50% occur in 3-12 month olds, 50% in 1-2 year olds
Intussusception manifestation: Pain - Correct Answer - •Episodes of acute abdominal pain with intervals of no pain
Intussusception manifestation: GI S/S - Correct Answer - •Vomiting
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