Procedures and Care - NCLEX-PN

An infant begins to show signs of anxiety toward strangers between 8 and 12 months of age and may recur until two years of age. This anxiety can show as silence, staring, writhing or crying in the presence of people they don't know.

Object permanence is the understanding that an object still exists even when it can not be seen, heard, or touched. It is often tested by placing an object on a surface, then covering that object and allowing the infant to attempt to uncover it, thus demonstrating a knowledge that the object remains present though it is hidden.

The grasping reflex is the earliest reflex developed by the infant. It is often present at birth: the infant will grasp at objects such as a finger placed into their open palm.

The inferior pincer grasp is the ability to pick up small objects such as by resting the forearm on a surface and pinching using the sides of the thumb and the index finger. It is an important milestone in the development of fine motor skills.

The "grimace" category of the APGAR score actually refers to a wide variety of reflexive behavior. These include sneezing and coughing, crying on stimulation, pulling away, and facial expression.

The APGAR score is calculated one minute after birth, and then again at five minutes after birth. It is common for infants to be born with depressed respiration, cyanosis, and other physical signs of struggle that are quickly resolved within five minutes after birth. If signs of respiratory or cardiovascular distress do not improve by this time, however, emergency intervention may be required.

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.

Pulsatilla is most often given for otitis media when the child is clingy, weepy, refuses fluids, and wants to be held or carried. They may be hot or sensitive to heat and desire fresh air. Belladonna may be used as a pain reliever, and and anti-inflammatory remedy. Arsenicum album is commonly used to treat anxiety and gastrointestinal inflammation. Sepia is most often used to treat female reproductive-related ailments.

Hypericum perforatum (St. John's wort) has shown significant antiviral activity against a wide variety of of enveloped viruses and retroviruses. Melissa officinalis (lemon balm) and a_vena sativa_ (milky oat seeds) are both better known for their sedative effects, and c_rategus spp_ (hawthorne) is used as an antiarrhythmic and mitigates oxidative stress in cardiomyopathies.

Uva-ursi contains the hydroquinone glycosides arbutin and methylarbutin, both of which have shown significant antimicrobial effects in the urinary tract. The other constituents listed have no effect on urinary infections.

Yawning, cramps, and diarrhea are common signs of heroin withdrawal.

Anxiety, nausea, and vomiting are common symptoms of opium withdrawal.

A urinalysis can be an important tool in diagnosis conditions such as the presence of kidney stones, urinary tract infection and even dehydration. A typical urinalysis will contain information on all of the parameters indicated. The presence of glucose, ketones, crystals, casts, and leukocyte esterase may also be included.

A BMP is a commonly ordered lab value set on patients. It checks commonly reported electrolytes in the body. It is also known as a Chem-7. It looks at: Sodium, potassium, carbon dioxide, bicarbonate, blood urea nitrogen (BUN), creatinine, and glucose. Phosphorous is not included in this laboratory order, and must be checked separately.

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.