Ch. 22 PrepU Peds

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note? The posterior spine when bending sideways The angle of the lower chest when sitting down The posterior spine when bending forward The angle of the iliac crest when bending forward

The posterior spine when bending forward

The nurse is caring for a child admitted with possible Legg-Calvé-Perthes disease. Which assessment question should the nurse ask the child's caregivers to help support this diagnosis? Are your child's knees every swollen and red?" "Does your child report pain in the groin that results in a limp?" "Does your child have difficulty standing or walking?" "Have you ever been told your child has any malformed vertebrae?"

"Does your child report pain in the groin that results in a limp?"

A nurse is assisting the parents of a child who requires a Pavlik harness. The parents are apprehensive about how to care for their baby. The nurse should stress which teaching point? "It is important that the harness be worn continuously." "The harness does not hurt the baby." "Let me teach you how to make appropriate adjustments to the harness." "The baby needs the harness only for 2 to 3 weeks."

"It is important that the harness be worn continuously."

The nurse is assessing an infant at a well-check visit. The infant's parent expresses worry about the infant's feet because they are so flat and wide. What is the most appropriate response by the nurse? "Your baby's feet are normal. The longitudinal arch will develop after your baby walks for several months." "I will notify the primary health care provider to see if additional testing is needed for your baby." "There is no need to worry about your baby's feet because they will change as your child grows." "We will continue to assess your baby's feet, but this probably indicates your baby will have a relatively flat foot."

"Your baby's feet are normal. The longitudinal arch will develop after your baby walks for several months."

Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele? Nausea and vomiting often follow repair of the cystic mass. Pain will interfere with the feeding process. The infant will have a poor sucking reflex. Assuming the usual feeding position will be difficult.

Assuming the usual feeding position will be difficult.

The nurse is assessing a child with spina bifida occulta. During the assessment, the parents say, "It's going to be so difficult taking care of our child. He'll never be able to walk." The nurse identifies which nursing diagnosis as the priority? Risk for injury related to lack of muscle control Ineffective coping related to diagnosis of chronic condition Impaired physical mobility related to spinal cord defect Deficient knowledge related to diagnosis and condition

Deficient knowledge related to diagnosis and condition

A nurse who is discussing Duchenne muscular dystrophy characterizes it correctly using which descriptors? Duchenne muscular dystrophy is a nonprogressive disorder that severely affects muscle function through spinal cord atrophy. Duchenne muscular dystrophy causes progressive muscular weakness that ends in death. Duchenne muscular dystrophy is a progressive disease of muscles and nerves that affects males and females equally. Duchenne muscular dystrophy is diagnosed in boys who develop gait changes during the late school-age years.

Duchenne muscular dystrophy causes progressive muscular weakness that ends in death.

A parent brings an 18-month-old child to the pediatrician's office for a well-child visit. The child has mild cerebral palsy that affects the child's gait. The nurse wants to assess the child's neuromuscular system. What is the best way for the nurse to make that assessment? Ask the parent to describe the child's development. Get down to the child's level and interact with the child. Quietly observe the child at play while interviewing the parent. Review the child's health history to determine if the child is on track developmentally.

Quietly observe the child at play while interviewing the parent.

The nurse is diligent to provide necessary care to each child. What major role do nurses help provide in the care of nearly all children with neuromuscular disorders? coordinating care with specialists consoling parents teaching children self-care helping with specialized equipment

coordinating care with specialists

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child: cannot plantarflex his foot. feels increasing severe pain. has a weak femoral pulse. has blue-looking nail beds on the toes.

feels increasing severe pain.

A 3-month-old infant is seen in the pediatric clinic. The infant's parent expresses concern that the child has developed cerebral palsy. The nurse assesses the infant. Which assessment finding indicates to the nurse that the parent's concern is valid? turns head toward sounds hypertonia in the upper extremities exhibits Gower sign unable to sit without support

hypertonia in the upper extremities

An infant with a femur fracture is placed in Bryant traction. What would the nurse include in the infant's plan of care? keeping the buttocks slightly elevated. wrapping the bandages from the ankle to the knee removing the traction boot every 8 hours provide range of motion to the unaffected extremity

keeping the buttocks slightly elevated.

When a child is suspected of having muscular dystrophy, a nurse should expect which muscles to be affected first? muscles of the foot muscles of the hip muscles of respiration muscles of the hand

muscles of the hip

The nurse is caring for a 2-year-old boy with cerebral palsy (CP). The medical record indicates "hypertonicity and permanent contractures affecting both extremities on one side." Based on these findings, the nurse identifies this type of CP as: athetoid or dyskinetic. mixed. spastic. ataxic.

spastic.

The nurse is caring for a child diagnosed with Duchenne muscular dystrophy and notes the presence of a Gower sign on the assessment form. What action by the child would support this assessment? the presence of a waddling gait and difficulty climbing stairs when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand a short heel cord caused by walking on the toes meeting motor milestones such as sitting, walking, and standing but at a later age than the average child

when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand