Ch.27 PrepU

The nurse is speaking with the parents of a child who has a cast. The parents state that the child reports itching in the area of the cast. What is the best response by the nurse? "A small amount of lotion or baby oil can be poured in the cast to moisturize the area." "You can put a pencil or coat hanger and scratch the area but don't let your child put anything down the cast without you there." "Itching is common. It's nothing to worry about." "Blowing cool air with a fan or hair dryer may relieve the feeling."

"Blowing cool air with a fan or hair dryer may relieve the feeling."

The nurse has completed client education with the parents of a child with a femur fracture. Which statement by a parent indicates successful education? "My child is at risk for abnormal growth of the leg because the break is in the outer layer of the bone." "Breaks that happen between the rounded end and the central shaft of the bone can cause growth issues in the future." "Since her fracture is in the central shaft of her leg, it may interfere with the growth of that leg." "Injuries that happen at the end of the bone, the epiphysis, are at a greater risk for becoming infected."

"Breaks that happen between the rounded end and the central shaft of the bone can cause growth issues in the future."

An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals? "It is important to correct spinal curvature before it gets too bad, causing you problems." "It is important to prevent torticollis." "It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms." "It is important to prevent herniation of a spinal disk, which is painful."

"It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms."

The nurse is caring for an 8-year-old child in traction. The client has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. The client is showing signs of regression with thumb sucking and pleas for the now tattered baby blanket. What would be the most helpful intervention? "Do you want a book to read?" "Would you like a coloring book?" "You are too big to suck your thumb." "Let's ask your parents to bring your friends for a visit."

"Let's ask your parents to bring your friends for a visit."

A child and mother come into the orthopedic clinic. The mother is concerned about her child who has recently been diagnosed with scoliosis. The mother asks about surgical treatment and if it will be necessary. The nurse bases her response on knowledge that surgery is implicated for curvatures greater than: 25 degrees. 20 to 25 degrees. 40 degrees. 25 to 30 degrees.

40 degrees.

The nurse is caring for an extremely active 13-year-old adolescent who has recently been prescribed a back brace to treat scoliosis. Which intervention will be most critical to the success of treatment? Emphasize and encourage compliance related to the use of a back brace. Show the adolescent how the brace works and when to wear it. Teach the parents about the disease and its treatment. Ask for the adolescent's feelings about being in a brace.

Emphasize and encourage compliance related to the use of a back brace.

In caring for a child being treated for scoliosis, the highest priority goal is which of the following? The child will verbalize acceptance of the treatment. The child's skin integrity will be maintained. The child will participate in age-appropriate activities. The child will remain free of injury.

The child will remain free of injury.

Which client would be the most likely person to be diagnosed with idiopathic scoliosis that requires treatment? a young adolescent female a school-age female a school-age male a teenage male

a young adolescent female

A nurse is performing a physical assessment of the musculoskeletal system of 5-year-old Manuel. Which of the following is a recommended assessment technique appropriate for this client? palpate the arms from the shoulders to the fingers. assess Manuel while he sits in his parent's lap. assess range of motion (ROM) of his head to check for torticollis. assess Manuel's hips for any dislocations.

assess Manuel while he sits in his parent's lap.

An adolescent wears a body brace for scoliosis. Which client education should the nurse provide? to wear the brace a maximum of 20 hours each day to continue with age-appropriate activities to stand absolutely still when not wearing the brace that secondary sex changes will stop until the brace is removed

to continue with age-appropriate activities

A nurse is conducting an in-service program for a group of pediatric nurses about pediatric rehabilitation and habilitation. When describing the differences between pediatric and adult services, which of the following would the nurse identify as the primary difference? Adult rehabilitation focuses on attaining skills previously unknown. Children most often need rehabilitation due to an injury. Children have strong experiential bases on which to build. Adults have reached a level of physical and mental maturity.

Adults have reached a level of physical and mental maturity.

Maria is a 9-month-old whose babysitter brings her to the emergency department. An x-ray shows a spiral fracture of the femur. The babysitter tells the nurse that she found the infant in this condition when she showed up to watch her an hour ago. Which of the following would be most appropriate for the nurse to do? Call social services to find the parents and evaluate them for child abuse. Ask the babysitter to advocate for the child and report the incident to the authorities. Evaluate the child for an underlying musculoskeletal disorder. Arrange for the parents to come in for an evaluation for possible physical abuse.

Arrange for the parents to come in for an evaluation for possible physical abuse.

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: has a weak femoral pulse. has blue-looking nail beds on the toes. feels increasing severe pain. cannot plantarflex his foot.

feels increasing severe pain.

A preadolescent girl with scoliosis is prescribed a body brace. What should the nurse teach the child about the purpose of the brace? corrects existing spinal curvature prevents torticollis improves spinal stability prevents herniation of a spinal disk

improves spinal stability

The client is a 9-month-old whose babysitter brings her to the ER. An x-ray shows a spiral fracture of the femur. The babysitter tells the nurse that she found the infant in this condition when she showed up to watch her an hour ago. How should the nurse respond to this situation? Evaluate the child for a seizure disorder, as that is probably why the infant is injured. Ask the babysitter to advocate for the child and report the incident to the authorities. Arrange for the parents to come in for an evaluation for possible physical abuse. Evaluate the infant for an underlying musculoskeletal disorder.

Arrange for the parents to come in for an evaluation for possible physical abuse.

The nurse is talking with the caregiver of a 13-year-old diagnosed with scoliosis. The child has come to the clinic to be fitted with a brace to begin her treatment. The child appears upset and angry and states, "I hate this brace; I hate it already." In an effort to support this child, which statement would be the most appropriate for the nurse to make to this child's caregiver? "Take your daughter to an oncology floor for a few minutes so she can see children who are much sicker than she is." "Children her age often withdraw during stressful times; let her have some time alone to think about the situation and to get used to the brace." "Remind your child that her spine needs to be corrected in order to keep her whole musculoskeletal system healthy for a long, long time." "If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."

"If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."