Clubfoot Practice Questions

The mother of a neonate with clubfoot feels guilty because she believes she did something to cause the condition. the nurse should explain that the cause of clubfoot is 1. unknown 2. always hereditary 3. due to unrestricted movement in utero 4. caused by the position of the fetus in utero

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The nurse is teaching about congenital clubfoot in infants. the nurse evaluates the teaching as successful when the parent states that clubfoot is best treated when 1. Immediately after dx 2. At age 4-6 months 3. Prior to waling (9-12 months) 4. After walking is established (15-18 months)

1 1. The best outcomes for clubfoot are seen if casting begins as soon as the diagnosis is made, usually at birth. 2. Although casting helps if started in the newborn period, the delay of even 4 to 6 months postpones the positive outcome. 3. Infants of 9 months are already pulling up to stand and taking steps. Clubfoot puts weight on surfaces of the feet that are not meant for weight-bearing. 4. Clubfoot does not allow for normal gait, and the delay will decrease the likelihood of a successful outcome. TEST-TAKING HINT: The general principle of early treatment of orthopedic problems should lead to the correct answer.

The parent of an infant dx with clubfoot asks the nurse about the casting treatment regimen. The nurse determines that further instruction is not needed when the parent states 1. The cast will be changed in 6 weeks 2. The cast will be changed in 2 weeks 3. The cast will be changed when his child starts to walk 4. The cast will be changed when his child starts to crawl

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The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state: 1."I should call if I see changes in the color of the toes under the cast." 2."I should use a pillow to elevate my child's foot as he sleeps." 3."My baby will need a series of casts to fix her foot." 4."Having a cast should not prevent me from holding my baby.

2. Elevating the extremity at different points during the day is helpful to prevent edema, but pillows should not be used in the crib because they increase the risk of sudden infant death syndrome (SIDS). A change in the color of the toes is a sign of impaired circulation and requires medical evaluation. Children typically need a series of 5 to 10 casts to correct the deformity. Infants with club feet still need frequent holding like any other newborn.

The parents of an infant born with clubfoot express feelings of guilt and anxiety about their child's condition. what is the nurses most appropriate intervention A. teach them about their child's condition B. introduce them to other parents whose children have the same condition C. ask if they would like to speak with the chaplain D. encourage discussion of their feelings

D

Which should the nurse include in the teaching plan for a child who had surgery to correct bilateral clubfeet and had the casts removed. select all that apply 1. Your child will need to wear a brace on the feet 23 hours a day for at least 2 months 2. Your child should see an orthopedic surgeon regularly until the age of 18 3. Your child will not be able to participate in sports that require a lot of running 4. Your child may have recurrence of clubfoot in a year or more 5. Most children treated for clubfeet develop feet that appear and function normally 6. Most children treated for clubfeet require surgery at puberty

1, 2, 4, 5. 1. After the final casting, bracing is required for 12 months. This decreases the likelihood of a recurrence. 2. Because clubfoot can recur, it is important to have regular follow-up with the orthopedic surgeon until age 18 years. 3. After treatment, most children are able to participate in any sport. 4. Even with proper bracing, there may be a recurrence. 5. Most children treated for clubfeet develop normally appearing and functioning feet. 6. Most children do not require surgery at puberty. TEST-TAKING HINT: If the test taker is aware that clubfoot can recur, providing instruction that includes long-term follow-up care will help in selecting answers

After the birth of an infant with clubfoot, the nursery nurse should do which when instructing the parents. select all that apply 1. Speak in simple language about the defect 2. Avoid the parents unless providing direct care so they can grieve privately 3. Keep the infants feet covered at all times 4. Present the infant as precious, emphasize well formed parts of the body 5. Tell the parents that defects could be much worse 6. Be prepared to answer questions multiple times

1, 4, 6. 1. The parents will likely be shocked immediately after the birth of the child. To facilitate their understanding, the nurse should speak in simple terms. 2. Avoiding the parents is not therapeutic. 3. The baby should be shown to the parents as are all newborns, without hiding the clubfoot. 4. The baby should be shown to the parents as are all newborns, emphasizing the well-formed parts of the body. 5. Negating the parents 'grieving is not therapeutic. 6. Information may need to be repeated as the family begins to absorb the information. TEST-TAKING HINT: The test taker can draw on therapeutic communication skills to choose correct answers.

The parent of a 3w week old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. which intervention should the nurse suggest the parent do first 1. Give pain medication 2. Reposition the infant in the crib 3. Check the neurocirculatory status of the foot 4. Use a cool blow dryer to blow into the cast to control itching

3 1. The cause of the crying needs to be determined prior to administering pain medication. 2. Although this is a good choice, it is not the first intervention 3. Checking the neurocirculatory status of the foot is the highest priority. 4. Although this is a good choice for cast discomfort, it is not the first choice. TEST-TAKING HINT: The test taker should prioritize nursing interventions and know that safety needs are paramount

After teaching the parents of an infant with clubfoot requiring application of a plaster cast how to care for the cast, which of the following statements would indicate that the parents have understood the teaching? 1."If the cast becomes soiled, we'll clean it with soap and water." 2."We'll elevate the leg with the cast on pillows, so the leg is above heart level." 3."We will check the color and temperature of the toes of the casted leg frequently." 4."The petals on the edge of the cast can be removed after the first 24 hours.

3 A cast that is too tight can cause a tourniquet effect, compromising the neurovascular integrity of the extremity. Manifestations of neurovascular impairment include pain, edema, pulselessness, coolness, altered sensation, and inability to move the distal exposed extremity. The toes of the casted extremity should be assessed frequently to evaluate for changes in neurovascular integrity. Wetting a plaster cast with water and soap softens the plaster, which may alter the cast's effectiveness. There is no reason to elevate the casted extremities when a child with clubfoot is being treated with nonsurgical measures. The legs would be elevated if swelling were present. Petals, which are applied to cover the rough edges of the cast, are to be left in place to minimize the risk for skin irritation from the cast edges.

The parents of a neonate born with congenital clubfoot express feelings of helplessness and guilt, and are exhibiting anxiety about how the neonate will be treated. Which of the following actions by the nurse would be most appropriate initially? 1.Ask them to share these concerns with the primary care provider. 2.Arrange a meeting with other parents whose infants have had successful clubfoot treatment. 3.Discuss the problem with the parents and the current feelings that they are experiencing. 4.Suggest that they make an appointment to talk things over with a counselor.

3. When an infant is born with an unexpected anomaly, parents are faced with questions, uncertainties, and possible disappointments. They may feel inadequate, helpless, and anxious. The nurse can help the parents initially by assessing their concerns and providing appropriate information to help them clarify or resolve the immediate problems. Referring the parents to the primary health care provider is not necessary at this time. The nurse can assist the parents by listening to their concerns. Having them talk with other parents would be helpful a little bit later, once the nurse assesses their concerns and discusses the problem and the parents' current feelings. If the parents continue to have difficulties expressing and working through their feelings, referral to a counselor would be appropriate.

A child is allowed full activity following the repair of a clubfoot. Which activity would be most helpful for this child 1. Playing catch 2. Standing 3. Swimming 4. Walking

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