ex 3 PED chapter 22
A parent calls the clinic nurse to say the child has shin splints after playing soccer. What instructions should the nurse provide this parent? "Applying ice to the area will reduce the pain and swelling." "Apply ice to the injury for 60 minutes on and 60 minutes off." "Elevate the legs, and use bed rest for 24 hours." "Taking warm baths will help relax muscles and reduce pain."
"Applying ice to the area will reduce the pain and swelling."
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? "Itching is common. It's nothing to worry about." "Blowing cool air with a fan or hair dryer may relieve the feeling." "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." "A small amount of lotion or baby oil can be poured in the cast to moisturize the area."
"Blowing cool air with a fan or hair dryer may relieve the feeling."
The parents of a infant born with an abnormality on the back are told by the neonatologist that their child has a myelomeningocele. They ask the nurse what exactly that means. Which would be the nurse's best reply? "It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved." "The contents of the sac you see only has fluid in it and should cause the child no problem." "Your child's defect involves only the nerves to the bladder and bowel and can be easily repaired." "The sac is a very small cyst and should resolve within the first year of life."
"It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved."
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 wear the brace now to stabilize your spinal alignment, decreasing your symptoms." "It is important to correct spinal curvature before it gets too bad, causing you problems." "It is important to prevent herniation of a spinal disk, which is painful." "It is important to prevent torticollis."
"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? "Let's ask your parents to bring your friends for a visit." "Would you like a coloring book?" "You are too big to suck your thumb." "Do you want a book to read?"
"Let's ask your parents to bring your friends for a visit."
A nurse is caring for an adolescent who is having a plaster cast applied. When the plaster strips are applied, the adolescent complains of it feeling hot. What is the best response by the nurse? "When the strips start to dry, they can get warm, but they won't burn you." "That is a normal feeling when casts are applied." "Your temperature may be going up. I'll check it when they are done applying the cast." "That is unusual. Most people complain of feeling cold."
"When the strips start to dry, they can get warm, but they won't burn you."
The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? a. "I will help you become comfortable in caring for your daughter." b. "You must learn how to care for your daughter at home." c. "You will need to learn to collaborate with all the caregivers." d. "There is a lot to learn, and you need a positive attitude."
A
The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? a. "If you wear your brace properly, you may not need surgery." b. "The good news is that you have very minimal curvature of your spine." c. "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." d. "Let's talk to the healthcare provider about your treatment options."
ANS: C Feedback:
The nurse is caring for a 6-year-old boy with Russell traction applied to his left leg. Which intervention would be most appropriate to prevent complications? Assess the popliteal region carefully for skin breakdown. Adjust the weights as needed. Clean and massage his entire leg daily. Provide pin care as needed.
Assess the popliteal region carefully for skin breakdown.
The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions? Encourage child to stifle cough and take shallow breaths to prevent ineffective breathing patterns. Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion. Check for a normal capillary refill of 3 to 5 seconds on a daily basis to ensure there in adequate arterial supply. Give the client large, frequent meals with decreased fiber and increased protein and Vitamin C.
Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.
The pediatric nurse practitioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this? The boy has a large tan skin lesion on his torso. Severe lordosis is evident in the lumbar spine. The head is held tilted with limited side-to-side motion. The boy rises from the floor by walking his hands up his legs.
The boy rises from the floor by walking his hands up his legs.
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 forward The angle of the iliac crest when bending forward The posterior spine when bending sideways The angle of the lower chest when sitting down
The posterior spine when bending forward
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? A. the presence of a waddling gait and difficulty climbing stairs. B. a short heel cord caused by walking on the toes C. meeting motor milestones such as sitting, walking, and standing but at a later age than the average child D. when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand
d. when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand
A type of traction sometimes used in the treatment of the child with scoliosis is called: Russell traction. halo traction. Bryant traction. Dunlop traction.
halo traction. Metal halo attached to skull via pins. Used for cervical or high thoracic vertebrae fracture or dislocation and for postoperative immobilization following cervical fusion.
Which condition would alert the nurse that a child may be suffering from muscular dystrophy? hypertonia of extremities increased lumbar lordosis upper extremity spasticity hyperactive lower extremity reflexes
increased lumbar lordosis
The nurse caring for a client with suspected muscular dystrophy would prepare her client for which diagnostic test? X-ray muscle biopsy EEG assessment of ambulation
muscle biopsy Muscle biopsy provides definitive diagnosis of muscular dystrophy demonstrating the absence of dystrophin. X-ray is best for identifying an osseous deformity. Ambulation assessment alone wouldn't confirm diagnosis of this client's disorder. EEG wouldn't be appropriate in this case.
Based on knowledge of the progression of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first? breathing sitting standing swallowing
standing Muscular dystrophy usually affects postural muscles of the hip and shoulder first. Swallowing and breathing are usually affected last. Sitting may be affected, but a client would have difficulty standing before having difficulty sitting.
An adolescent wears a body brace for scoliosis. Which client education should the nurse provide? to continue with age-appropriate activities to stand absolutely still when not wearing the brace to wear the brace a maximum of 20 hours each day that secondary sex changes will stop until the brace is removed
to continue with age-appropriate activities
The nurse is caring for a child who has a hip spica cast. The child's mother asks why is there a hole cut in it. What is the best response by the nurse? "The hole is called a window. It allows us to assess the incision on the hip." "The window allows us to assess bowel sounds and helps to prevent abdominal distention." "The hole is called a window. They put them in areas where the hard cast isn't needed." "The window helps to prevent a complication called compartment syndrome from happening."
"The window allows us to assess bowel sounds and helps to prevent abdominal distention."
A nurse is providing care to parents whose infant has been diagnosed with spinal muscular atrophy (SMA) type 1. The parents ask the nurse to explain what this diagnosis means for their child long term. Which statement should the nurse include in the explanation? This is an autosomal dominant disorder that affects motor and cognitive development. The slow progression of the disorder will allow the infant to have a fairly normal childhood. Muscular wasting results in generalized immobility and difficulty feeding and breathing. Intense physical therapy can aide the infant in learning to sit and walk independently.
Muscular wasting results in generalized immobility and difficulty feeding and breathing.
Which client would be the most likely person to be diagnosed with idiopathic scoliosis that requires treatment? a school-age female a teenage male a school-age male a young adolescent female
a young adolescent female
An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurses approach should include: a. Answering questions with straightforward honesty. b. Avoiding discussing the seriousness of the condition. c. Explaining that, although the amputation is difficult, it will cure the cancer. d. Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy.
a. Answering questions with straightforward honesty.
25. When infants are seen for fractures, which nursing intervention is a priority? a. No intervention is necessary. It is not uncommon for infants to fracture bones. b. Assess the familys safety practices. Fractures in infants usually result from falls. c. Assess for child abuse. Fractures in infants are often nonaccidental. d. Assess for genetic factors.
c. Assess for child abuse. Fractures in infants are often nonaccidental.
After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance? a. Limb-girdle b. Myotonic c. Distal d. Duchenne
d. Duchenne
young child with Duchenne muscular dystrophy is placed on both prednisone and calcium. Parents view these two medications as rather "common" and question their importance for the child. What explanation by the nurse will be most helpful to the parents? "Prednisone helps to keep muscle fibers strong and delays progression of the disease. Calcium protects against osteoporosis caused by both prednisone and lack of weight bearing." "Prednisone will help protect his vulnerable respiratory tract from developing reactive airway disease. Calcium is needed to guard against muscle cramping." "Prednisone will protect against nerve inflammation in his hips and legs. Calcium is necessary should dietary intake be insufficient to meet growth needs." "Prednisone will stimulate weight gain and appetite. Calcium is needed to ensure adequate supplies for the development of permanent teeth."
"Prednisone helps to keep muscle fibers strong and delays progression of the disease. Calcium protects against osteoporosis caused by both prednisone and lack of weight bearing."
After teaching the parents of a 6-year-old child about caring for a sprained wrist, which statement by the parents indicates the need for additional teaching? "We'll apply a warm moist compress to the wrist for 20 minutes at a time." "We can wrap the wrist in an elastic bandage to help reduce the swelling." "We'll make sure she keeps her arm above heart level." "She'll need to limit any activity that involves the wrist."
"We'll apply a warm moist compress to the wrist for 20 minutes at a time." Explanation: Care for a sprain includes rest, ice, compression, and elevation. Cold therapy, not heat, is used for 20 to 30 minutes at a time, then removed for 1 hour and repeated for the first 24 to 48 hours. Compression via an elastic bandage, elevating above heart level, and limiting activity are appropriate measures.
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse (child mistreatment) in which situation? A 10-year-old with a simple fracture of the femur, which the caregiver reports as having been caused when the child fell down a set of stairs. A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate. A 9-year-old with a compound fracture of the tibia, which the caregiver reports as having been caused when the child attempted a flip on a skateboard. A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports as having been caused when the child fell while ice-skating.
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
A nurse is performing a physical examination of a child with a suspected fracture. Which assessment technique would the nurse assume would not be used? Auscultation Palpation Inspection Observation
Auscultation
A child is born with clubfoot (congenital talipes equinovarus). The child later receives a cast on the affected leg to correct the problem. Which measure should the nurse mention to the mother to ensure good circulation in the affected leg? Apply Denis Browne splints to the infant each night. Perform passive foot exercises. Check the infant's toes for coldness or blueness. Change the infant's diapers frequently.
Check the infant's toes for coldness or blueness.
The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy? Gowers sign appearance of smaller than normal calf muscles indications of hydrocephalus lordosis
Gowers sign
What methods can a nurse use to evaluate extremity function in an 18-month-old? Select all that apply. Ask the child to squeeze the nurse's fingers simultaneously. Observe the child in developmentally appropriate play. Elicit from the parent a description of fine and gross motor activities. Have the child push against resistance with both feet. Look for symmetric motion in the arms and legs.
Observe the child in developmentally appropriate play. Elicit from the parent a description of fine and gross motor activities. Look for symmetric motion in the arms and legs.
Which nursing diagnosis will the nurse prepare for the infant who is placed prone to protect the myelomeningocele repair site? Peripheral neurovascular dysfunction Disorganized infant behavior Risk for activity intolerance Risk for impaired skin integrity
Risk for impaired skin integrity
In caring for a child in traction, which intervention is the highest priority for the nurse? The nurse should monitor for decreased circulation every 4 hours. The nurse should clean the pin sites at least once every 8 hours. The nurse should provide age-appropriate activities for the child. The nurse should record accurate intake and output.I
The nurse should monitor for decreased circulation every 4 hours. Explanation: Any child in traction must be carefully monitored to detect any signs of decreased circulation or neurovascular complications. Cleaning pin sites is appropriate for a child in skeletal traction to reduce the risk of infection. Providing age-appropriate activities and monitoring intake and output are important interventions for any ill child but would not be the highest priority interventions for the child in traction.
A nurse is preparing a presentation for a health fair focusing on prevention of congenital neuromuscular disorders. What would the nurse emphasize as most important in preventing neural tube defects? folic acid supplementation ultrasound screening at 16 weeks' gestation maternal serum alpha-fetoprotein screening genetic testing for gene identification
folic acid supplementation
he nurse is caring for a child requiring a cast. The mother asks why the doctor is recommending a fiberglass cast when it is more expensive. What information should the nurse share with the mother? Select all that apply "Fiberglass casts are lighter in weight than plaster casts." "They can be waterproof when a special liner is used." "Kids like them because they come in different colors." "Fiberglass casts are typically used when the casts need to be changed often." "Casts made out of fiberglass take longer to dry."
"Fiberglass casts are lighter in weight than plaster casts." "They can be waterproof when a special liner is used." "Kids like them because they come in different colors."
A 7-year-old child diagnosed with Duchenne muscular dystrophy (DMD) uses a wheelchair for mobility. The child's parent tells the nurse "I want my child to participate in activities with peers but I am so concerned about my child's health." Which comment(s) is appropriate for the nurse to make? Select all that apply. "You can assist your child in riding a stationary bicycle." "Each day engage in active or passive range-of-motion exercises." "Your child's diagnosis will not allow him or her to engage in activities with peers." "Wheelchair team sports might be something your child would enjoy." "Encourage your child to remain active but to also take time to rest."
"Wheelchair team sports might be something your child would enjoy." "Encourage your child to remain active but to also take time to rest."
The student nurse is preparing a presentation on bones and bone growth. What information should the student include? Select all that apply. Calcium and vitamin D play important roles in bone growth and bone breakdown. Calcitonin plays a role in remodeling of bone. Adipose cell formation happens in the red bone marrow. Periosteum is the outer covering of the bone. The diaphysis is the rounded end portion of the bone.
Calcium and vitamin D play important roles in bone growth and bone breakdown. Calcitonin plays a role in remodeling of bone. Periosteum is the outer covering of the bone. Explanation: Calcium, vitamin D, and calcitonin are involved in original bone formation, replacement of old by new bone tissue (remodeling), and bone breakdown (resorption). Adipose cell formation happens in the yellow, not red, marrow. The diaphysis is the lengthy central shaft of the long bone; the epiphysis is the rounded end portion of the long bone.
The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply. Color Sensation Pulse Capillary refill Vital signs
Color Sensation Pulse Capillary refill
The student nurse is developing a care plan for a child who suffered a fractured tibia and will have a cast on his lower leg for approximately 6 weeks. Which nursing diagnosis would be the priority for this client? Impaired physical mobility related to a cast on the leg Deficient diversional activities related to a need for imposed activity restriction for 6 weeks Situational low self-esteem related to the use of a walker Pain related to chronic inflammation of the lower leg
Impaired physical mobility related to a cast on the leg
A young girl has just injured her ankle at school. In addition to calling the childs parents, the most appropriate immediate action by the school nurse is to: a. Apply ice. b. Observe for edema and discoloration. c. Encourage child to assume a comfortable position. d. Obtain parental permission for administration of acetaminophen or aspirin.
a. Apply ice.
The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? a. Sluggish deep tendon reflexes b. Full range of motion in extremities c. Absence of hypotonia d. Lack of purposeful muscular control
a. Sluggish deep tendon reflexes
A group of students is reviewing information about the skeletal development in children. The students demonstrate understanding of the information when they identify that ossification is complete by what age? (ossification= su hoa xuong/ su cung nhac) adolescence school age preschool age toddlerhood
adolescence
An infant has been born and diagnosed with a meningocele. Which action will the nurse incorporate into each contact with this infant? inspection of the cystic sac on the child's back for leakage auscultation for bowel sounds listening for a shrill cry careful supine positioning
inspection of the cystic sac on the child's back for leakage. Leakage from the cystic area indicates loss of cerebrospinal fluid (CSF) and risk of infection of the central nervous system. Prompt intervention is needed, probably surgical. Listening for bowel sounds confirms intestinal peristalsis but is not necessary with each infant contact. A shrill cry may indicate increased intracranial pressure (ICP). This is important to note yet is not as pressing as being aware of leakage. T he baby would be positioned prone, not supine, to protect the sac. Reference:
The nurse is reinforcing teaching with the caregivers of a child who has been placed in an external fixation device for the treatment of an orthopedic condition. Which statement made by the caregivers indicates an understanding of the external fixation device? "We will have to get some of the elastic bandages to place around the pins and pin sites." "It will be hard, but we know our child will be in this device for a long time." "He is very sensitive about the way the device looks. I am glad that his clothes will fully cover it so his friends won't tease him." "If we see any drainage around the pins when we are cleaning them, we won't be concerned."
"It will be hard, but we know our child will be in this device for a long time."
The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse? "The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be." "Unfortunately, bracing is the only option for treating this disorder. I'm sure your child will get used to it after a few weeks." "The newer braces only have to be worn while the child is asleep and don't have to be worn at school." "Braces have been replaced with surgical intervention. Your child will only wear a brace for a few weeks after the surgery."
"The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."
A pediatric client's parent calls the nurse and states, "My child fell off the bike. My child was wearing a helmet, but did scrape the knee and it is bleeding a lot. What should I do?" Which response by the nurse is best? "You should apply pressure to the site and then bring your child in to be evaluated." "Apply ice packs to the site for 15 to 20 minutes, then elevate the extremity." "Tell me if your child can move all four extremities and knows his or her name and current location." "You need to immediately bring your child to his primary health care provider's office."
"You should apply pressure to the site and then bring your child in to be evaluated." Explanation: First, the nurse needs to address the client's bleeding by having the parent apply pressure to the site. Then, the child needs to be evaluated to determine if additional treatment is needed, such as stitches. Measures including rest, ice, compression, and elevation (RICE) will be further discussed with the parent and child after the bleeding is stopped and the wound has been evaluated. There is no indication the child needs immediate evaluation, nor is there indication the child cannot move other extremities or has an altered level of consciousness. Bleeding is priority for this client.
A nurse is preparing a program for a group of parents about injury prevention. What would the nurse include as an important contributing factor for cervical spine injury in a child? a. Exposure to teratogens while in utero b. Immaturity of the central nervous system c. Increased mobility of the spine d. Incomplete myelinization
ANS: C Feedback: Compared to the adult, a child's spine is very mobile, especially in the cervical spine region, resulting in a higher risk for cervical spine injury. Exposure to teratogens in utero may lead to altered growth and development of the brain or spinal cord. Immaturity of the central nervous system places the infant at risk for insults that may result in delayed motor skill attainment or cerebral palsy. Incomplete myelinization reflects the lack of motor control.
Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele? The infant will have a poor sucking reflex. Pain will interfere with the feeding process. Assuming the usual feeding position will be difficult. Nausea and vomiting often follow repair of the cystic mass.
Assuming the usual feeding position will be difficult. Because the repaired area will need to be protected, having to use an alternate feeding position is likely. The infant may need to be fed prone with the head turned to the side and may not be able to be held. Being able to provide food for the infant is central to parenting the child. Difficulty nurturing a child can be very stressful. Little pain will be experienced and should easily be controlled owing to loss of sensation in the area. The sucking reflex should not be affected by the myelomeningocele or its repair. Nausea and vomiting are unlikely after recovery from the anesthetic.
A nurse caring for a child wearing a brace to correct scoliosis provides client and family teaching for home care of the brace. Which of these are accurate interventions for this situation? Select all that apply. Avoid sitting in one position for long periods of time. Tell the client to loosen the brace during meals if necessary. Schedule brace wear for waking hours for best therapeutic results. Wear a 100%-cotton T-shirt under the brace to absorb moisture. Recommend a shower instead of a bath to stimulate the skin. Gradually decrease wearing time so the skin can develop tolerance.
Avoid sitting in one position for long periods of time. Tell the client to loosen the brace during meals if necessary. Wear a 100%-cotton T-shirt under the brace to absorb moisture.
Which statement is accurate concerning a childs musculoskeletal system and how it may be different from an adults? a. Growth occurs in children as a result of an increase in the number of muscle fibers. b. Infants are at greater risk for fractures because their epiphyseal plates are not fused. c. Because soft tissues are resilient in children, dislocations and sprains are less common than in adults. d. Childrens bones have less blood flow.
c. Because soft tissues are resilient in children, dislocations and sprains are less common than in adults. ANS: C Because soft tissues are resilient in children, dislocations and sprains are less common than in adults. A childs growth occurs because of an increase in size rather than an increase in the number of the muscle fibers. Fractures in children younger than 1 year are unusual because a large amount of force is necessary to fracture their bones. A childs bones have greater blood flow than an adults bones.
A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that: a. Traction is tried first. b. Surgical intervention is needed. c. Frequent, serial casting is tried first. d. Children outgrow this condition when they learn to walk.
c. Frequent, serial casting is tried first.
A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? a. Oral b. Subcutaneous injection c. Intramuscular injection d. Intravenous infusion
c. Intramuscular injection
The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included? a. Apply lotion or powder to minimize skin irritation. b. Remove the harness several times a day to prevent contractures. c. Return to the clinic every 1 to 2 weeks. d. Place a diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin.
c. Return to the clinic every 1 to 2 weeks.
The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal? bilirubin creatine kinase serum potassium sodium
creatine kinase Explanation: Serum creatine kinase levels are elevated early in the disorder, when significant muscle wasting is actively occurring. Bilirubin is a by-product of liver function. Potassium and sodium levels can change due to various factors and aren't indicators of muscular dystrophy.
The nurse is caring for an immobilized preschool child. Which of the following is helpful during this period of immobilization? a. Encourage wearing pajamas. b. Let child have few behavioral limitations. c. Keep child away from other immobilized children if possible. d. Take child for a walk by wagon outside the room.
d. Take child for a walk by wagon outside the room.
A nurse is preparing a class on neural tube disorders to present to a community group. What information regarding prevention is most important for the nurse to include in the teaching? dietary considerations genetic screening early prenatal care updated immunizations
dietary considerations
A nurse is conducting a physical examination of an infant with suspected metatarsus adductus. Type II metatarsus adductus is indicated when the forefoot is: inverted and turned slightly upward. flexible past neutral actively and passively. flexible passively past neutral, but only to midline actively. rigid, does not correct to midline even with passive stretching.
flexible passively past neutral, but only to midline actively. In type II metatarsus adductus, the forefoot is flexible passively past neutral, but only to midline actively. The forefoot is flexible past neutral actively and passively in type I. The forefoot is rigid, does not correct to midline even with passive stretching in type III. An inverted forefoot turned slightly upward is indicative of clubfoot (congenital talipes equinovarus).
The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding? kyphosis lordosis idiopathic scoliosis sway back
idiopathic scoliosis Explanation: Idiopathic scoliosis is an S-shaped curvature of the spine. Kyphosis is an outward curvature of the cervical spine. Lordosis is an inward curving of the lumbar spine. Sway back is another term used for lordosis.
Which condition would alert the nurse that a child may be suffering from muscular dystrophy? hypertonia of extremities increased lumbar lordosis upper extremity spasticity hyperactive lower extremity reflexes
increased lumbar lordosis Explanation: An increased lumbar lordosis would be seen in a child suffering from muscular dystrophy secondary to paralysis of lower lumbar postural muscles. Increased lower extremity support may also be seen. Hypertonia isn't seen in this disease. Upper extremity spasticity isn't seen because this disease isn't caused by upper motor neuron lesions. Hyperactive reflexes aren't indications of muscular dystrophy.
The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record? low serum calcium levels low alkaline phosphate levels high serum phosphate levels x-ray confirmation of adequate bone shape
low serum calcium levels rickets= disease caused by vit D deficiency / benh coi xuong
A nurse is conducting a physical examination of a 5-year-old boy with spinal muscular atrophy (SMA) type 2. What assessment findings would the nurse expect to find? pectus excavatum ("funnel chest") pseudohypertrophy of the calves loss of strength in hip extension loss of strength in ankle dorsiflexion
pectus excavatum ("funnel chest")
A nurse is performing a newborn assessment and notices a small dimple on the sacral area. The infant has a normal neurological assessment and moves all extremities well. What does the nurse suspect that the dimple indicates? a normal spinal closure spina bifida with meningocele spina bifida occulta spina bifida with myelomeningocele
spina bifida occulta
