PrepU Peds assignment 3

The nurse is caring for a school-age child diagnosed with transient synovitis. What statement by a parent indicates a need for further education regarding this diagnosis?

"I will get the prescription for the antibiotics filled as soon as we leave the office today."

A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care?

Maintaining intravenous antibiotic therapy

A toddler is diagnosed with osteomyelitis. What should the nurse anticipate as a priority intervention when planning this child's care?

Maintaining intravenous antibiotic therapy

The nurse is caring for a child in the postanesthesia care unit following a surgical procedure to place pins in the child's fractured femur. This pin placement is an example of which type of traction?

Skeletal

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 is caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate?

"Let's come up with things to do like books, movies, games, and friends to visit."

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."

At an obstetric visit 28 weeks into her pregnancy, an expectant mother tells the nurse that her friend's newborn has a soft spot on his head. She is concerned that something is wrong with this baby and is worried the same thing could happen to her child. The best explanation the nurse could offer this expectant mother regarding the bones in the skull would be which statement?

"The softer spot and unclosed sutures in the skull allow the bones to move as they need to so that the baby's head can move through the narrow birth canal."

The nurse is caring for a child who is using crutches due to a leg injury. The child's parents state that child reports pain in the axilla when using the crutches. What is the best response by the nurse?

"We need to make sure the crutches are not too tall; there should be about an inch of space between the crutch pad and the axilla."

The nurse is speaking with the parents of a child prior to surgery to place a distraction device to his tibia. What statement by a parent indicates a need for further education?

"We will turn the rods every day, they will be moved about 10 mm each time."

Upon reviewing the labs from the 3-year-old admitted with swelling, warmth, and pain, which findings would make the nurse suspect osteomyelitis?

-C-reactive protein 3.5mg/dL -ESR 13mm/hr -WBC 15,000UL

The nurse is caring for a child who fractured his harm in an accident. A cast has been applied to the child's right arm. Which actions should the nurse implement? Select all that apply.

-Document any signs of pain. -Check radial pulse in the both arms. -Monitor the color of the nail beds in the right hand.

A fiberglass cast is being applied to a preschooler who broke her arm. What information would influence the type of cast that the physician would apply? Select all that apply.

-Fiberglass casts come in many colors, making them fun for the child. -Fiberglass casts dry much faster than plaster of Paris casts. -Handling of a plaster of Paris cast requires handling with only open palms.

A group of students are reviewing information about bone healing in children. The students demonstrate understanding of this information when they state:

A child's bones heal more quickly than those of an adult.

When teaching a group of parents about the skeletal development in children, what information is most helpful?

A young child's bones commonly bend instead of break with an injury.

A group of students are 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?

Adolescence

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

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client?

Duchenne muscular dystrophy

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 active and passive range-of-motion activities to prevent ineffective tissue perfusion.

A child with muscular dystrophy has come into the clinic. The nurse assesses the child and finds him crawling up his legs with his arms to arise from the floor, which is a characteristic sign of muscular dystrophy. The nurse correctly identifies this as:

Gowers sign.

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

A school-age child is scheduled for a muscle biopsy. What should the nurse teach the client about the procedure?

Medication will be given so pain is minimized.

The nurse is caring for a child who had a cast on his lower leg placed two hours ago. When assessing the child's foot, the nurse notes that the toes are cool and the child reports extreme pain. What is the best action by the nurse?

Notify the health care provider of the findings immediately.

The nurse receives a report from the admission department that a child with a slipped femoral epiphysis is en route to the care area. For which type of child should the nurse begin to plan care?

Obese preadolescent male

The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse take first?

Reposition the child's foot on a pressure-reducing device.

The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?

Risk for impaired skin integrity due to cast and location

The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include?

Soaking the area in warm water every day

An 18-month-old was brought to the emergency department by her mother, who states, "I think she broke her arm." The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

Spiral fracture

A nurse is assessing a child with suspected osteomyelitis. Which finding would help support this suspicion?

Swelling and point tenderness

The nurse is evaluating a school-age child's ability to crutch walk so that no weight is placed on an injured leg. Which walking technique indicates that teaching has been effective?

Three-point swing-through gait

The nurse is caring for a child who has just received a cast for a broken wrist. Why should the nurse elevate the limb onto a pillow?

To prevent edema

While examining a 4-year-old child, the nurse notes a decrease in hip motion that causes pain upon movement. The nurse interprets this finding as indicating Legg-Calvé-Perthes disease, a common pediatric hip disorder that causes pain and decreased hip motion, possibly leading to a femoral head deformity.

True

The nurse is caring for a child with a broken wrist that has just been placed in a cast. The nurse would elevate the arm to:

prevent edema.

The charge nurse is observing a student nurse perform skeletal traction pin care. What action by the student nurse would indicate a need for intervention by the charge nurse?

unhooking a weight while providing pin care

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?

Greenstick

A 14-year-old girl is diagnosed as having scoliosis. When doing scoliosis screening with her, an important observation would be to note:

her posterior spine when she bends forward.

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?

idiopathic scoliosis