Chapter 30: The Child with Neuromuscular or Muscular Dysfunction ANS
The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching?
"My child should not eat bananas or kiwis."
How much folic acid is recommended for women of childbearing age?
0.4 mg
A toddler is admitted to the hospital with a possible diagnosis of tetanus. The health care provider has prescribed lorazepam (Ativan) intravenously 0.05 mg/kg/dose every 6 hours prn as a muscle relaxant. The child weighs 22 pounds. How many milligrams of Ativan should the nurse administer per dose? (Record your answer using one decimal place.)
0.5
The parents of a child with cerebral palsy ask the nurse whether any drugs can decrease their child's spasticity. The nurse's response should be based on which statement?
Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.
A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which intervention should the nurse perform first?
Implement a standing prescription to empty the bladder with a sterile in and out Foley catheter.
The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing?
Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.
The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which is a priority in the care for this child?
Assessing respiratory efforts
Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include which action?
Avoid using any latex product.
The nurse is conducting discharge teaching to parents of a preschool child with myelomeningocele, repaired at birth, being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function? (Select all that apply.)
Continue to perform the clean intermittent catheterizations (CIC) at home. Administer the oxybutynin chloride (Ditropan) as prescribed. Monitor for signs of a recurrent urinary tract infection.
The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?
Covered with a sterile moist nonadherent dressing
The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy?
Extensor reflex at 7 months of age
The nurse is reviewing prenatal vitamin supplements with an expectant client. Which supplement should be included in the teaching?
Folic acid for all women of childbearing age
The nurse is conducting a staff in-service on common problems associated with myelomeningocele. Which common problem is associated with this defect?
Hydrocephalus
Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply.)
Lordosis Gower sign Waddling gait
Which clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease)?
Lying in the frog position
A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Nursing care for this child includes which action(s)? (Select all that apply.)
Monitoring and maintaining systemic blood pressure Administering corticosteroids Monitoring for respiratory complications
The nurse is teaching a group of nursing students about newborns born with the congenital defect of myelomeningocele. Which common problem is associated with this defect?
Neurogenic bladder
Which should the nurse expect to find in the cerebral spinal fluid (CSF) results of a child with Guillain-Barré syndrome (GBS)? (Select all that apply.)
Normal glucose Fewer than 10 white blood cells (WBCs/mm3)
The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?
Progressive weakness and wasting of skeletal muscle
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is which position?
Prone, head turned to side, and nipple-fed
A 4-year-old child has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. The management plan should include which action?
Recommend genetic counseling.
A child steps on a nail and sustains a puncture wound of the foot. Which is the most appropriate method for cleansing this wound?
Soak foot in warm water and soap.
The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant? (Select all that apply.)
Temperature instability Irritability Lethargy
The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?
Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves
The nurse is planning a staff in-service on childhood spastic cerebral palsy. Spastic cerebral palsy is characterized by:
hypertonicity and poor control of posture, balance, and coordinated motion.
Therapeutic management of a child with tetanus includes the administration of:
tetanus immunoglobulin therapy.
