Peds Exam #3
What are three nursing interventions to initiate after birth for babies with myelomeningocele?
1. Keep pressure off the affected area 2. Keep the affected area moist and covered 3. Prepare for surgical intervention
What are two signs of developmental dysplasia of the hip?
1. Limited hip abduction 2. Shortened femur
What are 4 things to be expected from a nurse caring for a patient who just had a scoliosis repair surgery?
1. Log-rolling the patient for positioning 2. Using a Foley catheter 3. 4.
How can meningitis be diagnosed? (3)
1. Lumbar puncture 2. Blood culture 3. Noting symptoms and side effects
What two signs are tested when assessing for DDH?
1. Barlow maneuver 2. Ortolani test
When developing the plan of care for a newly admitted 2-year old child with the diagnosis of Kawasaki disease, which of the following would be the priority
monitoring intake and output every hour
a 16-month-old child diagnosed with Kawasaki disease is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. Which of the following would the nurse interpret as the priority?
placing the toddler in a quiet environment
when positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate?
prone with hips abduction
after teaching a group of school teachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizures. which of the following actions, when performed first, indicates that the nurse's teaching has been successful
removing any nearby objects that could harm the child
the parents of a child with occasional generalized seizures want to send the child to summer camp. the parents contact the nurse for advice on planning for the camping experience. which of the following activities would the nurse and family decide is most important for the child to avoid
rock climbing
which of the following would the nurse include when completing discharge instructions for the parents of a 12-month-old child diagnosed with Kawasaki disease and being discharged to home?
take the child's temperature daily for several days
What are 9 signs of increased ICP?
1. Irritability 2. Headache 3. Seizures 4. Diplopia 5. Changes in LOC 6. Sunsetting eyes 7. Nausea/vomiting 8. High-pitch cry 9. Changes in PERRLA
What are three important interventions to consider for hydrocephalus?
1. Monitor for symptoms of increased ICP 2. Monitor OFC measurements for kids under 2 3. Anticipate potential need for shunt placement
What are 6 things to remember when caring for a patient in a sling?
1. No rough activity 2. Keep at heart level or above 3. Don't insert anything inside 4. Neurovascular checks are important 5. Watch skin integrity 6. Prevent neurovascular injury
What are 7 things to remember when caring for a patient in a cast?
1. No rough activity 2. May need crutches or a wheelchair 3. Don't insert anything inside 4. Neurovascular checks are important 5. Watch skin integrity 6. Prevent neurovascular injury 7. Petaling
What are complications that can occur if meningitis is severe, untreated, or reoccurring? (3)
1. Brain damage 2. Stroke 3. Hearing loss
What are four needs for a kid with meningitis?
1. Comfort measures 2. Decrease stimulation 3. Bundle care 4. Complete frequent neurological checks
What are four features of kids with Downs syndrome?
1. Epicanthal folds 2. Simian crease 3. Stubby toes/fingers 4. Upward/outward slant of eyes
What are four interventions for preparing a room when admitting a child with a history of seizures?
1. Have suction and oxygen set-up 2. Place the bed in the lowest position 3. Pad the side rails of the bed 4. Remove any equipment or items from the bed
What are eight symptoms of meningitis?
1. Severe headache 2. Sudden high fever 3. Irritability 4. Stiff neck/nuchal rigidity 5. Bulging fontanel 6. Photosensitivity 7. Change in LOC 8. Sleepiness
What do you need to educate the parents of a child with a shunt on? (3)
1. Side effects of shunt malfunction 2. Signs of infection 3. Signs of increased ICP
When using a Pavlik harness, what are three important considerations?
1. Skin integrity 2. Fit/straps of the harness 3. Use knee socks and/or undershirt
What are the two goals of treatment for a patient with Perthes disease?
1. The bone grows back into a round shape 2. The bone fits well into the joint of the hip socket
What are four actions that should be taken when a child is seizing?
1. Time the seizure from start to stop 2. Document the seizure and time it occurred once the seizure has subsided 3. Take vitals and assess the patient after the seizure 4. Move potentially dangerous objects away from the child
What do shunts do?
They move CSF to decreased ICP from the brain
What is spina bifida?
A birth defect where the lower part of the neural tube doesn't close, causing varying levels of paralysis and sensory loss of the legs
What is myelomeningocele?
A section of the spinal cord and its nerves are exposed to the outside of the body
What is an important aspect of care for kids with cerebral palsy?
Anticipate a multidisciplinary care team
What is the most common cause of osteomyelitis?
Bacteria
Which form of meningitis is the most deadly?
Bacterial
What is the treatment for people who have scoliosis?
Depends on the degree of curvature
What kind of precautions should a person with meningitis be placed into?
Droplet
What is the most common form of Downs syndrome?
Each cell in the body has 3 separate copies of chromosome 21 vs. usual 2 copies (the cause is usually unknown)
What is the most commonly affected group of people that develop scoliosis?
Girls during growth spurts
What neurological condition is commonly associated with myelomeningocele?
Hydrocephalus
What does the treatment regimen for someone with osteomyelitis include?
IV or PO antibiotics for 3-6 weeks
If you cannot monitor or observe a patient with Perthes disease, what is most likely to happen?
Immobilization via traction or bracing
What two signs are tested when assessing for meningitis?
Kernig's and Brudzinski's signs
What is another term used for spina bifida?
Myelomeningocele
What two vaccines help prevent meningitis?
PCV and Hib
For babies up to 6 months old, which of the following is the most common intervention for DDH?
Pavlik harness
What is happening in developmental dysplasia of the hip?
The hip joint doesn't form properly. The femoral head and acetabulum are not properly aligned
What is happening to a patient who has Perthes disease?
There is a temporary loss of blood supply of the femoral head. The cause is unknown and overtime the blood supply will return, allowing the bone to grow back
What is happening to a child with hydrocephalus?
There is an increased CSF volume in the brain due to imbalanced CSF production and absorption
What is a VA shunt?
Ventriculoatrial shunt (drains CSF from the brain to the right atrium of the heart)
What is a VP shunt?
Ventriculoperitoneal shunt (drains CSF from the brain to the peritoneum)
What is clubfoot?
a congenital anomaly where the foot/feet is twisted out of the normal position
after talking with the parents of a child with down syndrome, which of the following would the nurse identify as appropriate
encouraging self-care skills in the child
the mother of a newborn with myelomeningocele asks if her baby is likely to have any other defects. the nurse responds based on the understanding that myelomeningocele is frequently associated with which of the following?
excessive cerebrospinal fluid within the cranial cavity
which of the following would alert the nurse initially to suspect hydrocephalus in an infant who has undergone surgical repair of a myelomeningocele?
increased head circumference and bulging fontanel
a preschooler with a history of repaired lumbar myelomeningocele is in the emergency department with wheezing and skin rash, Which of the following questions would the nurse ask the mother first
is your child allergic to bananas or milk products
when assessing a newborn admitted to the pediatric unit with upper lumbar myelomeningocele, which of the following would the nurse anticipate finding?
minimal movement of the lower extremities