PEDS EXAM IV
ITP commonly follows which disease process
After an infection
what might a teen girl with scoliosis complain of
"ill fitting clothing"
Cerebral Palsey---Interventions
STIMULATION PT (braces, walkers, bikes, standing devices) OT Speech therapy
Cerebral Palsey---S&S KNOW
Waddling gait Lordosis Frequent falling Abnormal motor performance Hyperactive reflexes stiff and ridged arms or legs
What are signs and symptoms of MD
Waddling gait lordosis frequent falling
ORIF (open reduction internal fixation)
surgical insertion of internal fixation devices, such as rods, wires, or PINS that help maintain alignment while healing occurs
Duchenne muscular dystrophy is an absence of what?
Dystrophin
Moderate to severe hemophilia
Go to the ED for replacement is ANY injury occurs
Most common thrombocytopenia of childhood
ITP
Duchenne Muscular Dystrophy---Cure
NONE help maintain muscle strength
Casts for a fracture
Plaster Spika --Pelvic and leg fractures
What is compartment syndrome?
Too much fascia in the bones, Painful Tx: Fasciotomy
Number one diagnostic test for Epiphyseal fracture
X-RAY
Torticollis
limited neck motion
what is the most common spinal deformity
scoliosis
Peek ages of juvenile idiopathic arthritis
1-3 and 8-10
When should the brace for scoliosis (TLSO) be worn?
24/7
Hip Dysplasia---Teaching to parents
Do not move harness! Bad Bathe --DRY WELL Massage skin under straps to increase circulation Keep small toys away
Hemophilia--Teaching
Do not put the child in contact sports use protective devices!!
how many CP patients have normal intelligence
50-80%
how many CP patients will be able to reach ambulation
85%
The potential physiologic and psychologic effects of prolonged immobilization on a 9-year-old child who has experienced significant trauma in a motor vehicle crash include which of the following? Select all that apply. A. Orthostatic intolerance B. Deep vein thrombosis C. Pressure ulcer formation D. Pneumonia E. Diarrhea F. Kidney stones G. Sense of euphoria and elation H. Constipation
A, B, C, D, F, H
Major goals for the therapeutic management of juvenile idiopathic arthritis include? A. Control pain; preserve joint function B. Prevent skin breakdown; relieve symptoms C. Minimize use of joint; achieve cure D. Reduce joint discomfort; regain proper alignment
A. Control pain; preserve joint function
You know that teaching is successful when the parent states that clubfoot is best treated when? A. Immediately after diagnosis, as close to birth as possible B. At about ages 9-12 months, just prior to walking C. At age 4-6 months D. After walking is established, 15-18 months
A. Immediately after diagnosis, as close to birth as possible
Which of the following can result from the bone deterioration associated with immobilization? A. Osteoporosis B. Urinary retention C. Pooling of blood D. Susceptibility to infection
A. Osteoporosis
Which of the following is the most common type of CP? A. Spastic B. Mixed type C. Ataxic D. Dyskinetic
A. Spastic
Hemophilia---S&S
Abnormal bleeding joint bleeding petechiae epistaxis
Hip Dysplasia---S&S
Abnormal gait, leg turns out, limited ROM POSITIVE Orolani test ("clunk")
A 2-day-old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip, and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include: A. Return to the orthopedist's office in 2 weeks to remove the hip spica cast B. The infant's bilateral foot casts should be elevated on pillows as much as possible C. Remove the Pavlik harness once a day for no more than 2 hours and inspect skin D. Remove the Pavlik harness while the infant is awake to allow "tummy time"
B
The nurse is instucting the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? A. Administer the iron at meal times B. Administer the iron through a straw C. Mix the iron with cereal to administer D. Add the iron to formula for every administration
B. Administer the iron through a straw
Which of the following is a physiologic effect of immobilization on children? A. Metabolic rate increases B. Circulatory stasis can lead to thrombus and embolus formation C. Venous return improves, since child is in supine position D. Bone calcium decreases, releasing less calcium in the body
B. Circulatory stasis can lead to thrombus and embolus formation
What position is best for an infant whose head is rotated left but side bending to the right? A. Prone B. Left side lying C. Supine D. Right side lying
B. Left side lying
The primary risk factor for the development of cerebral palsy is: A. Maternal chorioamnioitis B. Premature birth C. Birth asphyxia D. Intraventricular hemorrhage
B. Premature birth
the nurse knows that a fracture to the right humerus epiphyseal plate will? A. Create difficulty, since the child is left handed B. Require different management to prevent bone growth complications C. Heal slowly, since this is the weakest part of the bone D. Necessitate complete immobilization of the shoulder for 6 weeks
B. Require different management to prevent bone growth complications
What is a guaiac test?
Blood in the stool
The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The paretns ask the nurse if the child can perfrom range-of-motion exercises at this time. The nurse should make which response? A. "Avoid all exercise during painful periods" B. "Range-of-motion exercises must be performed every day". C. "Have the child perform simple isometric exercises during this time" D. " Administer additional pain medication before performing range-of-motion exercises"
C. "Have the child perform simple isometric exercises during this time"
The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? A. "I will encourage my child to perform prescribed exercises" B. "I will have my child wear soft fabric clothing under the brace" C. "I should apply lotion under the brace to prevent skin breakdown" D. "I should avoid the use of powerer because it will cake under the brace"
C. "I should apply lotion under the brace to prevent skin breakdown"
A child has sustained a closed fracture and has just had a cast applied to the affected arm. The child is complaining of intense pain. The nurse evaluates the limb, applies an ice bag, and administers an analgesic with little relief. Which problem may be causing this pain? A. Infection under the cast B. The anxiety of the child C. Impaired tissue perfusion D. The recent occurrence of the fracture
C. Impaired tissue perfusion
A 2 day old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include: A. Return to the orthopedist's office in 2 weeks to remove the hip spica cast B. The infant's bilateral foot casts should be elevated on pillows as much as possible C. Remove the Pavlik harness once a day for no more than 2 hours and inspect the skin D. Remove the Pavlik harness while the infant is awake to allow "tummy time"
C. Remove the Pavlik harness once a day for no more than 2 hours and inspect the skin
The most common approach to the treatment of clubfoot management is? A. Pavlik harness B. The latex fixation approach C. Serial cast D. Boston brace
C. Serial cast
The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? A. Soccer B. Basketball C. Swimming D. Field Hockey
C. Swimming
A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? A. Administer an antiemetic B. Increase the IV fluids C. Place the child in a Sims' position D. Notify the HCP
D. Notify the HCP
A 12-year-old who was in an ATV accident has a long-leg fiberglass cast on his left leg for a tibia-fibula fracture. He requests pain medication at 2 :00 am for pain he rates at a 10/10 on the Numeric Scale. The nurse brings the pain medication and notes that he has removed the pillows that kept his leg elevated. He complains of pain in the left foot, and she notes that there is 3+ edema in the exposed leg and foot and she is unable to slip a finger under the cast. The nurse's priority interventions in this situation should include: A. Administer the pain medication and elevate the child's leg on the pillows B. Elevate the leg on the pillows and follow up within 2 to 3 hours to see if the edema has decreased C. Let the child know he cannot have any additional pain medication until 6:00 am D. Notify the surgeon of the findings immediately
D. Notify the surgeon of the findings immediately
The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? A. Platelet count B. Hematocrit Level C. Hemoglobin Level D. Partial thromboplastin time
D. Partial thromboplastin time
Parents of special needs children experience sorrow. This is characterized by: A. Lack of acceptance of child's limitations B. Periods of intense sorrow when experiencing anger and guilt C. Lack of available support to prevent sorrow D. Periods of intense sorrow at certain times of child's development
D. Periods of intense sorrow at certain times of child's development
Lab studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the lab results, knowing which result indicates this type of anemia? A. Elevated hemoglobin level B. Decrease reticulocyte count C. Elevated RBCs D. RBCs that are microcytic and hypochromic
D. RBCs that are microcytic and hypochromic
Clubfoot---What is it?
Deformity of the foot twisting
Cerebral Palsey
Disorder characterized by impaired movement and posture resulting from an abnormality in the extrapyramidal or pyramidal motor system
Most sever and most common Muscular Dystrophy in childhood
Duchenne Muscular Dystrophy
Duchenne Muscular Dystrophy---Diagnosis
Elevated CK Muscle biopsy EMG
iron deficient anemia--Interventions for an infant
Iron-fortified formula delay infroduction to cow milk
What are some post-op interventions for spinal fusion
LOG ROLL NEUROLOGIC STATUS PT 2 PERSON ASSIST-ONE BEHIND BACK AND ONE UNDER LEGS
Torticollis---Treatment
Lay on affected side (probably left) PT @ home---gentile stretching Surgery is PT does not work (12-18 months)
When it ITP dianogised
Majority less than 10 years (peek 1-5 years)
what do you give iron supplements with
Multivitamin or fruit juice (VITAMIN C INCREASES ABSORBTION) DO NOT GIVE WITH milk or antacid because they decrease absorbtion
The larges and most important single group of muscle diseases of childhood
Muscular Dystrophy
Post-op Fracture Interventions
Neurovascular checks Pressure ulcers Muscle loss skin breakdown kidney stones PE COMPARTMENT SYNDROME
How do you want to treat a disabled/immobilized child?
Normalizing!!! Promote Independence Mainstreaming Self-Care Let him/her pick out what they will be wearing or what their daily schedule will look like
Kyphosis Causes
Osteoporosis, compound fracture, TB
Every newborn gets what kind of test? How is it measured
PKU Can be false positive Heel stick
Muscular Dystrophy---Interventions
PT, OT, ventilator support MAINTAIN INDEPENDENCE
Five P's of fracture assessment
Pain Pulse Pallor Paresthesia Paralysis
juvenile idiopathic arthritis---S&S
Pain stiffness swelling loss of function
iron deficient anemia---S&S
Pallor Weakness and fatigue Low hemoglobin and hematocrit RBC THAT ARE MICROCYTIC AND HYPOCHROMIC
Hip Dysplasia---Treatment
Pavlik harness! Worn for about 6-12 months 24/7
Fractures---Interventions
RICE
Hemophilia---Treatment
Replacement of the missing clotting factor Corticosteroids
Clubfoot---Interventions
SERIAL CAST Begin as soon as the child is born 8-12 Weeks----Cast needs to be refitted every week
juvenile idiopathic arthritis---Excerbation---what should the patient do?
Simple isometric exercises
juvenile idiopathic arthritis---Interventions
Sleep on soft/foam mattress
MOST common type of CP
Spasmic
Patients with MD should do what to preserve muscle strength?
Take frequent rest periods
Lordosis Causes
Trauma, Obesity
Cerebral Palsey--Cause
Traumatic Brain Injury
ITP--causes
Unknown
What to consider for an immobile child?
Who is at home, What are their Roles and who is the main Caregiver? Location of home finances
Diagnosis of Scoliosis
X-RAY!!!!!!!!!! Shoulders/hip may not be symmetrical
Duchenne Muscular Dystrophy ---Causes
X-linked Recessive trait (ALL GENETIC IN ORGIN)
Hemophilia is transmitted by
X-linked recessive disorder
A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? a. Limited ROM in the affected hip b. An apparent lengthened femur on the affected side c. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed d. Symmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table.
a. Limited ROM in the affected hip
Which of the following explains why iron deficiency anemia is common during infancy? a. cow's milk is a poor source of iron b. Fetal iron stores are depleted by 1 month of age c. Iron cannot be stored during fetal development d. Dietary iron can not be started until 12 months of age
a. cow's milk is a poor source of iron
How do you want to talk to a disabled child
at their developmental age level
the best therapy for a joint injury for a child with moderate hemophilia is? a. Nonsteroidal antiinflammatory drugs (NSAIDS) b. Intravenous (IV) infusion of factor VII concentrates c. DDAVP (synthetic vasopressin) d. evaluation and application of ice to involved joint
b. Intravenous (IV) infusion of factor VII concentrates
What MD is seen in patients over 8 and affects proximal muscles of both pelvic and shoulder girdles? a. Becker b. Limb Girdle c. Duchenne d. Fasciocapulohumeral
b. Limb Girdle
Acute form of immune thrombocytopenia occurs most commonly after all except? a. after infection with HPV b. severe sunburn due to over exposure c. upper respiratory tract infections d. childhood diseases of measles, mumps, rubella, or chicken pox
b. severe sunburn due to over exposure
When/ how do you administer iron supplements
between meals through a straw
Number one reason school age children get injured
bicycles
What may a person with scoliosis be worried about
body image
Complicated
bone fragments have damaged other organs or tissues
Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? a. "Treatment needs to be started as soon as possible" b. "I realize my infant will require follow-up care until fully grown" c. " I need to bring my infant back to the clinic in 1 month for a new cast" d. "I need to come to the clinic every week with my infant for the casting"
c. " I need to bring my infant back to the clinic in 1 month for a new cast"
Number one broken bone in children
clavicle
Greenstick
compressed side of bone bends, but tension side of bone breaks, causing incomplete fracture
when will parents of a disabled child be most upset?
during times of developmental milestones
Duchenne Muscular Dystrophy--Prognosis
early onset: 3-5 years Loss of independence ambulation by 9-12 years of age (death in adolescence due to cardiac or respiratory failure) "Gower sign"--Difficulty in raising from a sitting position using hands on legs to rise
Three purposes of screening
early recognition carriers population data
Most common type of hemophilia
factor VIII (hemophilia A or classic hemophilia) and factor IX deficiency (hemophilia B or christmas disease)
Epiphyseal fracture
fracture of the growth plate weakest point of long bones
Compound/Open
fractured bone protrudes through the skin
juvenile idiopathic arthritis---consequences
growth retardation
Most prevalent nutritional disorder worldwide
iron deficient anemia
A patient with CP should do speech therapy to preserve
jaw movements and feedings
Clubfoot---more common in males or females?
males
How much is "too much" milk-----leading to iron deficient anemia
more than 24oz of cows milk per day Only breast milk after 6 months
If an infant has a broken bone and its not from abuse what may it be from
motor vehicle accident
Torticollis-----S&S
neck is in a flexed position mass on the sternocleidomastoid muscle
ITP--Diagnosis
no definitive test abnormal terniquete test bleeding time clot reaction time platelet level of <20,000
juvenile idiopathic arthritis----Dx testing
none
juvenile idiopathic arthritis---treatment
none
Hemophilia--Diagnosis
pTT Factor VII & IX test
support groups for parents of a disabled child
parent-to-parent
what is the ternique test? when is it used?
piachae developes after after a terniquate of BP cuff is put on Determines that someone may have ITP
Most common type of kyphosis
postural
Younger children heal ________________ than older children
quicker
iron deficient anemia---Causes
rapid growth excessive milk intake blood loss sever iron deficiency in mother fetal blood loss before delivery
Comminuted
small fragments of bone are broken from fractured shaft and lie in surrounding tissue
How do you want to discipline a disabled child
the same as the other children
Why might a patient with ITP have a sleenecotmy?
to preserve platelets
leading cause of death in children older than one
trauma
Baclofen pump
tube inserted into the spine to delivered anti-spasms drugs
CP affects what neurons
upper neuron dysfunction
Does clubfoot run in families
yes
A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care and includes which intervention? 1. Ensure that all ropes are outside the pulleys. 2. Ensure that the weights are resting lightly on the floor. 3. Restrict diversional and play activities until the child is out of traction. 4. Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied
4- Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied
A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic. 2. Release the skin traction. 3. Apply ice to the extremity. 4. Notify the health care provider (HCP).
4-Notify the health care provider (HCP).
Following the sudden death of a 14-year-old seemingly healthy basketball player, his parents ask the school administration to install an automatic external defibrillator (AED) in a central area of the athletic center. The school nurse is asked to participate in a meeting with the parents in which the administrators insist such a device is not necessary. The school nurse advocates by providing which information about AEDs and children? A. An AED should be used only by health care persons trained in its use. B. An AED provides too much of an energy shock dose for children under 12 years of age. C. An AED can be effective in the resuscitation of a child or adolescent with a shockable rhythm. D. An AED is more commonly used in adults who have heart attacks than in children with undiagnosed heart conditions.
C
The parents of a child recently diagnosed with CP ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? A. An infectious disease of the CNS B. An inflammation of the brain as result of a viral illness C. A chronic disability characterized by impaired muscle movement and posture D. A congenital condition that results in moderate or severe intellectual disabilities
C. A chronic disability characterized by impaired muscle movement and posture
when is scoliosis most noticeable
during growth spirits
When parents consider genetic testing, especially after having a child born with an anomaly, which information could the nurse use to further instruct the family? Select all that apply. A. Genetic screening can provide early recognition of a disease, before signs and symptoms occur, for which effective intervention and therapy exists. B. Screening can occur at different times in a person's life: preconceptual, newborn screening, or maternal screening after delivery, depending on the circumstances. C. Genetic testing can help identify carriers of a genetic disease for the purpose of maximizing parenthood planning options. D. A thorough history by the nurse will include the parents' siblings, the parents, and the grandparents. E. Recognizing a genetic disorder can further facilitate a genetic evaluation by collecting pregnancy, labor and delivery, perinatal, medical, and developmental histories.
A, B, C, E
Disordered eating patterns, which may be observed in the female athlete triad, may include which of the following? Select all that apply. A. Use of diet pills and laxatives B. Fasting C. Binge eating D. Restriction of certain foods E. Inadequate caloric intake F. Excessive vitamin consumption
A, B, D, E
Which of these statements accurately describe Duchenne muscular dystrophy? SATA A. The absence of dystrophin leads to muscular fiber degeneration B. DMD is inherited as an X-linked recessive trait C. Cognitive and intellectual impairment are rare in children with DMD D. Affected children have a waddling gait and lordosis and fall frequently E. Ambulation usually becomes impossible by 12 years of age, and affected children are confined to a wheelchair F. Affected children must be hospitalized when ambulation becomes impossible
A, B, D, E
When working with a child with a disability, one of the most important tasks is to promote normal development. The nurse has a role in promotion of meeting these developmental milestones. Which tasks related to development are most important to be aware of in hospitalization or illness of the child with a disability? SATA A. Nurses should work with the parents of a newborn to promote attachment in spite of the disability B. It is important that school-age children understand that this disruption of their daily activities and hospitalization should not be considered a type of punishment C. One of the more crucial effects of chronic illness or disability on preschoolers is the feeling of guilt that they "caused" the illness through an imagined or real misdeed D. Nurses should respond to the school-age child's questions in simple, direct manner E. Nurses can facilitate the adolescents striving for autonomy by allowing and encouraging the adolescents participation in medical decisions
A, C, D, E
Caring for a child with a developmental disability or chronic illness is best accomplished using a team approach. What are some ways the nurse can facilitate this teamwork? SATA A. Understanding as parents become knowledgeable about their child's special health needs, they frequently become experts in providing care. B. In the absence of the child's family during hospitalization, the nurse should take this opportunity to establish new routines to enhance the child's care C. Although the families of the child with a disability are well versed in the care of their child at home, it is unrealistic to ask parents to take part in the hospitalized care D. The best predictors of the well-being of children with special health needs include how well the child can function in the presence of the health care team E. The nurse's role is collaborating, informing, and encouraging an open relationship with the family while caring for the child in the hospital
A, E
The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of Vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? SATA A. Restrict fluids B. Position for comfort C. Avoid strain on painful joints D. Apply nasal O2 at 2L E. Provide a high-calorie, high-protein diet F. Give meperidine, 25 mg IV, Q4H PRN pain
A. Restrict fluids F. Give meperidine, 25 mg IV, Q4H PRN pain
When caring for a 4-year-old with a disability, the nurse notes that while encouraging the child to take part in his care, the mother constantly gives in to the child, allowing him to have his own way. What anticipatory guidance can the nurse give to promote normalization in this relationship? A. "Giving in" is not a detriment to the child when he or she has a disability and limitations B. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations C. Advise the parent to wait to explain any procedure to the child until they are at the healthcare setting or just before the procedure to avoid unduly upsetting the child. D. Have the parent realize that it would be unfair to the siblings to expect similar rules to apply to all of the children in the family
B
The pediatric nurse may be in the unique position to talk with a family about further genetic evaluation of their child. Which assessment findings by the nurse may alert the nurse to this need? SATA A. Digestive difficulties, especially after 6 months of age. B. Skeletal abnormalities: limb abnormalities, asymmetry, hyper-extendible joints C. Recurrent infection or immunodeficiency: ear infections, pneumonia, poor healing of the umbilicus D. Urinary tract issues: recurrent infections, delay in toilet training E. Development and speech delays or loss of developmental milestones
B, C, E
You are discharging a patient with hemophilia. Which of the following responses by the parents indicate an understanding of this disorder? SATA A. "My child should remain active to decrease joint problems, and most children with hemophilia can participate in the same activities as peers" B. "Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge-tipped disposable toothbrush may be helpful" C. "Signs of internal bleeding should be recognized, such as a headache, slurred speech, loss of consciousness, and black, tarry stools D. "If there is bleeding in a joint, elevation, ice, and rest should help and may prevent the need for factor VIII replacement" E. "All of my son's teachers need to be aware of what to do if he gets a bloody nose"
B, C, E
children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have a resilience that is to be admired. Which of these statements reflect ways that they foster this resilience? SATA A. Protect the child from having to learn about his or her disability or illness on a repeated basis B. Develop relationships with other children and their families with similar circumstances to build support C. The parents set long-term goals to create a sense of hope. D. Focus on the child's strengths and encourage independence E. Accept that chronic illness is a part of living
B, D, E,
A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? A. "The cast may feel warm as the cast dries". B. "I can use lotion or powder around the cast edges to relieve itching". C. "A small amount of white shoe polish can touch up a soiled white cast". D. "If the cast becomes wet, a blow drier set on cool setting may be used to dry the cast".
B. "I can use lotion or powder around the cast edges to relieve itching".
The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? SATA A. Use the fingertips to lift the cast while it is drying B. Keep small toys and sharp objects away from the cast C. Use a paddle ruler or another padded object to scratch the skin under the cast if it itches D. Place a heating pad on the lower end of the cast and over the fingers if the finders feel cool E. Elevate the extremity on pillows for the first 24-48 hours after casting to prevent swelling F. Contact the HCP if the child complains of numbness or tingling in the extremity
B. Keep small toys and sharp objects away from the cast E. Elevate the extremity on pillows for the first 24-48 hours after casting to prevent swelling F. Contact the HCP if the child complains of numbness or tingling in the extremity
Hip Dysplasia---What is it?
Ball doesnt fit right in the socket!
Treatment of Scoliosis
Brace--> Surgery
As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by: a. Asking the parents how their extended families feel about their child's illness b. Exploring the use of alternative medicines and therapies c. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition d. Acknowledging that language constraints may make it necessary for the health care team to make some decisions
C
A child is admitted to the pediatric unit. The mother reports that the doctor says her son is anemic. What lab findings/manifestations would the nurse expect to see to confirm iron deficient anemia? A. Cyanosis, due to inadequate O2 sat of existing hemoglobin B. A decrease reticulocyte count C. A total iron-binding capacity (TIBC) that is elevated above the normal range D. Decreased BP changes, which are an early sign becuase of the compensatory mechanisms
C. A total iron-binding capacity (TIBC) that is elevated above the normal range
A 10-year-old with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? A. Injection of Factor X B. IV infusion of iron C. IV infusion of factor VIII D. IM injection of iron using Z-teack method
C. IV infusion of factor VIII
Which is the most accurate genetic explanation for a family with hemophilia? A. It is a Y-linked dominant disorder B. It is equally distributed among men and woman C. It is an X-linked recessive disorder D. It is an autosomal recessive disorder
C. It is an X-linked recessive disorder
The nurse us assisting the HCP examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? A. Babinski's Sign B. The Moro Reflex C. Ortolani's Maneuver D. The palmar-plantar grasp
C. Ortolani's Maneuver
Cerebral Palsey---Diagnosis
Can not diagnosis until 2 years of age MRI
Most common permanent physical disability in childhood
Cerebral Palsey
Epiphyseal fracture---Treatment
ORIF (Open reduction internal fixation)