Ch 22 & 24 Peds final

The 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."

The nurse is caring for a 9-year-old child with partial-thickness (second-degree) burns. The client rates the pain at an 8 on a 1 to 10 numerical pain scale. The nurse notes the client is sitting in the bed playing with toys and smiling. Which action will the nurse take?

Administer pain medication as prescribed.

The nurse is caring for a six-year-old boy would Russell traction apply to his left leg. Which intervention would be most appropriate to prevent complications?

Assess the popliteal region carefully for skin breakdown

Parents of a preschooler with cerebral policy as the nurse with the surgeon plans to implant in their child's body to control spasticity. What is the nurse's answer?

Baclofen pump

The nurse is caring for an eight year old in skeletal traction for a fractured femur. Which type of traction would be communicated in the shift handoff?

Balanced suspension traction

Which healthcare provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?

Barlow and Ortolani click

The nurse has completed client education with the parents of a child with a femur fracture. Which statement by a parent indicates successful education?

Breaks that happen between the rounded end and the central shaft of the bone can cause growth issues in the future.

Which statement about cerebral palsy would be accurate?

Cerebral palsy is a condition that doesn't get worse.

A client with severe chronic anemia is receiving ongoing transfusion therapy. The nurse frequently assesses the client for what major complication of this therapy?

Development of toxic iron overload

A nurse caring for an 8-year-old with a bleeding disorder documents the following nursing diagnosis: ineffective tissue perfusion related to intravascular thrombosis and hemorrhage. This diagnosis is most appropriate for a client with:

Disseminated intravascular coagulation Disseminated intravascular coagulation (DIC) is an acquired coagulopathy that, paradoxically, is characterized by both thrombosis and hemorrhage. The goal is for the child to maintain adequate tissue perfusion of all body systems affected by DIC and regain adequate laboratory values for hemostasis.

The nurse is caring for a child with a fractured femur and traction. Which action will the nurse complete while caring for this client

Ensure traction weights are hanging freely, not touching the bed or floor.

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?

Handling the cast with open palms when moving the arm.

A nurse is providing care to a hospitalized child diagnosed with cerebral palsy. The nursing is preparing the family for discharge. What action by the nurse will most ensure the family's success after discharge?

Have he family meet with the case manager before discharge

A child with leukemia is receiving methotrexate for therapy. Which nursing diagnosis should the nurse use to best guide this child's care at this time?

Impaired oral mucous membrane related to effects of chemotherapy

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 up approximately six weeks. Which nursing diagnosis would be the priority for this client?

Impaired physical mobility r/t a cast on the leg

The nurse is caring for a newborn with facial nerve palsy from birth trauma. The mother is very upset and concerned about the child's prognosis. Which response by the nurse would be most appropriate?

In most cases treatment is not necessary, only observation.

A child is in traction and is at risk for impaired skin integrity. Which intervention is mosteffective?

Inspect the child's skin for rashes, redness, irritation, or pressure injuries.

What characteristics is true of cerebral palsy?

It appears at birth or during the first two years of life

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?

It will be hard, but we know our child will be in this device for a long time

An infant with a femur fracture is placed in Bryant traction. What would the nurse include in the infants plan of care?

Keeping the buttocks slightly elevated

A nurse is assisting the parents of an infant who requires a Pavlik harness. The parents are apprehensive about how to care for their infant and concerned about holding and playing with the infant. How can the nurse best assist the parents?

Let's put you in touch with other families who have experienced this.

The nurse is assessing a newborn and suspects developmental dysplasia of the hip (DDH). For which sign is the nurse prioritizing in this potential diagnosis?

Limited abduction of the affected hip

Which diagnosis measure is most accurate in detecting neural tube defects?

Significant level of alpha-fetoprotein present in amniotic fluid

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is

Skeletal traction skeletal traction exerts pull directly on skeletal structures by means of a pin, wire, tongs, or other device surgically inserted through a bone. Skin traction applies pull on tape, rubber, or a plastic material attached to the skin, which indirectly asked her to pull on the musculoskeletal system. Ex of skin traction: Bryant traction, Buck extension traction, and Russell traction.

A parent brings a 12 month old child diagnosed with congenital cerebral policy to the clinic. The nurse complete an assessment which assessment finding requires immediate intervention by the nurse.

Suspected failure to thrive

The nurse is caring for an 18-month-old client with suspected iron-deficiency anemia. The nurse will expect to prepare the client for which laboratory tests first?

complete blood count and iron level

A child is in Buck traction to correct a hip problem. When caring for this child, it is mostimportant for the nurse to implement which intervention?

remove the boot every 8 hours

The nurse is talking with the caregiver of a 13-year-old diagnosed with scoliosis. The child has come to the clinic to be fitted with a brace to begin her treatment. The child appears upset and angry and states, "I hate this brace; I hate it already." In an effort to support this child, which statement would be the most appropriate for the nurse to make to this child's caregiver?

"If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."

The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which issues should be reported if they occur or are seen related to this child? Select all that apply.

- Any area on the cast that is warm to the touch - A foul odor under the cast - Drainage from under the cast - Looseness of the cast on the extremity

The nurse is assessing a 6-week-old at a pediatrician's appointment. What objective data gathered by the nurse indicates a diagnosis of possible developmental dysplasia of the hip? Select all that apply.

- Asymmetry of the gluteal skin folds - Limited abduction of the affected hip - Apparent shortening of the femur

The nurse is working in the newborn nursery and receives report from the delivery room nurse. When receiving hand-off report, which situation(s) will the nurse identify as common in the assessment findings of developmental dysplasia of the hip (DDH)? Select all that apply.

- breech position at or after 34weeks' gestation - female gender - oligohydramnios - family history of DDH

The nurse is caring for a 14 year old boy and Buck traction for a slipped capital femoral epiphysis (SCFE) What information with the nurse include when completing a neurovascular assessment of the affected leg? Select all the apply.

- color - sensation - pulse - capillary refill

How would the nurse best describe Gowers sign to the parents of a child with muscular dystrophy?

A transfer technique

The nurse is caring for an eight month old infant in Bryant traction for developmental dysplasia of the hip (DDH) and is monitoring for complications. Which assessment finding most concerns the nurse?

A weak pedal pulses

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority?

Monitor site dressing and vital signs

The nurse is caring for a 6-year-old boy with non-Hodgkin lymphoma who is being treated with monoclonal antibodies. What recommendation would the nurse include in the child's plan of care?

Monitoring for allergic reactions or anaphylaxis.

A nurse is performing crutch training for an adolescent who has a fractured tibia. What statement by the adolescent indicates successful teaching?

My mom is going to have to pick up all of her throw rugs so I don't slip on them.

The nurse is caring for a 6-year-old girl with leukemia who is having an oncologic emergency. Which signs and symptoms would indicate hyperleukocytosis?

Tachycardia and resp distress

A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client

Teach the client not to rest with the crutch pad pressing on the axilla

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 window allows us to assess bowel sounds and helps to prevent abdominal distention."

The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification?

Type II According to the Salter-Harris classification, a type II fracture is partially through the physis extending into the metaphysis. A type I fracture is through the physis, widening it. A type IV fracture is through the metaphysis, physis, and epiphysis. A type V fracture is a crushing injury to the physis.

A child with cerebral palsy is referred for physical therapy. When describing the rationale for this therapy, the nurse would emphasize what as the primary goal?

development of gross motor movement

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child:

feels increasing severe pain.

The nurse is caring for a child who fractured the arm in an accident. The cast has been applied to the child's right arm. Which action should the nurse implement select all that apply

- document any signs of pain - check capillary refill time in both arms - monitor the color of the nail beds in the right arm

The nurse is assessing a child in the pediatric intensive care unit. Which assessment finding(s) warrants immediate action? Select all that apply.

- increased D-dimer assay - petechiae - persistent oozing from venipuncture site

A child with sickle cell anemia comes to the emergency department for evaluation. The nurse suspects that the child is experiencing a vaso-occlusive crisis based on assessment of which signs and symptoms? Select all that apply.

- lower back pain - fever - distended abdomen

The nurse is completing a newborn assessment in the nursery. While assessing the right hip of the infant, the nurse suspects developmental dysplasia of the hip (DDH) based on which finding(s)? Select all that apply.

- right knee lower than the left when in supine position - asymmetry of gluteal skin folds - prominence of the trochanter on the right side

The young boy has fractured his left leg and has had a cast applied. The nurse educates a boy and his parents prior to discharge from the hospital. The parents should call the physician when which incidents occur select all that apply

- the boy has had a fever greater than 102 for the last 36 hours. - new drainage is seeping out from under the cast - the boy's toes are light blue and very swollen

The nurse is caring for a child who has had an open reduction with cast placement on the forearm. While assessing the cast, the nurse notes serosanguineous fluid on the cast. What action by the nurse is appropriate?

Using a ballpoint pen, outline the fluid stain. Mark the time it is outlined

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.

A 3-month-old infant is seen in the pediatric clinic. The infant's parent expresses concern that the child has developed cerebral palsy. The nurse assesses the infant. Which assessment finding indicates to the nurse that the parent's concern is valid?

hypertonia in the upper extremities

A parent expresses concern that the child has an autism spectrum disorder. The nurse obtains a health history of the symptoms to understand the parent's concern. Which question would the nurse ask first?

Does your child interact with you when playing?