MUSCULAR DYSTROPHY

An 8-year-old boy with Duchenne muscular dystrophy is being seen in the clinic for a routine health visit. An appropriate nursing diagnosis for this client would be: Select one: a. Risk for injury related to muscle weakness. b. Risk for impaired skin integrity related to paresthesia to lower extremities. c. Risk for infection related to altered immune system. d. Risk for altered comfort related to effects of muscular dystrophy disease.

a

The nurse observes as a child with Duchenne's muscular dystrophy attempts to rise from a sitting position on the floor. After attaining a kneeling position, the child "walks" his hands up his legs to stand. The nurse documents this as which of the following? 1.Galeazzi's sign. 2.Goodell's sign. 3.Goodenough's sign. 4.Gower's sign

4

Which foods would be best for a child with Duchenne muscular dystrophy? Select all that apply. 1. High-carbohydrate, high-protein foods. 2. No special food combinations. 3. Extra protein to help strengthen muscles. 4. Low-calorie foods to prevent weight gain. 5. Thickened liquids and smaller portions that are cut up.

4 5

The mother of a child with Duchenne's muscular dystrophy asks about the chance that her next child will have the disease. The nurse responds based on the understanding of which of the following? 1.Sons have a 50% chance of being affected. 2.Daughters have a 1 in 4 chance of being carriers. 3.Each child has a 1 in 4 chance of developing the disease. 4.Each child has a 50% chance of being a carrier.

1

The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and its management. Which of the following statements by the mother indicates successful teaching? 1."My son will probably be unable to walk independently by the time he is 9 to 11 years old." 2."Muscle relaxants are effective for some children; I hope they can help my son." 3."When my son is a little older, he can have surgery to improve his ability to walk." 4."I need to help my son be as active as possible to prevent progression of the disease.

1

The mother of a child with Duchenne muscular dystrophy asks the nurse who in the family should have genetic screening. Who should the nurse say must be tested? Select all that apply. 1. Mother. 2. Sister. 3. Brother. 4. Aunts and all female cousins. 5. Uncles and all male cousins.

1 2 4

The parents of a preschooler diagnosed with muscular dystrophy are asking questions about the course of their child's disease. Which should the nurse tell them? Select all that apply. 1. "Muscular dystrophies usually result in progressive weakness." 2. "The weakness that your child is having will probably not increase." 3. "Your child will be able to function normally and not need any special accommodations." 4. "The extent of weakness depends on doing daily physical therapy." 5. "Your child may have pain in his legs with muscle weakness."

1 2 5

A 5-year-old has been diagnosed with pseudohypertrophic muscular dystrophy. Which nursing intervention(s) would be appropriate? Select all that apply. 1. Discuss with the parents the potential need for respiratory support. 2. Explain that this disease is easily treated with medication. 3. Suggest exercises that will limit the use of muscles and prevent fatigue. 4. Assist the parents in finding a nursing facility for future care. 5. Encourage the parents to contact the school to develop an IEP.

1 3 5

Which will help a school-age child with muscular dystrophy stay active longer? Select all that apply. 1. Normal activities, such as swimming. 2. Using a treadmill every day. 3. Several periods of rest every day. 4. Using a wheelchair upon getting tired. 5. Sleeping as late as needed

1 3 5

The nurse knows that teaching was successful when a parent states which of the following are early signs of muscular dystrophy? 1. Increased muscle strength. 2. Difficulty climbing stairs. 3. High fevers and tiredness. 4. Respiratory infections and obesity

2

A nurse is making an initial visit to a family with a 3-year-old child with early Duchenne's muscular dystrophy. Which of the following findings is expected when assessing this child? 1.Contractures of the large joints. 2.Enlarged calf muscles. 3.Difficulty riding a tricycle. 4.Small, weak muscles.

3

When developing the plan of care for a child with early Duchenne's muscular dystrophy, which of the following nursing goals is the priority? 1.Encouraging early wheelchair use. 2.Fostering social interactions. 3.Maintaining function of unaffected muscles. 4.Preventing circulatory impairment.

3

When interacting with the mother of a child who has Duchenne's muscular dystrophy, the nurse observes behavior indicating that the mother may feel guilty about her child's condition. The nurse interprets this behavior as guilt stemming from which of the following? 1.The terminal nature of the disease. 2.The dependent behavior of the child. 3.The genetic mode of transmission. 4.The sudden onset of the disease.

3

The nurse knows that teaching has been successful when the parent of a child with muscle weakness states that the diagnostic test for muscular dystrophy is which of the following? 1. Electromyelogram. 2. Nerve conduction velocity. 3. Muscle biopsy. 4. Creatine kinase level

3 4

The nurse should tell the parents of a child with Duchenne (pseudohypertrophic) muscular dystrophy that some of the progressive complications include: Select all that apply. 1. Dry skin and hair, hirsutism, protruding tongue, and mental retardation. 2. Anorexia, gingival hyperplasia, dry skin and hair. 3. Contractures, obesity, and pulmonary infections. 4. Trembling, frequent loss of consciousness, and slurred speech. 5. Increasing difficulty swallowing and shallow breathing.

3 5

The nurse is caring for a school-age child with Duchenne muscular dystrophy in the elementary school. Which would be an appropriate nursing diagnosis? 1. Anticipatory grieving. 2. Anxiety reduction. 3. Increased pain. 4. Activity intolerance.

4

A young boy has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. The management plan should include which of the following? a. Recommend genetic counseling. b. Explain that the disease is easily treated. c. Suggest ways to limit use of muscles. d. Assist family in finding a nursing facility to provide his care.

a

Which statement best describes pseudohypertrophic (Duchenne) muscular dystrophy (DMD)? a. DMD is inherited as an autosomal dominant disorder. b. DMD is characterized by weakness of the proximal muscles of both the pelvic and shoulder girdles. c. DMD is characterized by muscle weakness, usually beginning at about age 3 years. d. The onset of DMD occurs in later childhood and adolescence.

c