NUR 410 PEDS PREPU
The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education?
"Because our child is being treated by using braces, the braces will have to be worn almost all the time."
An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals?
"It is important to wear the brace now to improve your spinal alignment, decreasing your symptoms."
The nurse has cared for a family of two boys with a progressive form of muscular dystrophy. The oldest boy died three years ago from complications of his condition at the age of 15. The younger boy is now 14. He confides to the nurse that he is becoming depressed and scared as he approaches the same age that his brother died. How should the nurse address the boy's concerns?
"Let's look at your health and how it differs from your brother's."
A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction?
"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."
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."
The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most important to emphasize to the boy and his parents?
"You and your coaches need to understand that you cannot play soccer for at least six weeks."
The young boy has fractured his left leg and has had a cast applied. The nurse educates the boy and his parents prior to discharge from the hospital. The parents should call the physician when which incidents occur? Select all that apply.
1. The boy has had a fever of greater than 102° F (38.9°C) for the last 36 hours. 2. New drainage is seeping out from under the cast. 3. The boy's toes are light blue and very swollen.
A child and mother come into the orthopedic clinic. The mother is concerned about her child who has recently been diagnosed with scoliosis. The mother asks about surgical treatment and if it will be necessary. The nurse bases her response on knowledge that surgery is implicated for curvatures greater than:
40 degrees.
The nurse is caring for an 8-month-old infant in Bryant traction for developmental dysplasia of the hip and is monitoring for complications. Which assessment finding most concerns the nurse?
A weak pedal pulse
A nurse is performing a physical assessment of the musculoskeletal system of 5-year-old Manuel. Which of the following is a recommended assessment technique appropriate for this patient?
Assess Manuel while he sits in his parent's lap.
In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?
Cartilage
The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:
Complete
The nurse is assessing a newborn following a caesarian section birth necessitated by a breech presentation. The nurse knows that this presentation places the newborn at increased risk for:
Developmental dysplasia of the hip.
The nurse is caring for a child with a fractured femur in 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 type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?
Greenstick
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 5-year-old child is in traction and at risk for impaired skin integrity due to pressure. Which intervention is most effective?
Inspect the child's skin for rashes, redness, irritation, or pressure sores
In understanding the function of the musculoskeletal system, the nurse recognizes that which of the following allows for movement of the body parts?
JOINTS
A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care?
Maintaining intravenous antibiotic therapy
The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which symptom?
Paresthesia
The nurse is caring for a 10-year-old child in traction. After performing a skin assessment, she notices that the skin over the calcaneus appears slightly red and irritated. What should be the first intervention?
Reposition the child's foot on a pressure-reducing device.
The school nurse is doing a presentation to a group of caregivers of children diagnosed with scoliosis. One of the caregivers asks the nurse about structural scoliosis. Which condition is involved with the diagnosis of structural scoliosis?
Rotated and malformed vertebrae
The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?
Spica cast
A child is admitted to the pediatric unit with osteomyelitis. The child is to be placed on antibiotics. The nurse expects antibiotic coverage to include which of the following as the most common cause of osteomyelitis?
Staphylococcus aureus
The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?
The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.
In caring for a child in traction, which intervention is the highest priority for the nurse?
The nurse should monitor for decreased circulation every 4 hours.
A 14-year-old male is brought to the ER by his parents with a suspected fracture of the arm sustained while playing soccer. An x-ray shows a comminuted fracture. Which of the following best describes this type of fracture?
There are three or more fracture fragments.
The nurse is caring for a child who has had a cast applied to treat a fracture of the fibula. To monitor the pulse of the child's involved extremity the nurse will monitor which of the following?
Tibial pulse
The nurse is caring for a child who has just received a cast for a broken wrist. Why should the nurse elevate the limb onto a pillow?
To prevent edema
After teaching a group of nursing students about osteogenesis imperfecta (OI), the instructor determines that the teaching was successful when the group identifies which type as the most common?
Type I
The nurse is caring for a child with osteomyelitis who has a leg wound. The highest priority nursing intervention for this child would be for the nurse to:
follow transmission-based precautions.
An emergency room nurse prepares a pamphlet to use as a teaching tool for the proper care of sprains. What information might be included in this guide? Select all that apply.
1. Promote early motion after acute injury of the soft tissue. 2. Perform quadriceps and hamstring exercises for knee sprains. 3. Perform ROM exercises for ankle and wrist injuries. 4. Wrap the extremity starting distal from the affected area.
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
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."
The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding?
idiopathic scoliosis
An adolescent wears a body brace for scoliosis. Which client education should the nurse provide?
to continue with age-appropriate activities
An adolescent girl has spinal instrumentation surgery at 16 years of age. Immediately after this procedure, the nurse would teach her to:
wait to be log rolled before turning from one side to the other.
A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client?
Bracing
A nurse is conducting an in-service program for a group of pediatric nurses about pediatric rehabilitation and habilitation. When describing the differences between pediatric and adult services, which of the following would the nures identify as the primary difference?
Adults have reached a level of physical and mental maturity.
The nurse is speaking with the parents of a child who has a cast. The parents state that the child reports itching in the area of the cast. What is the best response by the nurse?
"Blowing cool air with a fan or hair dryer may relieve the feeling."
A nurse is performing a physical assessment of the musculoskeletal system of Manuel, a 31/2-year-old. Which assessment technique would be most appropriate for this child?
Assess Manuel while he sits in his parent's lap.
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 for approximately 6 weeks. Which nursing diagnosis would be the priority for this client?
Impaired physical mobility related to a cast on the leg
An adolescent client who has scoliosis and is wearing a Milwaukee brace tells the nurse that she is ugly and cannot wear the same clothing as her friends. Which response by the nurse best addresses this client's altered self-image?
"Let's look at some clothing that you can wear with the brace that will look like everyone else's clothes but cover it."
