Pediatric Neuro
A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the best initial action by the nurse?
Placing the child on the floor
A nurse is caring for a school-aged child who has had a tonic-clonic seizure. How should the nurse describe the clonic phase?
Spasmodic body jerking
A 9-month-old infant is admitted to the pediatric unit with a possible head injury. Twelve hours later the nurse determines that the previous blood pressures were taken using a neonate-size cuff. The nurse documents the size of the cuff that was used for previous measurements. What is the best action for the nurse to take?
Taking the next measurement with both a neonate- and a child-size cuff
What safety instruction should a nurse teach a 10-year-old child with diminished sensation in the legs because of cerebral palsy?
Test the temperature of the water before a bath
Where will a preschool-aged child admitted with Reye syndrome most likely be placed?
in the ICU
A 7-year-old child who is taking medication to prevent seizures has been seizure free for 2 years. The child's parents ask a nurse, "How much longer will my child need to take the medication?" What is the best response by the nurse?
"It is important that the medications be gradually decreased."
A mother whose was diagnosed with cerebral palsy at 6 months of age asks why she was not told that her baby had cerebral palsy when the infant was born. How should the nurse respond?
"Until there's control of voluntary movement a diagnosis can't be confirmed."
A nurse notes that a child is exhibiting signs of cerebral palsy. At what age are these signs usually first noticeable?
12 months
Which type of seizure occurs during childhood and adolescence and rarely continues after adolescence?
Absence
What is the primary cause of otitis media in young children?
An obstructed eustachian tube
Which type of cerebral palsy may cause a wide-based gait in children?
Ataxic
An infant is found to have cerebral palsy (CP) several months after birth. When the infant is 10 months old the mother comes to the pediatric clinic because the child has begun to exhibit slow writhing movements. The nurse explains that these movements are characteristically associated with what type of CP?
Athetoid
A nurse is obtaining the health history from the mother of a preschooler with Reye syndrome. The nurse should ask the mother if the child has recently had what?
Chicken Pox
A 10-year-old child is undergoing radiation therapy for a brain tumor. What should the nurse include in the skin care for this child?
Cleansing the head with water
A child is being treated with oral ampicillin (Omnipen) for otitis media. What should be included in the discharge instructions that the nurse provides to the parents of the client?
Complete the entire course of antibiotic therapy.
A client is admitted to the hospital after sustaining a head injury. The nurse monitors for the most reliable sign of increased intracranial pressure, which is a slow what?
Decrease in the level of consciousness
A nurse is caring for an infant who has undergone myringotomy because of recurrent otitis media. What does the nurse expect to note when providing care to this child?
Drainage into the external auditory canal
Which is the most useful diagnostic procedure in diagnosing a seizure disorder? Electroencephalography Lumbar puncture Brain scan Skull radiography
Electroencephalography
A 7-year-old child with cerebral palsy who wears leg braces has a slight sensory loss in the lower extremities. What is the most essential information for the nurse to teach the child and parents?
Examine the skin for evidence of pressure points.
For how long should a nurse maintain isolation of a child with bacterial meningitis?
For 48 hours after antibiotic therapy begins
A 4-year-old child is brought to the pediatric clinic for a well-child visit. While entering the examination room the child bumps into the door jamb and then tilts his head to one side. The nurse suspects that the child has strabismus. What additional clinical finding supports this conclusion?
Frequent squinting
A nurse is planning to screen a school-age child for impaired hearing because the child is receiving an antibiotic that affects hearing. Which medication does the nurse suspect may have caused hearing impairment?
Gentamicin (Garamycin)
Which signs/symptoms are characteristics of brain tumors in children? (Select all that apply.) Headache upon awakening Projectile vomiting Seizure activity Decreased blood pressure
Headache upon awakening Projectile vomiting Seizure activity
______________ is the presence of blood in the anterior chamber of the eye.
Hyphema
The nurse is monitoring a client with a severe head injury for signs and symptoms of increasing intracranial pressure. Which finding is most indicative of increasing intracranial pressure?
Increased restlessness
A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. What does this finding indicate?
Increased white blood cell (WBC) count
An 8-year-old child with an influenza B viral infection was treated with aspirin and developed Reye syndrome. Which nursing intervention would be beneficial for this child?
Initiate hyperventilation
After many episodes of otitis media a 3-year-old child is to undergo myringotomy and have tubes implanted surgically. What should the nurse include in the discharge teaching for this family?
Insert earplugs during the child's bath.
A nurse is planning to teach the four-point alternate crutch gait to a 9-year-old child with cerebral palsy. The nurse teaches the parents that this gait was chosen because of what?
It provides for equal but partial weight bearing on each limb
The nurse anticipates that the family of a child with cerebral palsy is at risk for difficult parenting issues. What does the nurse conclude is the probable basis for this difficulty?
Loss of the expected healthy child
A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend?
Myringotomy
A nurse talks with parents of a toddler with strabismus about why this condition should be treated in early childhood. What complication should the nurse explain may occur if strabismus is not corrected?
Partial loss of sight
A 2-year-old toddler is admitted to the pediatric unit with a diagnosis of bacterial meningitis. What is the most important safety measure for the nurse to institute immediately after the child has a seizure?
Place the child in a side-lying position
The nurse notes that a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure. What is the priority nursing responsibility at this time?
Protecting the child from self-injury
What will the nurse include when performing cranial or neurological assessments? (Select all that apply.) Lung sounds Pupil assessment Vital signs Motor activity Level of consciousness
Pupil assessment Vital signs Motor activity Level of consciousness
An 8-year-old child is admitted to the emergency department with signs and symptoms of Reye syndrome. What information from the child's history is most important for the nurse to obtain in light of the child's tentative diagnosis?
Recent viral infection
A nurse is caring for a 2-year-old child with meningitis. For which clinical manifestations of increasing intracranial pressure should the nurse assess the child? Select all that apply. Seizures Vomiting Bulging fontanels Subnormal temp Decreased RR
Seizures Vomiting Decreased RR
The nurse is caring for a child with cerebral palsy. After reviewing the child's medical file, the nurse finds that the child has spastic deformities. Which treatment option would the nurse expect to be beneficial for this child?
Selective dorsal rhizotomy
At 1 am a 28-month-old toddler is admitted to the pediatric unit with suspected meningitis. At 3 am, after the child is settled in, the mother tells the nurse, "I have to leave now, but whenever I try to go my child gets upset and then I start to cry." What is the best action by the nurse?
Staying with the child while the mother leaves
The parents of an 18-month-old toddler are anxious to know why their child has experienced several episodes of acute otitis media. What should the nurse explain to the parents about why toddlers are prone to middle ear infections?
Structural differences between Eustachian tubes of younger and older children
A 2-year-old child who has been restricted to bed rest because of a diagnosis of meningitis is now allowed out of bed. The nurse suggests going to the playroom. The child responds by shaking the head vigorously from side to side, screaming, "No! Won't!" However, the child is trying to climb out of the crib at the same time. In light of these behaviors, what is the most likely conclusion by the nurse?
The child is trying to assert independence.
A nurse places a school-aged child with bacterial meningitis in isolation with droplet precautions. What is the purpose of these precautions?
They keep the child away from uninfected people
A school nurse is teaching the parents of school-aged children about the importance of immunizations for the childhood communicable diseases. What preventable disease may have the complication of encephalitis?
Varicella
Which diagnosis is related to the development of Reye's syndrome in conjunction with aspirin administration in the pediatric patient? Varicella Meningitis Encephalitis Strep throat
Varicella
What is considered a manifestation of retinoblastoma? Yellowish-white reflex seen in the pupil Red-eye reflex seen behind the retina Cloudy appearing cornea Increase in tear production
Yellowish-white reflex seen in the pupil
A child becomes cyanotic during a generalized tonic-clonic seizure. What is the most appropriate action by the nurse while the patient is seizing?
Continuing to observe the seizure
The parents of a school-aged child with fever, headache, and a stiff neck ask that the child be tested for meningitis. Which test should the nurse tell the parents is used to confirm the diagnosis of meningitis?
lumbar puncture
During a home visit a nurse discovers that a child in the household has a disability and has been experiencing seizures. In addition, the child's parent is unresponsive to the child's physical, emotional, or medical needs and seems to provoke seizure episodes by harsh verbal exchanges with the child. The nurse believes that intervention by an appropriate community resource is indicated. Where should the nurse make a referral?
CPS
A 2-year-old toddler is admitted with a fever of 103 F (39.4 C), stiffness of the neck, and general malaise and diagnosed with acute bacterial meningitis. What is the priority nursing intervention for this child?
initiating droplet precautions
The nurse, caring for a 3-year-old child with meningitis, should be alert for which signs and symptoms of increased intracranial pressure? Select all that apply. 1) Vomiting 2)Headache 3)Irritability 4)tachypnea 5) Hypotension
1) Vomiting 2)Headache 3)Irritability
Oral phenobarbital 30 mg every 6 hours is prescribed for a toddler who has had a seizure. A bottle of phenobarbital liquid labeled "20 mg/4 mL" is available. How much solution should the nurse administer? Record your answer using a whole number. __________
6 mL
What is the cause of athetoid cerebral palsy in infants?
birth asphyxia
A nurse in the pediatric clinic should be most observant for signs of cerebral palsy in which 6-month-old infant?
one born at 32 weeks
A 9-year-old child who has cerebral palsy and scoliosis also is mentally challenged and blind. The child is incontinent, has contractures of the elbows and wrists, and sits in a customized wheelchair most of the day. One goal of nursing care is for the child's skin integrity to remain intact. Which nursing action will best achieve this goal?
Changing disposable diapers every 2 to 3 hours
After a preschooler undergoes craniotomy for the removal of a brain tumor, the nurse identifies an area of serosanguineous drainage about the size of a quarter on the child's dressing. What is the immediate response by the nurse?
Circling the area with nonabsorbable ink
A four-year-old boy with Reye syndrome is beginning to show signs of recovery. The intracranial pressure has receded, the vital signs are stable, the fever has subsided, and urine output is within the acceptable range for the child's weight and fluid intake. What should the nurse tell the parents about their son's recovery?
"The recovery is now progressing as we'd hoped."
An 8-year-old child with cerebral palsy is admitted to the hospital for a tendon-lengthening procedure. After the surgery the parents ask a nurse why their child must wear braces and shoes for at least 12 hours a day, even while in bed. What is the best response by the nurse?
"They maintain body alignment and help prevent foot drop."
A nurse encourages parents to have their toddler's eyes tested especially for monocular strabismus. What should the nurse explain may occur if the condition is not corrected early?
Amblyopia will progress in the weak eye.
A nurse is caring for clients with various health problems. These problems include scarlet fever, otitis media, bacterial endocarditis, rheumatic fever, and glomerulonephritis. What common factor linking these diseases should the nurse consider?
Result from streptococcal infections that enter via the upper respiratory tract
The mother of a 10-month-old infant with otitis media tells the nurse in the pediatric clinic that this is her baby's third infection in 3 months. The infant is tugging at the ear but is not acutely ill. Before responding, the nurse should consider that:
The Eustachian tube is short and horizontal
The mother of a 2-year-old child tells the nurse that she is concerned about her child's vision. What behavior observed when the child is fatigued leads the nurse to suspect strabismus?
one eye moves inwards
