Peds Exam #3

What are three nursing interventions to initiate after birth for babies with myelomeningocele?

1. Keep pressure off the affected area 2. Keep the affected area moist and covered 3. Prepare for surgical intervention

What are two signs of developmental dysplasia of the hip?

1. Limited hip abduction 2. Shortened femur

What are 4 things to be expected from a nurse caring for a patient who just had a scoliosis repair surgery?

1. Log-rolling the patient for positioning 2. Using a Foley catheter 3. 4.

How can meningitis be diagnosed? (3)

1. Lumbar puncture 2. Blood culture 3. Noting symptoms and side effects

What two signs are tested when assessing for DDH?

1. Barlow maneuver 2. Ortolani test

When developing the plan of care for a newly admitted 2-year old child with the diagnosis of Kawasaki disease, which of the following would be the priority

monitoring intake and output every hour

a 16-month-old child diagnosed with Kawasaki disease is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. Which of the following would the nurse interpret as the priority?

placing the toddler in a quiet environment

when positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate?

prone with hips abduction

after teaching a group of school teachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizures. which of the following actions, when performed first, indicates that the nurse's teaching has been successful

removing any nearby objects that could harm the child

the parents of a child with occasional generalized seizures want to send the child to summer camp. the parents contact the nurse for advice on planning for the camping experience. which of the following activities would the nurse and family decide is most important for the child to avoid

rock climbing

which of the following would the nurse include when completing discharge instructions for the parents of a 12-month-old child diagnosed with Kawasaki disease and being discharged to home?

take the child's temperature daily for several days

What are 9 signs of increased ICP?

1. Irritability 2. Headache 3. Seizures 4. Diplopia 5. Changes in LOC 6. Sunsetting eyes 7. Nausea/vomiting 8. High-pitch cry 9. Changes in PERRLA

What are three important interventions to consider for hydrocephalus?

1. Monitor for symptoms of increased ICP 2. Monitor OFC measurements for kids under 2 3. Anticipate potential need for shunt placement

What are 6 things to remember when caring for a patient in a sling?

1. No rough activity 2. Keep at heart level or above 3. Don't insert anything inside 4. Neurovascular checks are important 5. Watch skin integrity 6. Prevent neurovascular injury

What are 7 things to remember when caring for a patient in a cast?

1. No rough activity 2. May need crutches or a wheelchair 3. Don't insert anything inside 4. Neurovascular checks are important 5. Watch skin integrity 6. Prevent neurovascular injury 7. Petaling

What are complications that can occur if meningitis is severe, untreated, or reoccurring? (3)

1. Brain damage 2. Stroke 3. Hearing loss

What are four needs for a kid with meningitis?

1. Comfort measures 2. Decrease stimulation 3. Bundle care 4. Complete frequent neurological checks

What are four features of kids with Downs syndrome?

1. Epicanthal folds 2. Simian crease 3. Stubby toes/fingers 4. Upward/outward slant of eyes

What are four interventions for preparing a room when admitting a child with a history of seizures?

1. Have suction and oxygen set-up 2. Place the bed in the lowest position 3. Pad the side rails of the bed 4. Remove any equipment or items from the bed

What are eight symptoms of meningitis?

1. Severe headache 2. Sudden high fever 3. Irritability 4. Stiff neck/nuchal rigidity 5. Bulging fontanel 6. Photosensitivity 7. Change in LOC 8. Sleepiness

What do you need to educate the parents of a child with a shunt on? (3)

1. Side effects of shunt malfunction 2. Signs of infection 3. Signs of increased ICP

When using a Pavlik harness, what are three important considerations?

1. Skin integrity 2. Fit/straps of the harness 3. Use knee socks and/or undershirt

What are the two goals of treatment for a patient with Perthes disease?

1. The bone grows back into a round shape 2. The bone fits well into the joint of the hip socket

What are four actions that should be taken when a child is seizing?

1. Time the seizure from start to stop 2. Document the seizure and time it occurred once the seizure has subsided 3. Take vitals and assess the patient after the seizure 4. Move potentially dangerous objects away from the child

What do shunts do?

They move CSF to decreased ICP from the brain

What is spina bifida?

A birth defect where the lower part of the neural tube doesn't close, causing varying levels of paralysis and sensory loss of the legs

What is myelomeningocele?

A section of the spinal cord and its nerves are exposed to the outside of the body

What is an important aspect of care for kids with cerebral palsy?

Anticipate a multidisciplinary care team

What is the most common cause of osteomyelitis?

Bacteria

Which form of meningitis is the most deadly?

Bacterial

What is the treatment for people who have scoliosis?

Depends on the degree of curvature

What kind of precautions should a person with meningitis be placed into?

Droplet

What is the most common form of Downs syndrome?

Each cell in the body has 3 separate copies of chromosome 21 vs. usual 2 copies (the cause is usually unknown)

What is the most commonly affected group of people that develop scoliosis?

Girls during growth spurts

What neurological condition is commonly associated with myelomeningocele?

Hydrocephalus

What does the treatment regimen for someone with osteomyelitis include?

IV or PO antibiotics for 3-6 weeks

If you cannot monitor or observe a patient with Perthes disease, what is most likely to happen?

Immobilization via traction or bracing

What two signs are tested when assessing for meningitis?

Kernig's and Brudzinski's signs

What is another term used for spina bifida?

Myelomeningocele

What two vaccines help prevent meningitis?

PCV and Hib

For babies up to 6 months old, which of the following is the most common intervention for DDH?

Pavlik harness

What is happening in developmental dysplasia of the hip?

The hip joint doesn't form properly. The femoral head and acetabulum are not properly aligned

What is happening to a patient who has Perthes disease?

There is a temporary loss of blood supply of the femoral head. The cause is unknown and overtime the blood supply will return, allowing the bone to grow back

What is happening to a child with hydrocephalus?

There is an increased CSF volume in the brain due to imbalanced CSF production and absorption

What is a VA shunt?

Ventriculoatrial shunt (drains CSF from the brain to the right atrium of the heart)

What is a VP shunt?

Ventriculoperitoneal shunt (drains CSF from the brain to the peritoneum)

What is clubfoot?

a congenital anomaly where the foot/feet is twisted out of the normal position

after talking with the parents of a child with down syndrome, which of the following would the nurse identify as appropriate

encouraging self-care skills in the child

the mother of a newborn with myelomeningocele asks if her baby is likely to have any other defects. the nurse responds based on the understanding that myelomeningocele is frequently associated with which of the following?

excessive cerebrospinal fluid within the cranial cavity

which of the following would alert the nurse initially to suspect hydrocephalus in an infant who has undergone surgical repair of a myelomeningocele?

increased head circumference and bulging fontanel

a preschooler with a history of repaired lumbar myelomeningocele is in the emergency department with wheezing and skin rash, Which of the following questions would the nurse ask the mother first

is your child allergic to bananas or milk products

when assessing a newborn admitted to the pediatric unit with upper lumbar myelomeningocele, which of the following would the nurse anticipate finding?

minimal movement of the lower extremities