Chapter 44 peds

prepU A nurse is teaching the parents of a child who has been diagnosed with spina bifida. Which statement by the nurse would be the most accurate description of spina bifida?

"Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately."

prepU A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown and there are many environmental factors that may contribute to it."

prepU The nurse is assessing an infant at a well-check visit. The infant's parent expresses worry about the infant's feet because they are so flat and wide. What is the most appropriate response by the nurse?

"Your baby's feet are normal. The longitudinal arch will develop after your baby walks for several months."

prepU When assisting parents in a home care plan for a child with Legg-Calvé-Perthes disease (LCPD), the nurse would teach the parents that which is anticipated?

A non-weight-bearing period initially occurs. Resting the affected femoral epiphysis aids healing.

prepU A 3-year-old demonstrates lateral bowing of the tibia. Which signs would indicate that the boy's condition is Blount disease rather than the more typical developmental bowlegs (genu varum)?

A sharp, beaklike appearance to the medial aspect of the proximal tibia on x-ray Blount disease is retardation of growth of the epiphyseal line on the medial side of the proximal tibia (inside of the knee) that results in bowlegs (genu varum). Unlike the normal developmental aspect of genu varum, Blount disease is usually unilateral and is a serious disturbance in bone growth that requires treatment. In those with Blount disease, the medial aspect of the proximal tibia will show a sharp, beaklike appearance.

prepU 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. Pressure of a crutch against the axilla could lead to compression and damage of the brachial nerve plexus crossing the axilla, resulting in permanent nerve palsy.

shin splints treatment

The first line of treatment for these injuries is RICE (rest, ice, compression, elevation)

Gower sign

To stand, they press their hands against their ankles, knees, and thighs (they "walk up their front"); Seen with Duchenne muscular dystrophy transfer technique

Transient synovitis

an inflammatory disease NSAIDs such as ibuprofen and limited activity are prescribed. Surgical intervention is not needed.

During adolescence, muscle growth is influenced by hormonal changes, primarily the increased production of

androgenic hormones

skin traction

applies pull on tape, rubber, or a plastic material attached to the skin, which indirectly exerts pull on the musculoskeletal system. diazepam is used for the treatment of muscle spasm associated with traction or casting

prepU An infant is placed in Bryant traction. For Bryant traction to be effective, the infant must be positioned on the:

back with hips up off the bed. BRYAN GET YOUR BUTT OFF THE BED !!

greenstick fracture

bending and incomplete break of a bone; most often seen in children

Fractures that occur in the epiphyseal plate, the area between the central shaft (diaphysis) and the rounded end portion (epiphysis):

can halt growth, stimulate abnormal growth, or cause irregular or erratic growth.

Legg-Calvé-Perthes disease

ccurs when blood supply to the femoral head of the hip joint is temporarily interrupted and the bone begins to die. The child with Legg-Calvé-Perthes disease will experience limited range of motion in the hip

skeletal traction

exerts pull directly on skeletal structures by means of a pin, wire, tongs, or other device surgically inserted through a bone. diazepam is used for the treatment of muscle spasm associated with traction or casting

spina bifida occulta

form of spina bifida without protrusion of the spinal cord or meninges In most cases benign and asymptomatic and produces no neurologic signs; Mobility typically is not impaired

Epiphysiolysis of the proximal humerus

is an overuse disorder that occurs with rigorous upper extremity activity such as pitching and causes tenderness in the shoulder.

prepU The nurse caring for a client with suspected muscular dystrophy would prepare her client for which diagnostic test?

muscle biopsy

myelomeningocele positions after surgery

side-lying (left and right) prone

prepU Which diagnostic measure is most accurate in detecting neural tube defects?

significant level of alpha-fetoprotein present in amniotic fluid

prepU The charge nurse is observing a student nurse perform skeletal traction pin care. What action by the student nurse would indicate a need for intervention by the charge nurse?

unhooking a weight while providing pin care Weights should never be moved or unhooked during skeletal traction. Pin care is a sterile procedure. Pins are cleaned with half-strength hydrogen peroxide and then typically covered with sterile cotton gauze.

Pavlik Harness

used for hip dysplasia in infants Remove only to take baths

syndactyly

webbed fingers or toes