Neuromuscular - The Point Questions

"We should give this drug before he eats anything."

A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

Pectus excavatum

A nurse is conducting a physical examination of a 5-year-old boy with spinal muscular atrophy (SMA) type 2. What assessment findings would the nurse expect to find?

"Prednisone helps to keep muscle fibers strong and delays progression of the disease. Calcium protects against osteoporosis caused by both prednisone and lack of weight bearing."

A young child with Duchenne muscular dystrophy is placed on both prednisone and calcium. Parents view these two medications as rather "common" and question their importance for the child. What explanation by the nurse will be most helpful to the parents?

Respiratory

In caring for the child with Guillain-Barré syndrome, the nurse will provide much supportive care while watching carefully for signs of deterioration in which body system?

Gene mutation

Muscular dystrophy is a result of which cause?

"Old urine remains in the bladder because of poor emptying or overfilling, putting your child at risk for urinary tract infection.

The child with a surgically repaired myelomeningocele has a neurogenic bladder. How will the nurse best explain this problem to the parents?

Creatine kinase

The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal?

Recommend raising the bed's side rails when a caregiver is not present.

The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury?

Deficient knowledge related to diagnosis and condition

The nurse is assessing a child with spina bifida occulta. During the assessment, the parents say, "It's going to be so difficult taking care of our child. He'll never be able to walk." The nurse identifies which nursing diagnosis as the priority?

Serum creatine kinase levels are elevated. The child is unable to rise easily into a standing position when placed on the floor. A muscle biopsy shows an absence of dystrophin.

The nurse is assessing a young boy who has been brought to the physician for mobility and balance issues by his parents. Which findings are positively associated with the presence of Duchenne muscular dystrophy? Select all that apply.

Athetoid

The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations?

spastic.

The nurse is caring for a 2-year-old boy with cerebral palsy (CP). The medical record indicates "hypertonicity and permanent contractures affecting both extremities on one side." Based on these findings, the nurse identifies this type of CP as:

"I need to monitor his skin at least twice a week."

The nurse is caring for a child with a spinal cord injury and providing instruction to the parents on promoting skin integrity. Which response from the mother indicates a need for further teaching?

Place a folded diaper in between the legs. Place synthetic sheepskin under the infant's chest. Place the child on a special care mattress.

The nurse is caring for an infant with a myelomeningocele who has paralysis of the lower extremities. Which actions would be most appropriate to help reduce friction resulting from this paralysis? Select all that apply.

"How do you feel when your daughter interrupts you?"

The nurse is conducting a health assessment of a 6-year-old girl with spinal bifida. During the interview, the girl keeps interrupting and shouting to get her mother's attention. The mother instantly responds to every interruption and attempts to placate her with promises of a trip to the ice cream store. Which response by the nurse would be most appropriate to address the mother's response to her daughter's demands?

Prevent rupture or leaking of cerebrospinal fluid

The nurse is providing presurgical care for a newborn with myelomeningocele. Which action is the central nursing priority?

"It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved."

The parents of a infant born with an abnormality on the back are told by the neonatologist that their child has a myelomeningeocele. They ask the nurse what exactly that means. Which would be the nurse's best reply?

Head lag when pulled from supine to sitting

Which finding will cause the nurse to refer a 6-month-old child for further neuromuscular testing?

Increased mobility of the spine

A nurse is preparing a program for a group of parents about injury prevention. What would the nurse include as an important contributing factor for cervical spine injury in a child?

The boy rises from the floor by walking his hands up his legs.

The pediatric nurse practioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this?