Peds Exam IV Neuro- Chapter 49

A parent of a child diagnosed with seizures states, "I've heard about a special diet that may control seizures, I think it's called ketogenic. What can you tell me about it?" Which are appropriate responses by the nurse? Select all that apply.

"About 40% to 50% of children who follow the diet have really good results." "The diet consists of high fat foods." "Protein is limited in this diet."

The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure?

"He was just staring into space and was totally unaware."

Isabelle, age 7, has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when Isabelle first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be best for the nurse to say to this mother?

"This might or might not be a problem. Watch Isabelle for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome."

The school nurse is observing a child in the classroom. The child is speaking and then suddenly stops and stares for about 5 seconds and then continues speaking. The nurse charts this as what type of seizure?

Absence

What information is most correct regarding the nervous system of the child?

As the child grows, the gross and fine motor skills increase.

The nurse is caring for a child who had a seizure, fell to the ground, and hit and injured his face, head, and shoulders. When notifying the healthcare provider, which type of seizure is the nurse most likely to report?

Atonic

The nurse is caring for a child who is having a seizure. What is the appropriate action by the nurse?

Attempt to turn the child on their side to prevent aspiration.

The nurse is caring for a child who was injured in a bike accident. The nurse determines that a child is experiencing late signs of increased intracranial pressure based on which assessment findings? Select all that apply.

Bradycardia Fixed dilated pupils Irregular respirations

What finding is consistent with increased ICP in the child?

Bulging Fontanelle

The nurse is in the room when a child with a seizure disorder is having a seizure. The child is exhibiting generalized jerking muscle movement, and the nurse notes the bed appears to be wet with urine. The child is in which stage of the generalized seizure?

Clonic

A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)?

Cloudy appearance Explanation: In the CSF of clients diagnosed with bacterial meningitis, the pressure is elevated, the appearance is cloudy, and the leukocytes are elevated. A decreased sugar content is noted.

A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply.

Complaints of stiff neck Photophobia Vomiting

The nurse is assigned an infant with a possible neurological disorder. Which assessment finding would the nurse communicate to the healthcare provider as a late sign of increased intracranial pressure?

Decorticate posturing and fixed and dilated pupils

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?

Dramatic increase in head circumference

Haemophilus influenzae meningitis is usually spread by which of the following methods of transmission?

Droplet

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

Absence seizures are marked by what clinical manifestation?

Loss of motor activity accompanied by a blank stare

Any individual taking phenobarbital for a seizure disorder should be taught:

Never to discontinue the drug abruptly

A symptom often seen in the child diagnosed with Haemophilus influenzae meningitis occurs when the child has a stiff neck. This symptom is referred to as which of the following?

Nuchal rigidity

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?

Positive Kernig sign Explanation: A positive Kernig sign can indicate irritation of the meninges. A positive Brudzinski sign also is indicative of the condition.

The nurse is planning care for a preschool-aged child with spastic cerebral palsy. Which nursing diagnosis should the nurse identify to guide care for this patient's musculoskeletal status?

Risk for disuse syndrome related to spasticity of muscle groups

The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be:

The child is in status epilepticus

When caring for a child who has a history of seizures, which nursing interventions would be appropriate? Select all that apply.

The nurse pads the crib or side rails before a seizure. The nurse stays with the child and calls for help when a seizure begins. The nurse has oxygen available to use during a seizure. The nurse positions the child on the side during a seizure. The nurse teaches the caregivers regarding seizure precautions.

A nurse is providing information to the parents of a child diagnosed with absence seizures. What information would the nurse expect to include when describing this type of seizure? Select all that apply.

This type of seizure is more common in girls than it is in boys. You might see a blank facial expression after a sudden stoppage of speech. This type of seizure is usually short, lasting for no more than 30 seconds. You might have mistaken this type of seizure for lack of attention.

The nurse caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply.

Time the seizure started Factors present before seizure started Eye position and movement Incontinence of urine or stool

The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as:

sunsetting

To detect complications as early as possible in a child with meningitis who's receiving I.V. fluids, monitoring for which condition should be the nurse's priority?

cerebral edema