Cerebral Palsy

2 - To prevent baclofen withdraw, pump refills are scheduled several days before anticipated low volume alarms. The nurse should make it a high priority to have the pump refilled ASAP. Discontinuing baclofen suddenly can result in a high fever, muscle rigidity, change in LOC, and even death. Waiting until the child leaves the hospital for a refill may lead to a low dose withdrawal. Waiting for the low volume alarm puts the client at risk because medication and team members who can refill the pump may not be readily available under all circumstances.

A child with spastic CP receiving intrathecal baclofen therapy is admitted to the pediatric floor with vomiting and dehydration. The family tells the nurse that they were scheduled to refill the baclofen pump today but had to cancel the appointment when the child became ill. The nurse should: 1. explain that the medication should be discontinued during illness 2. arrange for the pump to be refilled in the hospital 3. reschedule the pump refill for the day of discharge 4. instruct caregivers to call for a refill when the low volume alarm sounds

b,d,e - Prematurity is an etiology of CP that occurs before birth. Fetal viral infection, Brain injury & genetic factors are etiologies of CP that occurs before birth. Hyperbilirubinemia is an etiology of CP that occurs after birth.

SATA - The mother of a​ 4-year-old child with CP asks how this health problem occurred. Which​ pre-birth insults would the nurse explain to the mother are possible​ causes? a. Brain injury b. Prematurity c. Hyperbilirubinemia d. Fetal viral infection e. Genetic factors

a,b,e - When a child is diagnosed with CP, the doctor will refer the child for occupational, speech, and physical therapies for evaluation and treatment. A psychiatric evaluation is not a therapy. Massage therapy is a complementary therapy that the parents may be interested in exploring, but the physician will not likely order it as a treatment.

SATA - The nurse explains to family of an infant with CP what to expect for treatment for the child. Which of the following may be involved in the child's care? a. Physical therapy b. Occupational therapy c. Massage therapy d. Psychiatric evaluation e. Speech therapy

b - Infants & children with CP do not exhibit normal muscle tone. Infants with CP often exhibit arching of back. Children with CP often experience delay in reaching developmental milestones. Strabismus is seen in children with CP.

A​ 1-year-old child is being evaluated for CP. When assessing child, which finding is the nurse least likely to​ observe? a. Arching of back b. Normal muscle tone in all extremities c. Strabismus d. Developmental delay

a,b,c,e - Parents need financial assistance to provide appropriate appliances and therapy for a child with CP. Speech therapy can assist with communication. Although a child with CP should eat​ high-calorie foods, this is not a​ community-based intervention. Agencies such as the United CP Association and Shriners Hospitals can help acquire appropriate equipment for the child. Recreational activities at an appropriate level can help reduce spasticity.

SATA - A clinic nurse is talking to the mother of a​ 4-year-old child who has CP. The family is new to the community and needs help finding necessary services for their child. Which​ community-based intervention would the nurse​ provide? a. Names of speech therapists b. Information about recreational activities in the community c. Support services for financial assistance d. Importance of​ high-calorie snacks e. Contact information for United CP Association and Shriners Hospitals

d - Skin integrity and good body alignment are essential for a child with CP who is in a wheelchair.​ Pillows, towels, and bolsters may be needed for positioning or to take pressure off reddened areas of skin. Height and weight must be assessed for every​ child, as should nutrition status and bowel habits. Assessment of persistent newborn reflexes and for swallowing difficulty is used to detect clinical manifestations that may indicate a child has CP.

Tina​ White, a​ 7-year-old African American girl with dyskinetic CP, has used a stroller or wheelchair for mobility since birth. During every Dr. appointment, on which finding should nurse focus when assessing this​ client? a. Nutrition status & constipation b. Height & weight c. Persistent newborn reflexes & swallowing d. Skin integrity & body alignment

2 - The dx of meningitis at 6 months correlates to a diagnosis of CP. CP is often associated with birth trauma or virus/infection of the brain or spinal column.

Which information from mother of a child with CP correlates to diagnosis? 1. she was born at 40 weeks gestation 2. she had meningitis when she was 6 months old 3. she had physiologic jaundice after delivery 4. she had frequent sore throats

b - There is a risk for insufficient intake of fluids and fiber. This child with CP most likely also has insufficient physical activity, and the combination puts the child at risk for constipation. The child with CP may not be able to participate in as much physical activity due to lack of muscle control, but that does not mean the child is activity-intolerant. Impaired comfort and ineffective coping may be appropriate diagnoses for some children with CP, but the risk for constipation is a priority for all.

Which nursing diagnosis would the nurse select for a child with CP who has oral motor problems? a. Ineffective Coping b. Risk for Constipation c. Activity Intolerance d. Impaired Comfort

c - Hypotonia in infancy and muscle instability are seen in ataxic CP. Hypertonia and persistent primitive reflexes are seen in spastic CP. Tremors and exaggerated posturing are seen in dyskinetic cerebral CP. Hemiplegia and hypertonia are seen in spastic CP.

A​ 9-month-old child has been diagnosed with ataxic CP. Which clinical manifestation would the nurse expect to assess in this​ client? a. Tremors and exaggerated posturing b. Hypertonia and persistence primitive reflexes c. Hypotonia and muscle instability d. Hemiplegia and hypertonia

c - A physical therapist can assess the child and develop a plan for tendon stretching & range-of-motion exercises to decrease the rigidity and spasticity. Most school districts do not require that children with physical disabilities such as those associated with CP attend alternative schools. Children with CP require​ high-calorie foods because of feeding difficulties associated with spasticity and hypotonia. Computers are encouraged to promote communication.

A​ 6-year-old child with CP who is new to the school district is experiencing severe rigidity and spasticity. Which recommendation would the school nurse make to child​'s ​parents? a. ​"Offer only​ low-carbohydrate, low-calorie foods to the​ child." ​b. "Discourage the use of a​ computer." c. "Make an appointment with a physical​ therapist." ​d."Look into special schools for the​ handicapped."

3 - It is important to identify primary developmental delays in children with CP and to prevent secondary and tertiary delays. The arrested development is worrisome and requires further investigation. It is possible the lack of development indicates hearing loss or may be a sign of autism. The brain damage caused by CP is not progressive. The brain of a young child is quite plastic assuming the childs development has peaked at 3 would be a serious mistake. The therapy plan will need to be modified, but a better understanding of the underlying problem will lead to the greatest chance of creating a successful therapy plan.

During a developmental screening the nurse finds that a 3 year old child with CP has arrested social and language development. The nurse tells the family: 1. This is a sign the CP is progressing 2. Your child has reached his maximum language abilities 3. I need to refer you for more developmental testing 4. We need to modify your therapy plan

a - Ranitidine is a medication used to protect the gastrointestinal​ (GI) system.​ Baclofen, dantrolene, and botulinum toxin are medications used to control seizures and muscle spasms caused by CP.

Which med is not used to control seizures & muscle spasms in​ CP? a. Ranitidine b. Dantrolene c. Baclofen d. Botulinum toxin

a - ​75% of all cases of CP are classified as spastic.​ 10% to​ 15% of all cases of CP are classified as dyskinetic.​ 5% to​ 10% of all cases of CP are classified as ataxic. A small percentage of CP cases are classified as mixed.

The nurse is preparing to care for a child with CP. Knowing the different​ classifications, for which type of CP would the nurse most likely plan​ care? a. Spastic CP b. Mixed CP c. Ataxic CP d. Dyskinetic CP

b,c,d,e - Clinical therapy is used for clients who have CP to help them develop their maximum level of independence. In order to improve motor function & ability, referrals are made for​ physical, occupational & speech therapy & also special education. Complementary therapies such as massage therapy & hippotherapy are recommended but do not require a medical referral.

SATA - Which nonpharmacologic therapies are used in the care of a client with CP? a. Massage therapy b. Special education c. Occupational therapy d. Physical therapy e. Speech therapy

2,3,4,5 - Botulinum toxin injections can be used to improve many aspects of quality of life for the child with CP. The injections can help decrease pain from spasticity. Injections improve motor status by reducing rigidity and allowing for more effective physical therapy to improve range of motion. Decreased spasms enhance self esteem. Improved motor status facilitates the ability to provide some aspects of care, especially transfers. Botulinum does not significantly affect nutritional status or speech.

SATA - A child with spastic CP is to begin botulism toxin type A injections. Which treatment goals should the healthcare team set for the child related to botulinum toxin? 1. improved nutritional status 2. decreased pain from spasticity 3. improved motor function 4. enhanced self esteem 5. reduced care giver strain and improved self care 6. decreased speech impediments

a,c,d,e - Abnormalities that can be assessed that indicate CP include asymmetric​ crawling, head​ lag, arched​ back, and poor trunk control. Thumb sucking is not a manifestation of CP.

SATA - During an​ assessment, the nurse suspects that an​ 11-month-old infant is demonstrating manifestations of CP. Which assessment finding would bring the nurse to this​ conclusion? a. Arched back b. Thumb sucking c. Head lag d. Poor trunk control e. Asymmetric crawling

b,c - All infants who show symptoms of developmental delay should be evaluated by using two simple screening assessments. The first is a diaper​ pull, which is conducted by placing a clean diaper on the child​'s ​face; the infant with CP will use one hand or will not remove the cloth at all. The other test is the head​ turn, which is conducted by turning the infant​'s head to one​ side; if the child has a persistent asymmetric tonic neck reflex beyond 6 months of​ age, this indicates a pathological condition. Babinski reflex does not indicate presence or absence of CP. Phalen test is used to assess for carpal tunnel syndrome. The heeldash-shin test is used with adults to determine nervous system integrity of the lower extremities.

SATA - Which screening assessment is used for children showing developmental delays indicative of CP? a. Heel-shin test b. Head turn c. Diaper pull d. Phalen test e. Babinski reflex

a,b,d,e - It is appropriate to assess the following at each healthcare provider​ visit: height and​ weight, developmental​ abnormalities, persistent newborn​ reflexes, abnormal muscle tone or​ posture, and altered speech and swallowing. Sleep patterns of a newborn do not typically extend past the newborn period.

SATA - Which would be assessed in all children during healthcare provider​ visits? a. Altered speech and difficulty swallowing b. Height and weight c. Persistent newborn sleep patterns d. Abnormal muscle tone and abnormal posture e. Developmental abnormalities

b - Head​ lag, tonic neck​ reflex, and following objects 180 degrees are all normal for a​ 4-month-old infant. If head lag and tonic neck reflex persist beyond 6​ months, then they would be a concern and suggest CP. Hypotonia is not normal and could be a sign of CP.

The nurse is assessing a​ 4-month-old client because mother is concerned that Pt may be developmentally delayed. Which finding would lead the nurse to suspect CP in the​ infant? a. Tonic neck reflex b. Hypotonia c. Follows objects 180 degrees d. Head lag

a,c,e - nurse should teach the use of a helmet to protect against head injuries for children with CP who experience seizures. The nurse should teach use of seat belts for children in strollers & wheelchairs to decrease the likelihood of falling out of seat. The use of adaptive seating in automobiles is an important area of teaching related to safety.​ Range-of-motion exercises are important to enhance physical​ mobility, not for child safety. The use of splints & braces is important to prevent contractures & promote mobility but not for child safety.

SATA - The nurse is preparing discharge instructions for the parents of a child with CP. Which instruction would the nurse include to promote safety for this​ child? a. The use of a helmet to protect against head injuries b. The use of​ range-of-motion exercises c. The use of seat belts in strollers and wheelchairs d. The use of splints and braces e. The use of adaptive seating for automobile transportation

a,b,d,e - Muscle relaxants may help the child with spasticity often associated with CP. Surgery may be helpful for children who experience contractures as a result of CP. Serial casting may be helpful for children with CP. Positioning devices are used to prevent contractures. A​ low-calorie diet is not recommended for children with CP.

SATA - The nurse is preparing educational material for the parents of children with CP. Which treatment would the nurse include in this teaching​ session? a. Muscle relaxants b. Surgery c. Low-calorie diet d. Positioning devices e. Serial casting

a,b,d,e - Medications used to control seizures & spasms include skeletal muscle​ relaxants, baclofen,​ benzodiazepines & botulinum toxin. Antidepressants are not used to manage the symptoms of CP.

SATA - The parents of a child with CP ask if there are any medications available to help control the child​'s symptoms. Which type of medication would the nurse explain is used for symptom management for CP? a. Botulinum toxin b. Baclofen c. Antidepressants d. Muscle relaxants e. Benzodiazepines

a,c,d - Most cases of CP are caused before or during birth by a brain​ insult; this includes premature​ birth, fetal viral​ infection, and injury to periventricular white matter. CP can also develop after birth to age 2​ years, when it can be caused by neonatal sepsis and hyperbilirubinemia.

SATA - Which factor cause CP before or during​ birth? a. Fetal viral infection b. Hyperbilirubinemia c. Premature birth d. Injury to periventricular white matter e. Neonatal sepsis

c - Asking about maternal age at​ birth, prematurity, and birth order all assess possible prenatal causes of CP. Asking about accidents before age 3 can help determine whether the​ child's brain insult happened after birth.

The nurse is obtaining a health history from the parents of a child with CP). Which question would be most helpful in determining whether the​ child's brain insult happened after​ birth? ​a. "Was the mother older than 40 years when the child was​ born?" ​b. "Was the child born subsequent to the fourth​ child?" ​c. "Were there any accidents before age​ 3?" ​d. "Was the child born​ prematurely?"

a - Spastic CP is generally attributable to a brain insult in the cerebral cortex. Ataxic CP is generally attributable to a brain insult in the cerebellum. Mixed CP is generally attributable to multiple injury sites. Dyskinetic CP is generally attributable to a brain insult in the basal ganglia.

Stacy Capers is a term female newborn diagnosed with an infection contracted in utero. The Dr. advises parents that the newborn may have spastic CP because of a brain insult related to the infection. When talking with the​ parents, which area of the brain will the nurse indicate is affected by the​ insult? a. Cerebral cortex b. Cerebellum c. Multiple areas d. Basal ganglia

d - One of the first things that parents will notice in a child with CP is that the child is not keeping up with developmental milestones. The nurse assesses the child for milestones that should be accomplished by four months of age, such as bringing the hands to midline and placing objects in the mouth. A 6-month-old typically sits up without assistance. A 9- to 12-month-old pulls up in a crib and begins to play with parents.

The clinic nurse assesses a 4-month-old infant for suspected CP and uses which developmental milestone to help confirm a diagnosis of CP: The child's... a. Ability to sit up without assistance. b. Ability to play with the parent. c. Ability to pull up in a crib. d. Ability to bring hands to midline and place objects in mouth.

1 - Limited interaction or lack of interaction with friends and family may lead the nurse to suspect a possible problem with the familys ability to cope with others reactions and responses to a child with CP. Learning measures to meet the childs physical needs demonstrates some understanding and acceptance of the disease. Requesting teaching about CP suggests curiosity or a desire to understand showing the family is dealing with the situation. Participating in social media may serve as a form of support and can be a healthy coping mechanism.

The nurse assesses family's ability to cope with childs CP. Which action should alert the nurse to the possibility of their inability to cope with the disease? 1. limiting interaction with extended family and friends 2. learning measures to meet the childs physical needs 3. requesting teaching about CP in general 4. seeking advice on coping on social media

d - Small amounts of food should be given to a child with CP because of problems with chewing and swallowing. Utensils with​ large, not​ small, padded, adaptive handles should be utilized for this child. There is no need to restrict this child​'s ​fluid; the nurse would need to perform frequent assessments to determine hydration​ status, as the child may not be able to communicate thirst.​ Fiber, not​ protein, would be given to prevent constipation.

The nurse is caring for a child with CP. Which intervention would nurse use to promote nutrition for this​ child? a. Using utensils with​ small, padded, adaptive handles b. Restricting the child​'s fluid intake c. Providing adequate protein to prevent constipation d. Providing the child with small amounts of food at a time

1 - frequent rest periods for a client with CP help relax tense muscles, resulting in a decrease of grimacing and writhing movement.

The nurse is caring for a client with CP. The nurse should provide frequent rest periods because: 1. grimacing & writhing movements decrease with relaxation & rest 2. hypoactive DTRs become more active with rest 3. stretch reflexes are increased with rest 4. fine motor movements are improved with rest

b - During the family assessment of the child with CP, the nurse should ask about the mother​'s age when the child was​ born; the mother being older than age 40 at the time of the child​'s birth could be a prenatal cause for the development of disorder. The father​'s ​livelihood, an older brother​'s hearing​ deficit, or a maternal grandmother​'s health problems are not prenatal causes for the development of CP.

The nurse is completing the health history with the mother of a child with CP. Which information from the mother​'s history would the nurse identify as a prenatal cause for the child​'s development of the​ disorder? a. Maternal grandmother has heart disease b. Mother delivered the child at age 42 c. Father works in an automobile factory d. Older brother has a hearing disorder

c - Many clients with CP have physical disabilities but not intellectual disabilities. Parents should be instructed to encourage child's autonomy & abilities. Adaptive devices should be provided to help child communicate more effectively. Parents should use terminology appropriate for child's development​ level, not 1 year below. Vocational training options are appropriate and should be discussed with the parents. Although home schooling is an​ option, interacting with other children can stimulate the child​'s growth and may be encouraged.

The nurse is preparing an educational seminar about early intervention programs to promote growth and development of the child with CP​. Which information would the nurse include to assist the parents of these​ children? a. The value of home schooling so that child won't be exposed to children in school setting b. The need to use terminology 1 year below child's development level c. The use of adaptive devices to help child communicate more independently d. Explain vocational training is not appropriate but that assisting with a general job is appropriate

d - Injury to the immature periventricular white matter in premature infants is thought to be most common risk factor and cause of CP. The rate of CP increases with decreasing gestational age. Birth asphyxia causes a small percentage of CP. A maternal cold and poor nutrition by the mother do not pose as significant a risk as prematurity does. Although poor nutrition may be a cause of prematurity, it is not the only cause.

The nurse is teaching a group of pregnant women about CP and states the greatest risk for CP is found in: a. Poor nutrition in mother b. Birth asphyxia. c. Maternal infection with common cold d. Prematurity.

c - Braces and​ splints, serial​ casting & positioning devices like prone​ wedges, standers & side-lyers are used to prevent contractures and promote range of​ motion, skeletal​ alignment, stability, and control of involuntary movements.

The nurse is teaching the parents of a child with CP about appropriate therapies that can be helpful for child​'s mobility status. Which statement made by a parent indicates that this teaching has been​ effective? ​a. "Serial casting is not recommended for treatment​ anymore." ​b. "Nothing will help with involuntary​ movements." ​c. "Braces will help maintain our ​child's skeletal​ alignment." ​d. "We should not use splints on our ​child's ​limbs.

d - Adaptive & assistive technology to promote mobility includes the use of a customized wheelchair. American sign language would help with communication. Adaptive utensils ensure adequate nutritional intake. Receiving therapeutic massages would reduce spasticity and encourage muscle relaxation.

The nurse is visiting Gerry​, a​ 17-year-old adolescent with CP. Which would nurse recommend to assist this client with physical mobility in his planning to begin college in a few​ months? a. Use adaptive utensils b. Learn American sign language c. Receive therapeutic massages every week d. Obtain a customized wheelchair

3 - The term CP refers to a group of nonprogressive disorders of upper neuron impairment that result in motor dysfunction due to injury. In addition, a child may have speech or ocular difficulties, seizures, hyperactivity, or cognitive impairment. The condition of congenital malformed blood vessels in the ventricles is known as arteriovenous malformation. Viral infection and metabolic imbalances do not cause CP.

The nurse judges that the mother understands the term CP when she describes it as a term applied to impaired movement resulting from which factor? 1. injurty to the cerebrum caused by viral infection 2. malformed blood vessels in the ventricles caused by inheritance 3. nonprogressive brain damage caused by injury 4. inflammatory brain disease caused by metabolic imbalances

3 - The nurse needs to be honest with the mother. Most children with hemiparesis due to spastic CP are able to walk because the motor deficit is usually greater in the upper extremity. There is no need to refer the mother to the HCP. Pulling to a stand requires both upper body and lower body strength. The will to walk is important, but without neurologic stability the child may be unable to do so.

The parent asks the nurse whether a child with hemiparesis due to spastic CP will be able to walk normally because he can pull himself to a standing position. Which response by the nurse would be the most appropriate? 1. Ask Dr. what he or she thinks at next appointment 2. Being able to pull to a stand really only tells us his upper body strength is good 3. It is difficult to predict, but his ability to bear weight is a positive factor 4. If he really wants to walk, and works hard, he probably will eventually

3 - The parent is the childs HCP and may be very in tune to subltle changes in the childs behavior. If the parent thinks the child is in pain, it is very likely to be so. The nurse should administer pain med & evaluate if the med affected the childs behavior. The FLACC scale may be difficult to interpret when the child has spasticity. The FACES scale requires self report, which may not be possible in a child with communication disorder. The HCP should be contacted regarding the change in behavior only if other available interventions are unsuccessful)

The parent of a child with spastic CP & a communication disorder tells the nurse "He seems so restless. I think he is in pain". Which action is most indicated? 1. assess the child for pain using the faces, legs, activity, cry, consolability (FLACC) scale 2. Assess the child for pain using the pediatric faces scale 3. Administer prescribed pain medications 4. Notify the HCP of the change in behavior

c - Implantation of a baclofen pump allows continuous delivery of the drug​ baclofen, which improves muscle spasms. The surgical treatment of Achilles tendon lengthening is used to increase ankle range of motion and to allow the child to walk​ flat-footed. Intrathecal pump implantation actually increases the risk of infection and must be carefully monitored. Baclofen is not being provided to the client to prevent infections.

The parents of Tyler​ Thomas, a​ 5-year-old client with mixed CP, ask why a baclofen pump is scheduled to be surgically implanted in the child. Which explanation would nurse give about the purpose of this medication​ pump? a. increases ankle range of motion b. Allows​ flat-footed walking c. Controls muscle spasms d. Prevents infections

b - CP is a chronic disability characterized by difficulty controlling muscles as a result of an abnormality in the motor system. CP is not an infectious disease or result of inflammation due to a viral illness. Down syndrome is an example of a congenital condition causing mental retardation. Some children with CP, though not all, experience mental retardation.

The parents of a recently diagnosed child with CP ask the nurse about disorder. The nurse responds that CP is: a. An infectious disease b. a chronic disorder in which there is difficulty controlling muscles. c.A congenital condition causing mental retardation d. A viral illness that causes inflammation of the brain

4 - Delay in achieving developmental milestones is a characteristic of CP. Ninety percent of typically developing 15 month old children can put a block in a cup. Walking up steps is typically accomplished at 18-24 months. The ability to copy a circle is achieved at approx 3-4 years of age. A child usually is able to use a spoon at 18 months.

When assessing the development of a 15 month old child with CP, which milestones should the nurse expect a typically developing toddler of this age to have achieved? 1. walking up steps 2. using a spoon 3. copying a circle 4. putting a block in a cup

a - The goal for a child with CP is early diagnosis so that the child's abilities can be maximized. The cause of condition cannot be eliminated. It is best to minimize emotional disturbances, but not prevent them as child should develop emotional health. Improving muscle control is a component of treatment, but maximizing child's assets is a primary goal.

When planning care for child with CP, a primary goal is to: a. Maximize the child's assets. b. Improve muscle control and coordination. c. Prevent emotional disturbances. d. Eliminate the cause of the disease.

d - Emotional support of families affected by CP requires that the nurse listen to their concerns and encourage them to express their feelings. The nurse should encourage family to ask questions & should obtain answers to questions that the nurse is unable to answer. All children with CP are not eventually transferred to a​ long-term care​ facility; many are successfully cared for at home. Referrals for individual and family counseling are​ appropriate, but the nurse is not qualified to suggest a referral for marriage counseling.

Which action provides emotional support to families of children with CP? a. Making a referral for marriage counseling b. Explaining all children with CP are eventually placed in​ long-term care facilities c. Referring all medical questions to the healthcare provider d. Listening to parental concerns and encouraging the expression of feelings

c - Children with CP often have feeding difficulties, so the nurse teaches the parent to allow extra time for this child, sit the child upright for feeds, use blended and soft foods, and use adaptive utensils for feeding.

Which intervention will the nurse teach a parent to initiate in the home for a child with CP? a. Lay the child in the parent's arms for feeding. b. Allow the child to eat the same foods as the family. c. Allow extra time for chewing and swallowing. d. Teach the child to use eating utensils.

a - Utensils with adaptive handles may improve​ self-feeding ability in children with spasticity associated with CP. Other possible interventions include feeding small amounts of food at a​ time, providing hydration to non-communicative clients who may not be able to indicate they are​ thirsty & providing adequate fiber in diet.

Which intervention would improve​ self-feeding ability in a child with spasticity caused by CP? a. Providing utensils with adaptive handles b. Presenting large portions of food all at one time c. Restricting hydration d. Providing a​ low-fiber diet

d - Achilles tendon​ lengthening, not​ shortening, is a surgical intervention used to treat CP. Other surgical treatments include surgical implantation of an intrathecal​ pump, releasing the​ hamstrings, and dorsal rhizotomy.

Which surgical intervention is not used to treat CP? a. Dorsal rhizotomy b. Surgically implanted intrathecal pump c. Releasing the hamstrings d. Achilles tendon shortening

b - The nurse teaches the parents how to administer medications, the desired effects of the medications, and the potential signs of adverse effects. Not all children with CP will be wheelchair-bound or have mental retardation. At some point, the parents may consider a group home for the child, but it is inappropriate for the nurse to suggest such a move.

Which will the nurse include in the instructions to the parents of a young child with CP? a. Parents should find a school with a program for children with mentally retardation. b. Parents need a good understanding of child's meds. c. Parents should order a wheelchair as soon as possible. d. Parent should consider placing the child in a group home.