Chapter 49: Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders

The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for: Rickets Scurvy Hip dysplasia Paget disease

Rickets Explanation: Rickets is associated with a Vitamin D deficiency whereas scurvy is associated with a Vitamin C deficiency. Hip dysplasia is not associated with a Vitamin D deficiency. Paget disease is not associated with children.

A client with osteomalacia asks, "How can I be deficient in vitamin D?" Which of the following is the nurse's best response? "Tell me about your typical daily food intake." "You do not go out in the sun enough." "You should ask your doctor." "You must be deficient in phosphate."

"Tell me about your typical daily food intake."

Which of the following should the nurse teach a client about syndactyly? "This is a rare abnormality." "This condition can be prevented." "This is a simple webbing of the fingers or toes." "There is no cure for this condition."

"This is a simple webbing of the fingers or toes." Explanation: The nurse should tell the client that syndactyly is a simple webbing of the fingers or toes that occurs at birth. It is not a rare abnormality. It is unknown if it can be prevented. Surgery can remove the webbing.

What is the definition of a congenital deformity? Abnormalities occurring after birth Abnormalities present at birth Deformities occurring at inception Deformities occurring from the birthing process

Abnormalities present at birth Explanation: Congenital deformities are abnormalities that are present at birth. They range in severity from mild limb deformities, which are relatively common, to major limb malformations, which are relatively rare.

What is one of the most serious complications of Paget disease? Cardiovascular disease Respiratory disease Peripheral vascular disease Musculoskeletal disease

Cardiovascular disease Explanation: Cardiovascular disease is the most serious complication of Paget disease as well as the most common cause of death in those with advanced generalized Paget disease.

What should the nurse teach a client who is on bed rest ? Immobility will lead to deconditioning of muscles. Immobility will allow muscles to rest. Immobility has no effect on muscles. It is possible to increase muscle endurance during immobility.

Immobility will lead to deconditioning of muscles. Explanation: Immobility and periods of prolonged inactivity leads to deconditioning, primarily of the slow-twitch muscle fibers.

The pediatric nurse is providing teaching to a parent of a child with toeing-out (slew foot). Which statement should the nurse include in the teaching? It will most likely require several surgeries and night splints. This is rare condition. It will most likely self-correct as the child becomes proficient in walking. Sleeping in a supine position prolongs the problem.

It will most likely self-correct as the child becomes proficient in walking Explanation: Toeing-out (slew foot) is a common problem in children that usually corrects itself as the child becomes proficient in walking. Occasionally a night splint is utilized. Sleeping in the supine position does not impact toeing-out.

An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications? Scleroderma Osteoarthritis Rheumatoid arthritis Osteoporosis

Osteoporosis

Which teaching will the nurse provide for parents of a child who has clubfoot, or talipes? Serial manipulations and casting of the affected extremity Immediate corrective surgery Bilateral hip spica cast Chemotherapy

Serial manipulations and casting of the affected extremity Explanation: When treatment of clubfoot is initiated during the first few weeks of life, a nonoperative procedure may be effective. Serial manipulations and casting are used gently to correct each component of the deformity. Surgery may be required for the most severe deformities. Bilateral hip spica cast is used to treat developmental dysplasia of the hip. Chemotherapy is used to treat cancers and is not needed for clubfoot.

Which statement is true about treatment of developmental dysplasia of the hip? Treatment needs to be individualized. All infants will need surgery for this condition. Treatment needs to be completed within 2 weeks. Subluxation never resolves on its own.

Treatment needs to be individualized. Explanation: Treatment for developmental dysplasia of the hip needs to be individualized. Subluxation often resolves on its own. Treatment should be completed within 6 months after birth. Not all infants will need surgery.

The nurse suspects idiopathic scoliosis in a client based on which assessment finding? Uneven shoulders or iliac crest Late onset of first menarche Loss of bone density confirmed with x-ray Reports of back pain in the teen years

Uneven shoulders or iliac crest Explanation: The cardinal signs of scoliosis are uneven shoulders or iliac crest, prominent scapula on the convex side of the curve, asymmetry of the thoracic cage, and rib hump. Curves that are detected before menarche are more likely to progress than those detected after. This is not the only cause of pain in teens.

A child with Osgood-Schlatter disease most often presents with which assessment finding? pain in front of the knee pain in the hip inability to walk no symptoms

pain in front of the knee Explanation: Osgood-Schlatter disease involves microfractures in the area where the patellar tendon inserts into the tibial tubercle and often presents with pain in front of the knee. Although ambulation may bring discomfort, it does not prevent the client from walking.