Pedi Exam 3

How would you conduct a scoliosis screen?

Evaluating their bare back, ask child to bend forward from hips and let arms hang free; check curve of spine, rib malpresentation and symmetry of hips

What care is indicated for a child with juvenile arthritis?

Exercise for mobility, splint affected joint, teach med regimen and side effects

What is compartment syndrome?

Extremity damage to nerves and vasculature from compression

Why are fractures of the epiphyseal plate a special concern?

May affect limb growth

What are s/s of compartment syndrome?

Abnormal neurovasc. assess-> cold extremity, severe pain, inability to move extremity, poor cap refill

What discharge instructions should be included for child with spica cast?

*circulation; keep dry; free of stool and urine; do not turn child using abductor bar

How is skeletal traction applied?

Pins and wires are fixed to distal fractured bone

Which would the nurse teach a patient when NSAIDs are prescribed for treating juvenile idiopathic arthritis (JIA)? 1. Take with food. 2. Take on an empty stomach. 3. Blood levels are required for drug dosages. 4. Good oral hygiene is needed.

1. Take with food.

The parent of a 2-year-old who is HIV+ questions the nurse about placing the child in day care. Which of the following is the best response? 1. The child should not go to day care until older, because there is a high risk for transmission of the disease. 2. The child can be admitted to day care without restrictions and should be allowed to participate in all activities. 3. The child can go to day care but should avoid physical activity. 4. The child may go to day care, but the parent must inform all the parents at the day care that the child is HIV+.

2. The child can be admitted to day care without restrictions and should be allowed to participate in all activities.

Which would the nurse expect to assess on a 3-week-old infant with developmental dysplasia of the hip (DDH)? 1. Excessive hip abduction. 2. Femoral lengthening of an affected leg. 3. Asymmetry of gluteal and thigh folds. 4. Pain when lying prone.

3. Asymmetry of gluteal and thigh folds.

The parent of a 3-week-old states that the infant was re-casted this morning for clubfoot and has been crying for the past hour. Which intervention should the nurse suggest the parent do first? 1. Give pain medication. 2. Reposition the infant in the crib. 3. Check the neurocirculatory status of the foot. 4. Use a cool blow-dryer to blow into the cast to control itching.

3. Check the neurocirculatory status of the foot.

What are normal findings in a neurovascular assessment?

Warm extremity, brisk cap refill, free movement, normal sensation of affected extremity, equal pulses

A 12-year-old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that long? 1. Pain from the brace. 2. Difficulty in putting the brace on. 3. Self-consciousness about appearance. 4. Not understanding what the brace is for.

3. Self-consciousness about appearance.

Which is the nurse's best explanation to the parent of a toddler who asks what a greenstick fracture is? 1. It is a fracture located in the growth plate of the bone. 2. Because children's bones are not fully developed, any fracture in a young child is called a greenstick fracture. 3. It is a fracture in which a complete break occurs in the bone, and small pieces of bone are broken off. 4. It is a fracture that does not go all the way through the bone

4. It is a fracture that does not go all the way through the bone

The nurse is instructing the parent of a child with HIV about immunizations. Which of the following should the nurse tell the parent? 1. Hepatitis B vaccine will not be given to this child. 2. Members of the family should be cautioned not to receive the varicella vaccine. 3. The child will need to have a Western blot test done prior to all immunizations. 4. Pneumococcal and influenza vaccines are recommended.

4. Pneumococcal and influenza vaccines are recommended.

What are s/s of congenital dislocated hip?

Unequal skin folds of buttocks, Ortolani sign, limited abduction, unequal leg lengths

What are the instructions for child with scoliosis who has skeletal brace?

Wear 23 hrs a day, t-shirt under brace, check skin for irritation, back and abdominal exercises, modify clothing. Encouraged to maintain normal activities as tolerated

The parent of a child diagnosed with osteomyelitis asks how the child acquired the illness. Which is the nurse's best response? 1. "Direct inoculation of the bone from stepping barefoot on a sharp stick." 2. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone." 3. "The blood supply to the bone was disrupted because of the child's diabetes." 4. "An infection of the upper respiratory tract."

2. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone."