Peds neurology PrepU
The nurse helps position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure?
"For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back."
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?
"I always keep phenobarbital with me in case of a fever."
While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education?
"I will cradle her in my arms after the procedure for at least 30 minutes."
The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status?
"She has been irritable for the last hour....seems like she is just upset for some reason."
A 1-year-old infant has just undergone surgery to correct craniosynostosis. Which comment is the best psychosocial intervention for the parents?
"The surgery was successful. Do you have any questions?"
The nurse has performed discharge teaching for parents of a child diagnosed with epilepsy. The child has been prescribed Zonegran (zonisamide). Which comments by the parents indicate the need for further discharge teaching regarding this medication? Select all that apply.
"This medication can make our child very sedated so we need to monitor for this side effect." "We need to watch our child's gums for swelling since this commonly happens with this medicine." "We may need to add B-complex vitamin supplementation to our child's medications because this can help mange side effects."
The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?
"Use this information to teach family and friends."
The parents of a 10-month-old child bring the infant to the emergency department after finding the infant face down in the bathtub. The parent states, "I just left the bathroom to answer the phone." Which assessments are priority for the nurse to complete? Select all that apply.
Airway Respiratory status Circulation
The nurse is caring for a child diagnosed with hydrocephalus following ventriculoperitoneal shunt placement. The child is currently on a ventilator. Which nursing action is priority?
Assess the client's respiratory status
A child has been diagnosed with a basilar skull fracture. The nurse identifies ecchymosis behind the child's ear. This would be documented as:
Battle sign
Antibiotic therapy to treat meningitis should be instituted immediately after which event?
Collection of cerebrospinal fluid (CSF) and blood for culture
The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as a possible trigger?
Drinking three cans of diet cola
A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. The nurse should first ____ followed by ____.
Ensure proper oxygenation Administer IV or IM benzodiazepine
The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all that apply.
Eye opening Verbal response Motor response
The nurse is caring for a child who has suffered a head injury and has had an ICP monitor placed. Which prescription by the health care provider would the nurse question?
Initiate an IV of 0.9% NS to run at 250 ml/hr.
What is a true statement regarding status epilepticus?
It is a common neurologic emergency in children.
Absence seizures are marked by what clinical manifestation?
Loss of motor activity accompanied by a blank stare
The nurse is preparing a toddler for a lumbar puncture. For this procedure, the nurse should place the child in which position?
Lying on one side, with the back curved
The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure?
Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention
The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity?
Moving the infant's head every 2 hours
A client presents reporting headache that she describes as "throbbing pain on the left side of my head and sensitivity to light and motion." The nurse asks the client to describe the sequence of events before the onset of the headache. Which signs and symptoms described by the client are characteristic of the prodrome phase of a migraine headache? Select all that apply.
Neck stiffness Frequent yawning Loss of appetite
A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?
Positive Kernig sign
A 10-year-old boy has been experiencing complex partial seizures and has not responded well to medication. Surgery is planned to remove brain tissue at the seizure foci. Which diagnostic test would be the most accurate in identifying the seizure foci?
Positron emission tomography (PET)
In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care?
Risk for injury related to seizure activity
Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis?
Signs of increased intracranial pressure (ICP)
A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate?
Teach the child and his parents to keep a headache diary
The nurse is providing education to the parents of a female toddler with hydrocephalus who has just had a shunt placed. Which statement is the best to make during a teaching session?
Tell me your concerns about your child's shunt.
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
Which of these age groups has the highest actual rate of death from drowning?
Toddlers
The nurse is preparing a child experiencing new-onset seizures for an electroencephalogram (EEG) test. How can the nurse best explain this procedure to the child?
Use a doll with electrodes attached to the head
The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client?
Use of anticonvulsant medications
The nurse is caring for a 3-year-old boy who is experiencing seizure activity. Which diagnostic test will determine the seizure area in the brain?
Video electroencephalogram
The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)?
While assessing the child's pupils, there is no change in diameter in response to a light.
A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply.
Oxygen gauge and tubing Suction at bedside Padding for side rails
A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority?
Serum glucose level
A school-aged child with seizures is prescribed phenytoin sodium, 75 mg four times per day. What instruction would the nurse give the parents regarding this medication?
The child will have to adhere to good tooth brushing
Gabapentin has been prescribed for a pediatric client. Which statement by the client indicates an understanding of teaching related to the medication?
"I can't take this medication within 2 hours of taking my antacid medication."
The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?
"I hate to think that I will need to be worried about my child having seizures for the rest of his life."
The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching?
"I need to watch for any new bruises or bleeding and let my health care provider know about it."
The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond?
"I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."
The parent of a 12-year-old child with Reye syndrome approaches the nurse wanting to know how this happened to the child, saying, "I never give my children aspirin!" What could the nurse say to begin educating the parent?
"Sometimes it is hard to tell what products may contain aspirin."
A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform?
Assess the level of consciousness (LOC)
During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take?
Report the findings to the pediatric health care provider
The nurse is caring for a child admitted with focal onset motor seizures (simple partial motor seizures). Which clinical manifestation would likely have been noted in the child with this diagnosis?
The child had shaking movements on one side of the body.
The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?
Head trauma