Peds PrepU 5

A pregnant client asks if there is any danger to the development of her fetus in the first few weeks of her pregnancy. How should the nurse respond?

"During the first 3 to 4 weeks of pregnancy, brain and spinal cord development occur and are affected by nutrition, drugs, infection, or trauma."

The clinic nurse talks with the parent of a child with Down syndrome. The parent states, "I thought my 1-year-old would be walking by now. I am concerned." What response by the nurse is best?

"Milestones are often delayed for children with Down Syndrome."

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 always cries when the person holding her has on glasses...I guess glasses scare her." -"She is a pretty happy baby, unless her diaper is wet, then she cries until we change her diaper." -"She typically breastfeeds, but lately we have had to supplement with some oat cereal." -"She has been irritable for the last hour....seems like she is just upset for some reason."

"She has been irritable for the last hour....seems like she is just upset for some reason."

A nurse is caring for a client at 18 weeks' gestation with the karyotype results shown above (3 chromosomes on #21). After receiving genetic counseling, the client asks what the child's life will be like. Which response by the nurse is best?

"Specialists and developmental therapies will need to be utilized throughout life."

A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown and there are many environmental factors that may contribute to it."

The nurse provides education to the parent of an infant being treated for hydrocephalus with a ventriculoperitoneal (VP) shunt. Which statement by the parent indicates the need for further instruction?

"This shunt is the only surgery my baby will need."

The nurse is providing education to the parents of a 3-year-old girl with hydrocephalus who has just had an external ventricular drainage system placed. Which question is best to begin the teaching session?

"What questions or concerns do you have about this device?"

The nurse is caring for a newborn with Down syndrome. The nurse educates the parents regarding potential complications that their newborn is at higher risk for developing such as ______,_____, and _____

-Autoimmune disorders -Endocrine disorders -Spinal problems

What information is most correct regarding the nervous system of the child? -As the child grows, the gross and fine motor skills increase. -The child has underdeveloped fine motor skills and well-developed gross motor skills. -The child's nervous system is fully developed at birth. -The child has underdeveloped gross motor skills and well-developed fine motor skills.

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

What finding is consistent with increased intracranial pressure (ICP) in an infant?

Bulging fontanels (fontanelles)

Parents have just given birth to a child diagnosed with trisomy 21 (Down syndrome). The couple are parents of 3 other children under the age of 8 years old with no genetic disorders. What would be a priority nursing diagnosis at this time?

Deficient knowledge regarding trisomy 21

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

A nurse is preparing a presentation for a group of expectant parents about neural tube defects and prevention. Which would the nurse emphasize?

Folic acid supplementation

The nurse is educating parents of an toddler with Down syndrome. What would the nurse include in the teaching plan?

Have the child's thyroid function tested regularly.

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

Irritability, fever, and vomiting

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

While in a pediatric client's room, the nurse notes that the client is beginning to have a tonic-clonic seizure. Which nursing action is priority?

Protect the child from hitting the arms against the bed.

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highestpriority?

Risk for injury

A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intercranial pressure?

change in level of consciousness

Which physical assessment finding would the physician be more likely to find in an examination of a client with Down syndrome than of other clients without Down syndrome?

congenital heart defects

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

never to discontinue the drug abruptly.

The nurse is caring for a special needs child who is preparing for hippotherapy. The nurse is aware that this is what type of therapy?

therapeutic horseback riding

What is the main purpose of nurses having basic genetic knowledge?

to provide support and education to families

The nurse is caring for the family of a 9-year-old child with cerebral palsy. Which intervention will best improve communication between the nurse and the family?

using reflective listening techniques