Podcast
Questions and Answers
Which type of seizure is characterized by the rhythmic alternating contraction and relaxation of muscle groups?
Which type of seizure is characterized by the rhythmic alternating contraction and relaxation of muscle groups?
What is a common initial manifestation of a complex focal seizure?
What is a common initial manifestation of a complex focal seizure?
Which of the following statements about febrile seizures is TRUE?
Which of the following statements about febrile seizures is TRUE?
What defines status epilepticus?
What defines status epilepticus?
Signup and view all the answers
Which factor is NOT considered a risk factor for febrile seizures?
Which factor is NOT considered a risk factor for febrile seizures?
Signup and view all the answers
What is a key nursing intervention for a child who is immobilized?
What is a key nursing intervention for a child who is immobilized?
Signup and view all the answers
Which statement is true regarding fractures in children?
Which statement is true regarding fractures in children?
Signup and view all the answers
What is a common cause of toddler's fractures?
What is a common cause of toddler's fractures?
Signup and view all the answers
Which assessment tool is used to assess the risk of pressure sores?
Which assessment tool is used to assess the risk of pressure sores?
Signup and view all the answers
Why might stress fractures in children require an MRI for diagnosis?
Why might stress fractures in children require an MRI for diagnosis?
Signup and view all the answers
What should be considered when assessing a child for potential child abuse related to fractures?
What should be considered when assessing a child for potential child abuse related to fractures?
Signup and view all the answers
What is an important factor regarding the healing of fractures in children?
What is an important factor regarding the healing of fractures in children?
Signup and view all the answers
What is a recommended approach for allowing autonomy in immobilized children?
What is a recommended approach for allowing autonomy in immobilized children?
Signup and view all the answers
Which symptom is typically seen in infants with increased intracranial pressure (ICP)?
Which symptom is typically seen in infants with increased intracranial pressure (ICP)?
Signup and view all the answers
What is the most common cause of hydrocephalus?
What is the most common cause of hydrocephalus?
Signup and view all the answers
Which of the following is considered a late manifestation of increased intracranial pressure?
Which of the following is considered a late manifestation of increased intracranial pressure?
Signup and view all the answers
What nursing care is essential in management of increased ICP?
What nursing care is essential in management of increased ICP?
Signup and view all the answers
Which clinical manifestation may indicate a child is experiencing hydrocephalus?
Which clinical manifestation may indicate a child is experiencing hydrocephalus?
Signup and view all the answers
What is a possible complication following a ventriculoperitoneal shunt placement?
What is a possible complication following a ventriculoperitoneal shunt placement?
Signup and view all the answers
What is the primary genetic inheritance pattern for Duchenne Muscular Dystrophy (DMD)?
What is the primary genetic inheritance pattern for Duchenne Muscular Dystrophy (DMD)?
Signup and view all the answers
Which symptom is an early manifestation of increased ICP?
Which symptom is an early manifestation of increased ICP?
Signup and view all the answers
What is the primary infection associated with osteomyelitis in children?
What is the primary infection associated with osteomyelitis in children?
Signup and view all the answers
What protein is associated with Duchenne Muscular Dystrophy, crucial for muscle fiber strength?
What protein is associated with Duchenne Muscular Dystrophy, crucial for muscle fiber strength?
Signup and view all the answers
Which of the following best describes Cushing's triad?
Which of the following best describes Cushing's triad?
Signup and view all the answers
At what age does the onset of symptoms typically occur for children with Duchenne Muscular Dystrophy?
At what age does the onset of symptoms typically occur for children with Duchenne Muscular Dystrophy?
Signup and view all the answers
What is a characteristic cry of infants with increased ICP?
What is a characteristic cry of infants with increased ICP?
Signup and view all the answers
What is one of the first clinical signs of Duchenne Muscular Dystrophy?
What is one of the first clinical signs of Duchenne Muscular Dystrophy?
Signup and view all the answers
Which of the following is a potential complication associated with Duchenne Muscular Dystrophy?
Which of the following is a potential complication associated with Duchenne Muscular Dystrophy?
Signup and view all the answers
Which intervention is NOT used for Duchenne Muscular Dystrophy?
Which intervention is NOT used for Duchenne Muscular Dystrophy?
Signup and view all the answers
What diagnostic method is commonly used to assist in diagnosing Duchenne Muscular Dystrophy?
What diagnostic method is commonly used to assist in diagnosing Duchenne Muscular Dystrophy?
Signup and view all the answers
What is most commonly used as a symptomatic treatment to help maintain muscle strength in DMD?
What is most commonly used as a symptomatic treatment to help maintain muscle strength in DMD?
Signup and view all the answers
What is the most common sign of nephroblastoma (Wilm's tumor)?
What is the most common sign of nephroblastoma (Wilm's tumor)?
Signup and view all the answers
What diagnostic tool is considered the gold standard for identifying brain tumors?
What diagnostic tool is considered the gold standard for identifying brain tumors?
Signup and view all the answers
Which of the following is NOT a common symptom of increased intracranial pressure (ICP) related to brain tumors?
Which of the following is NOT a common symptom of increased intracranial pressure (ICP) related to brain tumors?
Signup and view all the answers
What nursing consideration is critical when managing a patient with nephroblastoma?
What nursing consideration is critical when managing a patient with nephroblastoma?
Signup and view all the answers
Which treatment modalities are typically employed for brain tumors?
Which treatment modalities are typically employed for brain tumors?
Signup and view all the answers
What is a significant complication of chemotherapy that impairs the body's ability to fight infections?
What is a significant complication of chemotherapy that impairs the body's ability to fight infections?
Signup and view all the answers
Which phenomenon involves the rapid release of intracellular contents in patients with large tumor burdens?
Which phenomenon involves the rapid release of intracellular contents in patients with large tumor burdens?
Signup and view all the answers
In which condition would you expect a peripheral white blood cell count greater than 100,000?
In which condition would you expect a peripheral white blood cell count greater than 100,000?
Signup and view all the answers
What is a common early manifestation of leukemia in children?
What is a common early manifestation of leukemia in children?
Signup and view all the answers
What diagnostic procedure is used to determine CNS involvement in leukemia?
What diagnostic procedure is used to determine CNS involvement in leukemia?
Signup and view all the answers
Which treatment options are commonly used for managing leukemia?
Which treatment options are commonly used for managing leukemia?
Signup and view all the answers
Which condition is characterized by excessive microthrombi due to overwhelming infection?
Which condition is characterized by excessive microthrombi due to overwhelming infection?
Signup and view all the answers
What is one of the late manifestations of leukemia?
What is one of the late manifestations of leukemia?
Signup and view all the answers
Which syndrome is caused by compression of the superior vena cava due to space-occupying lesions?
Which syndrome is caused by compression of the superior vena cava due to space-occupying lesions?
Signup and view all the answers
Which type of leukemia is most common in pediatric patients?
Which type of leukemia is most common in pediatric patients?
Signup and view all the answers
Study Notes
Exam 3 Study Guide
- Exam 3 consists of 40 questions.
- The exam covers content from week 8-10.
- There will be 4 math questions.
- There are 6-10 questions from each module.
- Exam format includes multiple choice and select-all-that-apply questions.
- A calculator is allowed (not a phone), and scrap paper is permitted.
- Study content includes pathophysiology, clinical manifestations, nursing assessment, interventions, education, and management.
Week 8: Musculoskeletal Impact of Immobility in Children
-
Loss of innervation:
- Sensory and perceptual deprivation
- Decreased exposure to normal play opportunities
- Impaired growth and development
Nursing Care of the Immobilized Child
-
Physical assessment:
- Repositioning/position changes
- Pressure reduction mattresses
- ROM exercises
- Braden scale
-
Encourage activity and mobility devices:
- Allow autonomy when possible
Fractures & Complications
-
Toddler's fracture:
- 9-36 months
- Trivial trauma
- Spiral fx of the tibia
- Stress fractures (repetitive sports activities)
- MRI may be needed for diagnosis (not always visible on plain X-rays)
- Child abuse: Ensure the history matches the injury! Look for multiple fractures that might not be obvious.
-
Muscle strains/sprains:
- Salter 1 injuries - Bones do not grow if an epiphyseal plate is fractured while it is open.
- Doctors may still cast even if injury is not confirmed.
Fractures in Children
- Growth plate: Absorbs shock.
- Periosteum: Thicker and stronger in children.
- Bones: More likely to bend, buckle, or break in younger children.
- Children: Only complain when something is wrong.
-
Clinical manifestations:
- Generalized swelling/edema
- Pain or tenderness
- Decreased use of affected area
- Ecchymosis (bruising)
- Warmth or redness
-
Diagnostic Evaluation:
- X-rays
- etc..
Nursing Care Management- Child with Emergent Fracture
- Stabilize the injured site.
- Cover open wounds with sterile dressing.
- Apply manual traction if circulatory compromise is present.
- RICE protocol
Complications of Fractures
- Pain: Assess for severe pain.
- Pulse: Assess distal to fracture site.
- **Pallor:**Assess for decreased blood flow.
- Paresthesia: Assess for sensation distal to fracture site.
- Paralysis: Assess movement distal to fracture site.
Cast Care in Children
- Clubfoot (congenital talipes equinovarus)
Legg-Calvé-Perthes Disease
- Disruption of blood flow to the femoral head.
- Manifestations: painless limp, hip pain/ stiffness, decreased hip ROM.
Scoliosis
- Complex spinal deformity in three planes.
- Classification based on age of onset (infantile, juvenile, adolescent).
- Screening guidelines are often controversial; however, screenings should be recommended in ages 10-12 in girls, and 12-13 in boys.
- Signs & symptoms: asymmetry of shoulder height, scapular shape and hip height.
Developmental Dysplasia of the Hip (DDH)-
- Hip instability after birth due to abnormal development of the femur head and acetabulum.
- Clinical signs: asymmetric skin folds, Galeazzi's sign, limited hip abduction, Symmetry of gluteal and thigh folds (infant)
- Diagnostic tests: ultrasound (in infants), X-ray (>4 months).
- Treatment: Pavlik harness, traction, surgical closed reduction
Increased Intracranial Pressure (ICP)
- Excessive pressure on the rigid cranial vault.
- Etiology: Conditions that increase tissue or fluid volume in the skull
- Manifestations (early): Irritability, fatigue, personality changes. In infants/young children: tense, bulging, anterior fontanelle, high pitched cry, increased head circumference, "setting sun" sign.
- Manifestations (late): Bradycardia, decreased motor and sensory response, alterations in pupil size, and reactivity
Hydrocephalus
- Increased amount of CSF. Caused by impaired absorption of CSF, excessive production, or obstructed circulation.
- Manifestations: Bulging fontanelles in newborns and infants, increased head circumference, sunset eyes, irritability.
Seizures
- Cushing's triad
- Post-op care: Monitor for signs of increased ICP
- VP shunts (ventriculoperitoneal shunt)
- Spinal cord compression
Spina Bifida
- Insufficient folic acid intake.
- Failure of osseous spine to close.
- Types: occulta, cystica (meningocele, myelomeningocele)
Epilepsy vs Febrile Seizures
- Epilepsy: 2+ unprovoked seizures at least 24 hours apart; OR one unprovoked seizure and high probability of further seizures in the next 10 years.
- Febrile seizures: seizure associated with a febrile illness in a child >1 month of age who has no prior history of seizure activity.
Meningitis
- Acute infection of meninges or CSF. Bacterial or viral
- Manifestations: fever, chills, headache, vomiting, and alterations in sensorium.
Head Trauma
- PATHOPHYSIOLOGY: intracranial contents (brain, blood, CSF) are damaged due to force.
- Clinical manifestations: depend on the area injured.
- Commonly caused by falls, being struck by something, or a motor vehicle accident.
Skull Fracture
- result from direct blow to the skull
- Common in children under 2 years old.
- Types: linear, depressed, diastatic, and basilar (Battle's sign & Raccoon eyes).
Cerebral Palsy
- Nonprogressive neuromuscular disorder of varying degrees.
- Usually caused by unknown prenatal factors.
Muscular Dystrophy
- Group of inherited disorders with progressive degeneration of symmetric skeletal muscle groups causing progressive weakness and wasting.
- Types include Duchenne, Becker, Myotonic, etc.
- Onset of disease, pace of progression and muscle group affected depend on type.
- Genetic/X-linked inheritance, mutation in gene that codes for dystrophin.
Childhood/Postnatal Risk Factors
- Associated disabilities: altered learning, reasoning, wide range of intelligence, behavioral problems, sensory impairment, speech and language disorders, bowel/bladder problems, dental concerns, and skin breakdown
Oncology & Hematology
- Complications of oncologic therapy/treatment: infection, tumor lysis syndrome, hyperleukocytosis, superior vena cava syndrome, spinal cord compression.
Leukemia
- Unrestricted proliferation of immature white blood cells in blood forming tissues
- Acute lymphoblastic leukemia (ALL), and acute myelogenous leukemia (AML)
- Clinical manifestations: anorexia, irritability, lethargy, chronic infections, fever, shortness of breath, bleeding, pallor, petechiae, bone pain, limp.
Lymphoma
- Cancer of lymphoid tissue.
- Hodgkin's lymphoma: develops in single lymph node (often cervical or supraclavicular) and contains Reed-Sternberg cells.
- Non-Hodgkin's lymphoma: variable presentation, and often spreads widely.
Osteosarcoma
- Cancer of bone tissue that starts in immature bone cells.
- Typically occurs in the ends of long bones during growth spurts.
- Manifestations: pain localized, mass, limping.
Neuroblastoma
- Cancer of the developing cells of the sympathetic nervous system.
- Most tumors in the abdomen (from adrenal gland).
- Can spread.
Hemophilia
- Inherited bleeding disorders caused by a deficiency of specific coagulation factors.
- Types: A (Factor VIII deficiency), B (Factor IX deficiency).
- X-linked inheritance pattern.
Anemia
- Reduction of red blood cell (RBC) volume and/or hemoglobin concentration to levels below normal.
- Types, causes, clinical manifestations, diagnostic procedures,
- Basic causes: excessive red blood cell loss, increased destruction of RBCs, impaired or decreased rate of RBC production.
Normal Hemoglobin Values (by age).
- Values for infants, children, and adolescents are listed
- Importance of monitoring through appropriate screening.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Prepare for Exam 3 with this study guide covering the topics from weeks 8-10, including musculoskeletal impact of immobility in children and nursing assessments. Brush up on critical nursing interventions, clinical manifestations, and management strategies needed for caring for immobilized children. Ensure you're ready for various formats of questions, including multiple choice and select-all-that-apply.