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level: Pt. 3

Questions and Answers List

level questions: Pt. 3

QuestionAnswer
What is the child at higher risk for if the diagnosis of Legg-Calve-Perthes is made after age 6?Hip deformity and osteoarthritis
Curvature of the spine of less than __ degrees necessitates no treatment20 degrees
What is the most commonly used brace for scoliosis?TLSO
How does the foot appear in a child with talipes equinovarus (club foot)?Pointed inward and downward
Talipes equinovarus (club foot) occurs in 1 per ____ live births1 per 1000
How often is the cast changed in an infant with club foot?Weekly
What is tenotomy?Surgical release of the Achilles tendon
What kind of surgical intervention is required in severe cases of club foot?Tenotomy
What achieves the most reliable correction of talipes equinovirus (club foot)?Serial casting
Duchenne muscular dystrophy (DMD) primarily affects which gender?Girls
Who are carriers the DMD gene?Women are carriers
What is the most common and severe form of all dystrophies?DMD
What sign is present in a child with DMD?Gowers sign
What kind of infection usually occurs in the final stages of DMD?Respiratory tract infection
What is the nursing goal for DMD?To maintain independence for as long as possible
Children with DMD rarely live past what age?20
What joints are most commonly affected by septic arthritis?Hip Knee Shoulder Wrist Ankle
What are the most common bacteria involved in septic arthritis?Streptococci and staphylococcus
A child with septic arthritis maintains the joints in a _______ position.Flexed
List some potential causes of septic arthritis:Ear infections Bites Infected wounds Open fractures
The child with septic arthritis is ordered a course of IV antibiotics, followed by oral antibiotics. How long is the course of each?IV antibiotics for 10-14 days Oral antibiotics for 4 weeks
What may happen if the hip is involved in septic arthritis, leading to long-term disability?Avascular necrosis can develop
What are the most common fracture sites in children?Long bones Clavicles Wrists Fingers Skull
What kind of fractures are frequently the result of abuse?Spiral fractures
An open reduction requires what kind of intervention to realign the bones?Surgical
Casting is a form of ______ reductionClosed reduction
The use of pins, wires, plates, and screws is involved in _______ reductionOpen reduction
What are the three main categories involved in disorders of neurologic function?1. Increased intracranial pressure 2. Hypoxia 3. Seizure activity
Most cases of meningitis affect children younger than __ years5 years
Which two "signs" are present in a child with meningitis?Kernig's sign Brudzinski's sign
What is the most common form of meningitis?Bacterial
Which vaccine, beginning in 1990 led to a dramatic decrease in bacterial meningitis caused by H. influenzae?Hib vaccine
What is nuchal rigidity?Pain and stiffness in the neck when flexed; seen in meningitis
How long does IV antibiotic therapy continue for the child with meningitis?At least 10 days or until the CSF culture is negative
Why should safety measures be initiated for the child with meningitis?Seizures may develop
Administering __________ can prevent the spread of meningitisProphylactic Rifampin
What are some residual deficits resulting from meningitis?Hydrocephalus Hearing loss Blindness Seizures Learning disorders Attention deficit disorder
For a child with encephalitis, corticosteroids such as __________ are prescribed to reduce brain inflammationDexamethasone
What causes hydrocephalus?Increased production of CSF Obstruction within ventricular system Defective reabsorption of CSF
Overproduction of CSF results most commonly from a tumor in the _____ ______.Choroid plexus
In hydrocephalus, the sclera is seen above the iris, which is called the ________ ______ signSetting sun sign
What is the term for a group of nonprogressive disorders of motoneuron impairment that result in motor dysfunctionCerebral palsy
What are the primary manifestations of cerebral palsy?Abnormal muscle tone and poor coordination
What plays the most significant role in the pathologic process of brain damage?Anoxia
What is used to treat spasticity of muscles in cerebral palsy?Botox
What is used to treat severe spasticity in children with cerebral palsy?Intrathecal or oral baclofen
What is the major reported adverse effect of Botox injection?Pain at the injection site
At what ages are children most prone to seizures?Between birth and 2 years
What are the two categories of seizures?Partial and generalized
What is the most useful tool for evaluating seizure disorders?Electroencephalography
When can a child discontinue anticonvulsant medications?When the electroencephalogram is normal, and the child has been seizure free for at least 2 years
Why is the use of felbamate controversial in seizure management?Side effects of aplastic anemia and hepatic failure
Abrupt withdrawal of anticonvulsants can result in:An increase in the number and severity of seizures, and status epilepticus
What is status epilepticus?Continuous seizure activity
Antiseizure medication may reduce the effectiveness of ___________.Hormone-based contraceptives
Congenital defects of the neural tube is known as _______ ________.Spina bifida
What may be seen over the defect in patients with spina bifida oculta?Tuft of hair Cleft Small, fatty mass
List some contributing factors of spina bifida?Advanced maternal age Genetics Antiseizure medication Obesity Diabetes
How much folic acid should be consumed by the woman of child-bearing age per day to help prevent neural tube defects?400-800 mcg
What percentage of neural tube defects could be prevented if all women met folic acid dietary requirements?70%
In spina bifida, the spinal cord most commonly ends at the ______Defect
The most common type of congenital heart defect involves:Increased pulmonary blood flow
What tests are used to help detect a neural tube defect?Uterine ultrasonography Elevated levels of alpha-fetoprotein
Hydrocepahalus is present in the majority of infants affected with ________ _______Spina bifida
What are the most common sites for metastatic disease?Liver Skin Lymph nodes Bone Bone marrow
Where is the most common location for a neuroblastoma?Abdomen
What is the prognosis for a child with a neuroblastoma?Poor
Lead poisoning is a blood lead level higher than ___mg/dL10 mg/dL
Any lead that is retained by the body is stored in the _____.Bone
When lead exceeds the amount that the bone can absorb, it travels through the circulatory system causing _______Anemia
The use of lead has been illegal in the US since _____.1978
What kind of treatment is a key intervention for children who have excess levels of lead?Chelation therapy
Infants experiencing neonatal abstinence should be kept in what kind of environment?Nonstimulating, free of bright lights and loud noises
Papules, vesicles, and pruritis are seen in which noninfectious disorder of the skin?Contact dermatitis
What is the inflammatory, delayed immune response of the skin resulting from contact with environmental antigens?Contact dermatitis
Isotretinoin is contraindicated in which individual?Pregnant women
Patients receiving isotretinoin treatment must be monitored for elevated _______ and _______ levels.Cholesterol and triglyceride
Candidiasis can by transmitted by contaminated _______, _______, and ________.Hands, nipples, and pacifiers
What are common areas affected by C. albicans?Tongue Buccal cavity GI tract Vagina
What is the most common antifungal agent used to treat candidiasis (thrush)?Nystatin suspension
Which parasitic disorder is caused by a mite?Scabies
What are prodromal symptoms?Early signs of a developing condition or disease
What is a significant cause of otitis media?Accumulation of bacteria in the nasopharynx
When do children with otitis media begin to feel better with antibiotic therapy?48 to 72 hours
Profoundly cognitively impaired is reflected by an IQ of less than ___25
How long are symptoms present before the attempted or completed suicide?At least one month
Where will a harsh systolic murmur be heard in a patient with an atrial septal defect?Over the third intercostal space
A loud, harsh systolic murmur and a palpable thrill will be heard in a patient with which congenital heart defect?Ventricular septal defect
What is apparent on x-ray study in a patient with transposition of the great vessels?Cardiomegaly
Infants affected by tetralogy of Fallot are profoundly _______ at birthCyanotic
Poor growth patterns, fatigue, and a machine-like murmur at the upper left sternal border with widened and bounding pulse is seen in which congenital heart defect?Patent ductus arteriosus
The pulmonary artery arises from the left ventricle, and the aorta arises from the left ventricle in which congenital heart defect?Transposition of the great vessels
Signs and symptoms of RDS include:Nasal flaring Expiratory grunting Dusky color Tachypnea (80-120) Dyspnea Low body temperature
List 5 points of patient teaching for a child with a tonsillectomy:1. Avoid irritating foods 2. Avoid gargles 3. Avoid coughing/clearing throat 4. Use mild analgesics/ice collar 5. Do not use aspirin
What are the four causative agents of pneumonia?Bacterial Viral Mycoplasmal Foreign body aspiration
What are four antenatal factors contributing to the development of cerebral palsy?Drug ingestion Hypoxia Infections Blood incompatibilities
What is subluxation?The degree of DDH most common in infants