Quiz #2 Study Questions Flashcards
So what do you need to assess (priority) when you have a fracture?
a. Pulses first
b. Then color, temperature
Checking for pulse, temp, color of extremity for possible complication → compartment
syndrome
a. If not treated appropriately → volkman contractur can occur
Cancer of the femur and long bones → ewing sarcoma a. Two types of treatment
i. Bone lengthening device in the bone
ii. Amputation
Occurs in the shots of long bones and of trunk bones. Treatment includes surgical biopsy, intensive radiation therapy to tumor site, and chemotherapy, but not amputation.
The nurse is caring for a patient with a left above the knee amputation. The patient is complaining of severe pain in the left leg and wants something for pain. What should the nurse do first?
- Notify the surgeon.
- Medicate the patient immediately.
- Advise the patient that several therapies are available for the treatment of this problem.
- Tell the patient that this is phantom limb pain and sometimes follows amputation.
- Tell the patient that this is phantom limb pain and sometimes follows amputation.
The nurse should first explain to the patient that this is phantom limb pain and sometimes follows amputation. The patient should be given pain medication afterwards. The surgeon should be notified if this is continuous. The patient should also be advised that there are several therapies available for the treatment of this problem.
Amputation nursing consideration dealing with phantom pain
a. Explain to patients that this phantom pain is expected and normal and that we will help them to find a coping mechanism with this new phantom pain
If someone has knock knee, how are they standing?
a. Their knees are attaching with their feet apart
Is also known as Genu Valgum
Scoliosis is usually found at what age
a. Adolescent
congenital- occurs in fetal development
infantile- occurs at birth to 3 years of age
juvenile- occur in children ages 3-10 years old
adolescent- occurs at 10 years of age or older
A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention.
Which of the following behaviors by the adolescent should the nurse anticipate because it is the most common reaction?
A. Body image changes.
B. Loss of privacy.
C. Feelings of displacement.
D. Identity crisis.
A. Body image changes.
A client who has sustained a crush injury to the right lower leg reports numbness and tingling of the affected extremity. The skin of the right leg appears pale. Which is the nurse’s first intervention?
a. Assess pedal pulses.
b. Apply oxygen by nasal cannula.
c. Increase the IV flow rate.
d. Document the finding.
a. Assess pedal pulses.
The symptoms represent early warning of acute compartment syndrome. In acute compartment syndrome, sensory deficits such as paresthesias precede changes in vascular or motor signs. If the nurse finds a decrease in pedal pulses, the health care provider should be notified as soon as possible.
A nurse is caring for a toddler who has a fractured right femur and is in Bryant’s traction. When monitoring to determine if the traction is appropriately assembled, the nurse expects to observe which of the following?
a. Skin straps maintaining the leg in an extended position
b. Weights attached to a pin that is inserted in the femur
c. A padded sling under the knee of the affected leg
d. The buttocks elevated slightly off the bed
d. The buttocks elevated slightly off the bed
rationale: The child’s hips are flexed at a 90° angle with the legs suspended by pulleys and weights. The weights must hang freely from the bed to maintain alignment
A child with developmental dysplasia of the hip has a spica cast applied. Which action(s) specific to the spica cast should be taken? (Select all that apply)
A. Check for cracks or breaks in the cast.
B. Ensure the child’s head is higher than his feet.
C. Assess for circulation, movement, and sensation.
D. Measure the blood pressure frequently.
E. Auscultate the bowel sounds.
F. Use the rod between the child’s legs to lift and turn the child.
G. Check for swelling and tightness.
H. Position with feet elevated above heart level.
I. Place a disposable diaper inside the edges of the rear part of the cast.
A. Check for cracks or breaks in the cast.
B. Ensure the child’s head is higher than his feet.
C. Assess for circulation, movement, and sensation.
E. Auscultate the bowel sounds.
G. Check for swelling and tightness.
I. Place a disposable diaper inside the edges of the rear part of the cast.
Patient with SPICA cast, what are the nurses interventions to assess?
a. Pulses, color, movement, any circulation of numbness or tingling
A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which state should the nurse make?
A. “The blood supply to the bone is disrupted.”
B. “Normal bone growth can be affected”
C. “Bone Marrow can be lost though the fracture”
D. “the younger the child the longer the healing process will take”
b.“Normal bone growth can be affected.” RA fracture of the epiphyseal plate can affect growth in a child. Therefore, it needs to be detected and treated rapidly.
Goal for septic arthritis
a. Treat the underlying infection
An infant with developmental dysplasia of the hip is placed in a Pavlik harness. Which instructions should the nurse include in a teaching plan for the parents?
a-Apply lotion or powder to minimize skin irritation.
b-Put clothing over the harness for maximum effectiveness.
c-Check for red areas under the straps two to three times a day.
d-Use a thin absorbent disposable diaper over the harness.
c-Check for red areas under the straps two to three times a day.
Child with developmental dysplasia of the hip, will wear a pavlik harness at home, what can you teach about home care?
a. can only take off 1hr max a day for showering
Need to be kept on for 23 hours/day
a nurse is caring for a 10 month old infant who is in a cast for developmental dysplasia of the hip (DDH). which of the following strategies should the nurse implement to promote the infant’s growth and development
a. The colorful latex balloons to the side of the crib
b. Provide a small electronic toy
c. Change the infant’s diaper as soon as soiling occurs
d. Allow infant to stand in the crib
d. Allow infant to stand in the crib
** If patient is in a cast for hip dysplasia, what can you educate the child to do to help with their growth and development?
a. Stand in their crib**
During your assessment of a patient with croup (laryngotrachealbronchitis), which of the following is most likely to be seen?
Barking seal cough
The manifestations of croup are a harsh cough described as barking or brassy, hoarseness, inspiratory stridor, low-grade fever, increased respiratory rate, and respiratory distress that may develop slowly or quickly.
What would be the treatment for a child with croup with barking cough?
a. Humidified air via tent or mask
b. Cool mist to decrease stridor
c. NPO (do not feed them)
d. Racemic epinephrine to decrease edema and mucus build up
e. Have intubation equipment avail at bedside
f. Allow parents to hold the child to comfort them
2 year in respiratory distress, what signs can you assess to check for improvements?
A. Listen to lungs and breathing are clear
B. Listen for decrease of the cough
C. Decrease of nasal flaring
D. Decrease of retraction
E. Oxygen sats going up
F. HR below 140
A 3 year old arrives to the ER. The child has a temperature of 102.4 F, respiratory rate of 45, and is agitated. The child is diagnosed with epiglottitis. You note the child is sitting up, positioned forward with chin in the air and the tongue is protruding with the mouth open. Which nursing intervention below is NOT appropriate for this patient?
A. Assist the patient in a supine position.
B. Keep the child on the parent’s lap during treatments.
C. Keep the child nothing by mouth.
D. Avoid taking a temperature on the patient orally.
A. Assist the patient in a supine position.
Allow the child to be in a position that allows them to breathe and be comfortable. The child is in the tripod position, which is a common finding with epiglottis. Placing the child in the supine position is contraindicated because it impedes respiratory effort.
What is the position that a patient with epiglotitis should assume?
A. Tripod upright position
What do you see when assessing someone suspecting of pneumonia?
A. Crackles in the lung bilaterall
B. Dehydrated due to lack of intake → BUN and sodium slightly elevated
What do you see with a patient admitted with RSV?
a. Secretions with retractions
b. Pretty sleepy
c. Respiratory rate will be elevated
A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?
a. Sweat chloride test, stool for fat, chest radiograph films
b. Stool test for fat, gastric contents for hydrochloride, chest radiograph films
c. Sweat chloride test, bronchoscopy, duodenal fluid analysis
d. Sweat chloride test, stool for trypsin, biopsy of intestinal mucosa
a. Sweat chloride test, stool for fat, chest radiograph films
A sweat chloride test result greater than 60 mEq/L is diagnostic of CF.
Cystic fibrosis, what is the diagnostic test done for them
a. Diagnostic test? → Sweat chloride test
b. Treatment? → nebulizer with albuterol prior to chest physiotherapy
Pancreatic enzymes are administered to the child with cystic fibrosis (CF). Nursing considerations should include to:
a. not administer pancreatic enzymes if child is receiving antibiotics.
b. decrease dose of pancreatic enzymes if child is having frequent, bulky stools.
c. administer pancreatic enzymes between meals if at all possible.
d. pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
d. pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
How do you know if the discharge teaching for CF has been affective in relation to medication administration?
a. They understand that they can sprinkle the pancreatic enzymes with snacks and meals
b. Why? → CF patients can not digest the fat in their foods
The nurse is caring for a school-aged child with cystic fibrosis. Which pathophysiologic factor has the greatest impact on the child’s health status and is of priority in the care plan?
1. Extremely thick mucus causes obstructed airways.
2. There is acute inflammation of the lung parenchyma.
3. Endocrine glands secrete increased levels of hormones.
4. Increased irritability of the airways results in obstruction.
- Extremely thick mucus causes obstructed airways.
How would you decribe the secretions for a CF patient? a. Thick
a respiratory disorder that results from inheriting a mutated gene. It is characterized by mucus glands that secrete an increase in the quantity of thick, tenacious mucus, which leads to mechanical obstruction of organs
How do you know, after performing tracheal suctioning on a patient, that it has been
Effective?
a. Listen to lung sound for clearness
