Quiz 3

Question 1

NEUROLOGICAL STATUS:

Answer 1

Hx of history of headaches, blurred vision, changes in behavior, balance, coordination, motor function, fatigue, numbness/tingling, seizures, tremors, slurred speech, muscle strength, weakness, recent injury

Question 2

Immunizations:
Dtap:

Answer 2

2mo, 4mo, 6mo, 18mo, Syrs +Boosters

Question 3

Immunizations: Teens:

Answer 3

Tada! I’m a teen! Tdap Meningitis HPV

Question 4

Increased Intracranial Pressured

Answer 4

nurse assesses a child with a CNS infection and notices a fontanel Bulging infection and high pitched cry
ared flag for ICP (Report cry to MD). Headaches in the middle of night an
Vomiting bc of it

Question 5

ED if fever

Answer 5

Baby 3mo or younger go to

Question 6

Following a head injury, an infant’s level of consciousness can deteriorate, s/s

Answer 6

increased or excessive sleeping, and eventually go into a coma. A Nurse monitoring this child should report excessive sleeping and raise a red flag for ICP after a trauma

Question 7

Assess pupillary reaction to light. An increase in intracranial pressure due to acute hemorrhage can cause

Answer 7

neurological changes in pupillary reaction to light. Pupil responses to light can be unresponsive, unequal, or slow. NPO. Measure infants, head palpate fontanelles.

Question 8

Older child: ICP

Answer 8

Headache Vomiting, with or without nausea Motor weakness, discoordination, and seizures Diplopia and blurred vision Irritability, restlessness, and behavioral changes Sleep alterations and somnolence Personality changes LATE SIGNS OF INCREASED ICP
Bradycardia

Question 9

PAIN MANAGEMENT FOR THE COMATOSE CHILD PARALYTICS-

Answer 9

NORCURON- PAVULON
SEDATION - FENTANYL DRIP/Versed

Question 10

What is a clinical manifestation of increased intracranial pressure (ICP) in infants?

Answer 10

a. Irritability

Question 11

NURSING CARE OF UNRESPONSIVE CHILD.

Answer 11

initiate IV access

Question 12

Important nursing observation in a child with a skull fracture is:

Answer 12

To monitor the child for signs of hemorrhage or edema.

Question 13

SUBMERSION:

Answer 13

Near drowning: Risk for Aspiration Amount of time in the water and quality of resuscitation efforts will determine a child’s prognosis,

Question 14

ENCEPHALITIS

Answer 14

inflammation of brain tissue, headache, decreased LOC, seizures, behavior changes, nausea, vomiting, changes in speech, increased ICP Organisms - viral, herpes, CMV. mosquitos, ticks, autoimmune Incubation 3-5 days Medication - Acyclovir 10 days

Question 15

ENCEPHALITIS s/s

Answer 15

Headache
• Headache |
* Fever
* NV
* Nuchal rigidity

Question 16

BACTERIAL MENINGITIS

Answer 16

Intracranial infection of meninges, headache, high fever, neck rigidity, inflammation causing edema, photosensitivity, nausea, vomiting, malaise, irritability Organisms bacterial, droplet transmission streptococcal, Neisseria, haemophiles pneumococcus, Incubation few hours to days Medication - Ampicillin & Cephalosporins
Vaccines THE ROUTINE USE OF H INFLUENZA TYPE B (Hib) AND STREP PNEUMONAIE (PCV13) VACCINES HAS REDUCED THE INCIDENCE OF BACTERIAL MENENGITIS Droplet precautions

Question 17

BACTERIAL MENINGITIS s/s

Answer 17

Irritable
Headache
Fever
NV
CSF: elevated WBC count, neutrophils, protein and pressure, and decreased glucose.
Nuchal rigidity
Photophobia/Increased sensitivity to light

Question 18

ASEPTIC MENIGITIS Patho:

Answer 18

Viruses that inflame meninges Measles, mumps, leukemia, herpes S/S: Fine skin rash

The nurse is assigned to child diagnosed with bacterial meningitis, which of the following would be appropriate: Respiratory isolation will remain for 24 hours.

Question 19

REYE SYNDROME:

Answer 19

Acute encephalitis with altered LOC • ASA known to damage mitochondria of cell so intensifies viral process with endotoxins • Do not give Aspirin to child under 18

Question 20

EPILEPSY:

Answer 20

Patient safety, lie lateral and if vomiting turn on side. Nursing management: Position the child laterally. Positioning the child laterally facilitates airway patency. Prevent risk of aspiration

Question 21

STATUS EPILEPTICUS

Answer 21

Fosphenytoin with Phenobarb if phenytoin level is below therapeutic level. This puts the child at risk for seizure

• The nurse should suspect brainstem damage in child who presents with which of the following? Bilateral dilated, nonreactive pupils

Question 22

CEREBRAL PALSY

Answer 22

Diagnosed one to two years after birth, stiff or rigid limbs, arching back, pushing away, floppy tone poor head control after three months unable to sit at eight months clenched fists after three months

POC; modify environment

Question 23

CEREBRAL PALSY

Answer 23

A 6-month-old infant does not smile, has weak head control and a persistent Moro reflex, and often gags or chokes while eating. The nurse recognizes that these findings most likely suggest. By 8months they need to sit w/pillows propped: These symptoms are classic findings in children with cerebral palsy (CP).|

Question 24

SPINAL MUSCULAR ATROPHY

Answer 24

Usually appears after two years

Question 25

Werdnig-Hoffman Disease Autosomal Recessive Trait Paralytic disease

Answer 25

progressively worsens.

Question 26

DUCHENNE MUSCULAR DYSTROPHY

Answer 26

Abchild with DMD will attain standing position by waddling gait & "Walking" up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.

Question 27

DUCHENNE MUSCULAR DYSTROPHY

Answer 27

Av child with DMD will attain standing position by waddling gait & "Walking" up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.

Question 28

DUCHENNE MUSCULAR DYSTROPHY

Answer 28

Av child with DMD will attain standing position by waddling gait & "Walking" up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.

Question 29

SCABIES (BED BUGS):

Answer 29

Caused by scabies mite as female burrows into the epidermis to deposit eggs and feces (rash w/burrows).

Question 30

INFANT BOTULISM

Answer 30

Food poisoning from spores anaerobic Bacilli Clostridium Botulinum Improperly sterilized home canned foods Honey and dark corn syrup formulas * Signs and symptoms - constipation, weakness, lack of head control dizziness, headache, diplopia, speed difficulties, vomiting, progresses to resp paralysis : San ecouis has feeding dificulties and hypotonia but poor refoxes.

Question 31

PEDICULOSIS CAPITIS (HEAD LICE):

Answer 31

white particles on the hair. Pediculus capitis, or head lice, are tiny parasitic insects that live on the scalp and can be spread by close contact with other people. Their eggs (nits) appear much like flakes of dandruff but stick firmly to the hair shaft instead of flaking off of the scalp.

Question 32

PEDICULOSIS CAPITIS (HEAD LICE): teaching

Answer 32

"All recently used clothing, bedding, and towels must be washed in hot water." Anything that cannot be washed should be sealed in a plastic bag for 10 to 14 days. Non-washable items can include jackets, sweaters, hats, pillows, bicycle helmets, and stuffed animals. Furniture, carpets, and car seats can be sprayed with a variety of over-the-counter products.

Question 33

IMPETIGO

Answer 33

is a highly contagious bacterial skin infection with honey crusted lesions •Also teach the parent to ensure the child changes her clothes every day and to wash all clothing in hot water. •Have the infected child use their own utensils and towels • Tx: Antibiotics

Question 34

IMPETIGO; nursing consideration

Answer 34

The nurse should keep and use dedicated equipment, such as blood pressure monitor, stethoscope, and thermometer in the client's room to prevent the spread of infection from client to client.

Question 35

INTESTINAL PARASITES. S/s

Answer 35

Helminths (worms): Pinworms • Protozoa: Giardiasis S/S Perianal Itching Abd pain, nausea, diarrhea, bloating, "wiggling their seat".

Question 36

INTESTINAL PARASITES. S/s

Answer 36

Helminths (worms): Pinworms • Protozoa: Giardiasis S/S Perianal Itching Abd pain, nausea, diarrhea, bloating, "wiggling their seat".

Question 37

INTESTINAL PARASITES: assessment

Answer 37

The child would undress and put on an examination gown or undergarments. Anticipate that the provider would do a genital examination due to the complaint and explain the procedure to the parent and child.

Question 38

INTESTINAL PARASITES: Test

Answer 38

Clear tape (not tape with a frosted finish or "magic tape") is used in a loop with the sticky side out and pressed firmly against the child's perianal area at night during sleep. * Stool samples are collected in the morning as soon as the child awakens and BEFORE the child has a bowel movement or bathes. : The samp fe broug the fre die a toret a pisivaminion by placing the tape smoothly on a glass slide, with the sticky side down. • Parents are instructed to carefully clean their hands before and after collecting * Specimens must be kept in a glass jar or sealed bag.

Question 39

AUTISM SPECTRUM DISORDERS (ASDS)

Answer 39

Complex neurodevelopmental disorders of brain function (Range from mild to severe) Impaired social interaction, don't play well with others, avoid eye contact, lack of empathy, tantrums. Restice riperve and storeotyped patterns of behavior, interests, and activities (Lining up cars) * Delays or abnormal functioning with onset before 3 years of age (MCHAT screening at WCC) Tx: Structured routines, reward system for positive behavior, always supervise activities, SSRis, Antipsychotics, melatonin, family support.