| 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 treatment | 20 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 births | 1 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 ______ reduction | Closed reduction |
| The use of pins, wires, plates, and screws is involved in _______ reduction | Open 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 __ years | 5 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 meningitis | Prophylactic 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 inflammation | Dexamethasone |
| 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 ________ ______ sign | Setting sun sign |
| What is the term for a group of nonprogressive disorders of motoneuron impairment that result in motor dysfunction | Cerebral 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/dL | 10 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 birth | Cyanotic |
| 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 |
