NSG 332- Peds exam 2 QUESTIONS WITH
|\ |\ |\ |\ |\ |\ |\
ANSWERS
The nurse notes that a 4-year-old childs gums bleed easily and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
he has bruising and petechiae on his extremities. The lab value
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that would be consistent with these symptoms is:
|\ |\ |\ |\ |\ |\ |\
a. Platelet count of 25,000/mm3
|\ |\ |\ |\
b. Hemoglobin level of 8 g/dl
|\ |\ |\ |\ |\
c. Hematocrit level of 36%
|\ |\ |\ |\
d. Leukocyte count of 14,000/mm3
|\ |\ |\ |\
A
What is Spina Bifida? |\ |\ |\
The spinal column does not close completely.
|\ |\ |\ |\ |\ |\
What type of defect is spina bifida?
|\ |\ |\ |\ |\ |\
Neural tube defect |\ |\
Spina bifida cystica |\ |\
sections of the spinal cord and nerves are exposed and visible
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
outside of the body. |\ |\ |\
What is the most severe type of Spina Bifida?
|\ |\ |\ |\ |\ |\ |\ |\
Explain what is going on with meningocele
|\ |\ |\ |\ |\ |\
open directly into the spinal column, there is a sac present on the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
lower back which contains meninges
|\ |\ |\ |\ |\
What must the nurse ensure with meningocele?
|\ |\ |\ |\ |\ |\
to keep a sterile moist dressing over the site.
|\ |\ |\ |\ |\ |\ |\ |\
Spina bifida occulta |\ |\
,most common |\
defect is not visible
|\ |\ |\
what are the characteristics of spina bifida occulta
|\ |\ |\ |\ |\ |\ |\
dimpling and tuft of hair in the lumbar sacaral area.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Meningocele
Hydrocephalus
cerebrospinal fluid collects in an abnormal pattern in the brain |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
causing enlargement of the ventricles.
|\ |\ |\ |\
what can hydrocephalus cause
|\ |\ |\
increased ICP, this is fatal if not treated. |\ |\ |\ |\ |\ |\ |\
common s/sx of hydrocephalus |\ |\ |\
vomiting, rapid increase in head circumference, large head
|\ |\ |\ |\ |\ |\ |\ |\
(Macrocephaly) bulging fontanel, sunset eyes. |\ |\ |\ |\
Obstructino within the ventricles of the brain or inadequate |\ |\ |\ |\ |\ |\ |\ |\ |\
reabsoprtion of cerebrospinal fluid may be responsible for the |\ |\ |\ |\ |\ |\ |\ |\ |\
occurrence of: |\
a. meningitis
|\
b. meningocele
|\
c. spina bifida occulta
|\ |\ |\
d. hydrocephalus
|\
D
The nurse caring for an infant with hydrocephalus would take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
special precaution to: |\ |\
a. align the limbs
|\ |\ |\
b. support the head
|\ |\ |\
c. keep the head lower than the hips
|\ |\ |\ |\ |\ |\ |\
d. check intake and output
|\ |\ |\ |\
b
, Rationale: this causes a heavy head on a small body with poor |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle tone, the head must be supported when feeding and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
moving the hcild to prevent injury of the neck.
|\ |\ |\ |\ |\ |\ |\ |\
After feeding a baby with hydrocephalus, the nurse will take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
special care to: |\ |\
a. sit the baby upright in an infant seat
|\ |\ |\ |\ |\ |\ |\ |\
b. place the baby over the shoulder to burp
|\ |\ |\ |\ |\ |\ |\ |\
c. leave the baby in a side-lying position
|\ |\ |\ |\ |\ |\ |\
d. stimulate the baby by rubbing its feet
|\ |\ |\ |\ |\ |\ |\
C
rationale: because children with hydrocephalus are prone to |\ |\ |\ |\ |\ |\ |\ |\
vomiting, the child is fed and then positioned in the side-lying |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
position in a quiet atmosphere to reduce the incidence of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
vomiting.
The nurse caring for the child who has had a ventriculoperitoneal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
shunt for hydrocephalus observes an increasing abdominal girth.
|\ |\ |\ |\ |\ |\ |\ |\
The most appropriate response would be to:
|\ |\ |\ |\ |\ |\ |\
a. elevate the childs head
|\ |\ |\ |\
b. check bowel sounds
|\ |\ |\
c. record retnetion of feeding
|\ |\ |\ |\
d. notify charge nurse of possible malabsorption
|\ |\ |\ |\ |\ |\
D
- an increasing abdominal girth in a child with a VP shunt may be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
indicative of malabsoprtion of the CSF that is being shunted to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the peritoneum |\
Hydrocephalus
what is sunsetting eyes |\ |\ |\
eyes might deviate downward, eye whites (sclera) are visible
|\ |\ |\ |\ |\ |\ |\ |\ |\
above the pupil. |\ |\
What is the priority for hydrocephalus ?
|\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\ |\
ANSWERS
The nurse notes that a 4-year-old childs gums bleed easily and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
he has bruising and petechiae on his extremities. The lab value
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that would be consistent with these symptoms is:
|\ |\ |\ |\ |\ |\ |\
a. Platelet count of 25,000/mm3
|\ |\ |\ |\
b. Hemoglobin level of 8 g/dl
|\ |\ |\ |\ |\
c. Hematocrit level of 36%
|\ |\ |\ |\
d. Leukocyte count of 14,000/mm3
|\ |\ |\ |\
A
What is Spina Bifida? |\ |\ |\
The spinal column does not close completely.
|\ |\ |\ |\ |\ |\
What type of defect is spina bifida?
|\ |\ |\ |\ |\ |\
Neural tube defect |\ |\
Spina bifida cystica |\ |\
sections of the spinal cord and nerves are exposed and visible
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
outside of the body. |\ |\ |\
What is the most severe type of Spina Bifida?
|\ |\ |\ |\ |\ |\ |\ |\
Explain what is going on with meningocele
|\ |\ |\ |\ |\ |\
open directly into the spinal column, there is a sac present on the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
lower back which contains meninges
|\ |\ |\ |\ |\
What must the nurse ensure with meningocele?
|\ |\ |\ |\ |\ |\
to keep a sterile moist dressing over the site.
|\ |\ |\ |\ |\ |\ |\ |\
Spina bifida occulta |\ |\
,most common |\
defect is not visible
|\ |\ |\
what are the characteristics of spina bifida occulta
|\ |\ |\ |\ |\ |\ |\
dimpling and tuft of hair in the lumbar sacaral area.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Meningocele
Hydrocephalus
cerebrospinal fluid collects in an abnormal pattern in the brain |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
causing enlargement of the ventricles.
|\ |\ |\ |\
what can hydrocephalus cause
|\ |\ |\
increased ICP, this is fatal if not treated. |\ |\ |\ |\ |\ |\ |\
common s/sx of hydrocephalus |\ |\ |\
vomiting, rapid increase in head circumference, large head
|\ |\ |\ |\ |\ |\ |\ |\
(Macrocephaly) bulging fontanel, sunset eyes. |\ |\ |\ |\
Obstructino within the ventricles of the brain or inadequate |\ |\ |\ |\ |\ |\ |\ |\ |\
reabsoprtion of cerebrospinal fluid may be responsible for the |\ |\ |\ |\ |\ |\ |\ |\ |\
occurrence of: |\
a. meningitis
|\
b. meningocele
|\
c. spina bifida occulta
|\ |\ |\
d. hydrocephalus
|\
D
The nurse caring for an infant with hydrocephalus would take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
special precaution to: |\ |\
a. align the limbs
|\ |\ |\
b. support the head
|\ |\ |\
c. keep the head lower than the hips
|\ |\ |\ |\ |\ |\ |\
d. check intake and output
|\ |\ |\ |\
b
, Rationale: this causes a heavy head on a small body with poor |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle tone, the head must be supported when feeding and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
moving the hcild to prevent injury of the neck.
|\ |\ |\ |\ |\ |\ |\ |\
After feeding a baby with hydrocephalus, the nurse will take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
special care to: |\ |\
a. sit the baby upright in an infant seat
|\ |\ |\ |\ |\ |\ |\ |\
b. place the baby over the shoulder to burp
|\ |\ |\ |\ |\ |\ |\ |\
c. leave the baby in a side-lying position
|\ |\ |\ |\ |\ |\ |\
d. stimulate the baby by rubbing its feet
|\ |\ |\ |\ |\ |\ |\
C
rationale: because children with hydrocephalus are prone to |\ |\ |\ |\ |\ |\ |\ |\
vomiting, the child is fed and then positioned in the side-lying |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
position in a quiet atmosphere to reduce the incidence of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
vomiting.
The nurse caring for the child who has had a ventriculoperitoneal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
shunt for hydrocephalus observes an increasing abdominal girth.
|\ |\ |\ |\ |\ |\ |\ |\
The most appropriate response would be to:
|\ |\ |\ |\ |\ |\ |\
a. elevate the childs head
|\ |\ |\ |\
b. check bowel sounds
|\ |\ |\
c. record retnetion of feeding
|\ |\ |\ |\
d. notify charge nurse of possible malabsorption
|\ |\ |\ |\ |\ |\
D
- an increasing abdominal girth in a child with a VP shunt may be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
indicative of malabsoprtion of the CSF that is being shunted to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the peritoneum |\
Hydrocephalus
what is sunsetting eyes |\ |\ |\
eyes might deviate downward, eye whites (sclera) are visible
|\ |\ |\ |\ |\ |\ |\ |\ |\
above the pupil. |\ |\
What is the priority for hydrocephalus ?
|\ |\ |\ |\ |\ |\
