Which set of symptoms are characteristic of spastic cerebral palsy?
a. Hypertonicity and poor control of posture balance and coordinated motion
b.
... [Show More] Athetosis and dystonic movements
c. Wide-based gait and poor performance of rapid repetitive movements
d. Tremors and lack of active movement>>> ANS: A
Hypertonicity poor control of posture balance and coordinated motion are part of the classification of spastic cerebral palsy. Athetosis and dystonic movements are part of the classification of dyskinetic/athetoid cerebral palsy. Wide-based gait and poor performance of rapid repetitive movements are part of the classification of ataxic cerebral palsy. Tremors and lack of active movement may indicate other neurological disorders.
The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. What knowledge is the basis of the nurses' response?
a. Anticonvulsant medications are sometimes useful for controlling spasticity.
b. Medications that would be useful in reducing spasticity are too toxic for use in children.
c. Many different medications can be highly effective in controlling spasticity.
d. A pump can be implanted that delivers medication into the intrathecal space to decrease spasticity.>>> ANS: D
Baclofen given intrathecally is best suited for children with severe spasticity that interferes with activities of daily living and ambulation. Anticonvulsant medications are used when seizures occur in children with cerebral palsy. The intrathecal route decreases the adverse effects of the drugs that reduce spasticity. Few medications are presently available for the control of spasticity.
What term is used for a hernial protrusion of a saclike cyst of meninges spinal fluid and a portion of the spinal cord with its nerves through a defect in the vertebral column?
a. Rachischisis
b. Encephalocele
c. Meningocele
d. Myelomeningocele>>> ANS: D
A myelomeningocele is a visible defect with an external saclike protrusion containing meninges spinal fluid and nerves. Rachischisis is a fissure in the spinal column that leaves the meninges and spinal cord exposed. Encephalocele is a herniation of the brain and meninges through a defect in the skull producing a fluid-filled sac. Meningocele is a hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elements.
Which problem is most often associated with a myelomeningocele?
a. Hydrocephalus
b. Craniosynostosis
c. Biliary atresia
d. Esophageal atresia>>> ANS: A
Hydrocephalus is a frequently associated anomaly in 80 to 90% of children with myelomeningocele. Craniosynostosis is the premature closing of the cranial sutures and is not associated with myelomeningocele. Biliary and esophageal atresias are not associated with myelomeningocele.
What is the most common problem for children born with a myelomeningocele?
a. Neurogenic bladder
b. Cognitive impairment
c. Respiratory compromise
d. Cranioschisis>>> ANS: A
Myelomeningocele is one of the most common causes of neuropathic (neurogenic) bladder dysfunction among children. Risk of cognitive impairment is minimized through early intervention and management of hydrocephalus. Respiratory compromise is not a common problem in myelomeningocele. Cranioschisis is a skull defect through which various tissues protrude and is not associated with myelomeningocele.
Which supplement is recommended to prevent neural tube defects?
a. Vitamin A throughout pregnancy
b. Multivitamin preparations as soon as pregnancy is suspected
c. Folic acid for all women of child-bearing age
d. Folic acid during the first and second trimesters of pregnancy>>> ANS: C
The widespread use of folic acid among women of childbearing age is expected to decrease the incidence of spina bifida significantly. Vitamin A does not have a relation to the prevention of spina bifida. Folic acid supplementation is recommended for the preconception period and during the pregnancy but only 42% of women actually follow these guidelines.
How much folic acid is recommended as a daily dose for women of child-bearing age?
a. 0.1 mg
b. 0.4 mg
c. 1.5 mg
d. 2 mg>>> ANS: B
It has been estimated that a daily intake of 0.4 mg of folic acid in women of child-bearing age will prevent 50 to 70% of cases of neural tube defects. A 0.1 mg dose is too low and 1.5 and 2 mg are not recommended dosages of folic acid.
The nurse is caring for an infant born with a myelomeningocele. Surgery to repair the defect is scheduled for the next day. What is the most appropriate way to position and feed this newborn?
a. Left lateral and tube feed
b. Prone turn head to side and nipple feed
c. Supine in infant carrier and nipple feed
d. Supine with defect supported with rolled blankets and nipple feed>>> ANS: B
In the prone position feeding is a problem. The infant's head must be turned to one side for feeding. If the child is able to nipple feed there is no indication for tube feeding. Before surgery the infant should be kept in the prone position to minimize tension on the sac and risk of trauma.
The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent indicates she correctly understands the teaching?
a. "My child will have an allergic reaction if he comes in contact with yeast products."
b. "My child may have an upset stomach if he eats foods made with wheat or barley."
c. "My child will probably develop an allergy to peanuts."
d. "My child should not eat bananas or kiwis.">>> ANS: D [Show Less]