Mobility
With Developmental Hip Dysplasia, what is one characteristic finding and how is DDH corrected?
Absent or asymmetrical gluteal folds on the dislocated side.
Pavlik Harness or Spica Cast
Remember this is a dislocation of the hip, pediatric bones are porous and flexible. This concern has no risk factors for anything later in life.
Autism can affect social interaction and communication for the child. What are some ways to help aid the child with these?
Rewarding good behavior
Behavioral Therapy
Support groups for parents
What maternal medication helps to reduce the risk of a fetus developing spina bifida (myelomeningocele, meningocele)
Folic acid
What part of the bone, when damaged or fractured, can cause a delay in bone growth making the bone shorter or crooked?
Epiphyseal plate
What type of vitamin deficiency is most commonly associated with parents giving their child to much milk?
Iron Deficiency
What is the common surgical corrective procedure for Scoliosis, and what will be the priority nursing intervention for a patient who has this procedure?
Harrington-Rod Procedure
Pain Management
Remember this is where rods are placed in the spinal column to help correct. It is extremely painful.
When is an appropriate time for an ADHD medication to be administered to a child?
Morning or in the afternoon. If given to late it can give the child insomnia which is a listed side effect. This includes all stimulant and non-stimulant forms of medication
List 5 Pre/Post Op nursing interventions for an infant who is diagnosed with a Myelomeningocele and is having surgery
Keep the infant Prone or Lateral
Monitor for CSF leakage
Head Circumference Measurements
Neuro and Vital Checks
Leave diaper off to avoid covering the sac
What are the key characteristics or hallmark signs of Legg-Calve Perthes disease?
Child walking with a limp
Complaints of hip pain with no history of trauma
Avascular necrosis of the femoral head
Bucks Traction is a form of treatment
What are your key characteristics of Intusseception?
Sausage-Shaped Mass (remember SS in sausage shaped is the SS in Intussusception)
Red-Current Jelly like stools/blood and mucus in the stool
The bowel is telescoping into itself
Diagnosed and corrected with an air contrast enema or surgery
Risk factors are bowel necrosis or obstruction
After surgery we give them Pedialyte to put electrolytes back into the body that they have lost
What are some of the key characteristics of Cerbral Palsy?
Non-Progressive Lesion on the brain
Deficits are determined by location of the lesion
Does not have a pattern of progression
Poor Tone, difficulty walking or sitting without support devices.
Not fatal
Primitive/Newborn Reflexes last throughout life
What are some key characteristics of Trisomy 21 (Down Syndrome)
Simian Crease (transverse line on palm)
Protruding Tongue
Epicanthal Eye Folds
Intellectual Disability
Flat Nasal Bridge and wideset eye spacing
Why do we measure head circumference on children 2 years and under?
To monitor for signs of increased ICP.
Increased ICP could be from Head Trauma, Meningitis, or a defect that alters cerebral spinal fluid
What are some key points about Sickle Cell Disease?
Crisis can be triggered by: Illness, Cold, Stress, Dehydration
Interventions: Hydration (oral and IV) this helps load the vessels with fluid so the sickled cells aren't sticky. Managing Pain as well as giving oxygen.
Vaso-occlusive crisis is the sickled cells clumping together and occluding the vessels which restrict blood flow. This can create ischemia to organs including the brain.
What are your key characteristics of Pyloric stenosis?
Overgrowth/proliferation of tissue that causes an obstruction
Olive shaped mass in the right upper abdominal quadrant
Projectile Vomiting
Diagnosed by ultrasound and surgically corrected
Nutrients cannot empty from the stomach into the pylorus because of blockage, so they lack getting nutrient absorption and appear malnourished
What are some key facts the nurse should understand about Duchenne's Muscular Dystrophy?
It is characterized by muscle fiber
degeneration and muscle wasting
It starts in the lower limbs first then progresses upward
Most are wheelchair bound by age 12
Terminal (most die in their 20's from cardiac or respiratory failure)
Gower's Maneuver is observed with this disorder
Diagnosed with a muscle biopsy to measure Dystrophin or will have a high CK serum level
If not diagnosed early and treatment started, what concern can cause an irreversible intellectual disability in infants?
Congenital Hypothyroidism
Absence of a red reflex can possibly indicate which emergent condition?
Retinoblastoma
What are some care tips for a child with hemophilia?
Make sure they receive factor replacement therapy.
Make sure if injured they know the RICE techniques. Remember cold compress not heat..Heat will dilate the vessels and cold will constrict them reducing the bleeding.
Make sure the child is using safety equipment with play
At what age should an infant start solid foods such as iron-fortified rice cereal?
6 months
What are some key educational points about corrective devices such as a spica cast or pavlik harness
Make sure to assess the skin for skin breakdown as this can lead to infection
Make sure to assess circulation. Infants can't communicate so if they are crying and inconsolable they should be brought in
The straps of the harness should be on the outside of the diaper to prevent friction
They need to wear the harness as much as possible. Parents should not remove or adjust straps this is for the physician to do.
The posterior fontanelle should close at ______ months. The Anterior fontanelle should close at ______ months.
2-3 months
18 months
What are some key characteristic of fetal alcohol syndrome?
Smooth Philtrum
Hyperactivity
Flattened nose
What are key characteristics of clubfoot.
Includes 3 areas of bone in the foot
Usually positional remember bones are soft and flexible where tendons and ligaments in newborn are stronger than bone intially
Serial casting for 4-6 weeks to correct
Why is it that we do not recommend honey within the first year of life?
Increases the risk of botulism