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Exam 4 : NUR230 / NUR 230 (Latest
2026/2027 Update) Concepts of Nursing: The
Childbearing/Child Caring Family |
Questions & Answers | 100% Correct | Galen
Q: Name 3 things that are assessed in a child's cerebral function assessment
Answer
- Motor function
- Posturing
- Reflexes
Q: The presence of Cushing reflex may indicate...
Answer Increased intracranial pressure
Q: A nurse is assessing a 12-month-old infant, what 2 things should she include in the
cerebral function assessment?
- Answer Assessment of posterior fontanelles
- OFC (head circumference)
Q: Posture may be referred to as ______________/flexion or
______________/extension Answer Decorticate; decerebrate
Q: When is the treatment for any fine or gross motor skill deficits preferred?
Answer Before the child is school-aged
Q: Studies show that the most common cause of neural tube defects is...
Answer Folic acid deficiency during pregnancy
Q: Congenital deformity/neural tube defect where some or all of the fetal brain does not
develop/is missing Answer Anencepahly
Q: Type of neural tube defect where the spinal column does not close completely, brain is
being pulled to the top of the spinal cord from the bottom, and nerves are enclosed Answer Spina bifida cystica/myelomeningocele
Q: A nurse is caring for a child who is post-op from a surgical closure of a neural tube defect,
what are 3 actions of the nurse? Answer
- Perform clean intermittent catheterizations (CIC) Q4hrs
- Perform bowel training
- Place child in a prone or side-lying position
Q: A nurse is caring for a child who is post-op from a surgical closure of a neural tube defect,
what should the nurse promote to the family? Answer Encourage bonding
Q: A child has been diagnosed with myelomeningocele, what should the nurse be aware of?
Answer The child may have a Latex allergy
Q: Cerebrospinal fluid collects in an abnormal pattern in the brain and ventricles
dilate/enlarge, causing harmful pressure to be exerted upwards on fragile tissues of the brain, involves an imbalance in the production & absorption of CSF Answer Hydrocephalus
Q: Name 3 S/S of hydrocephalus in infants
Answer
- "Sunset eyes"
- Cre du Shaw
- MacEwen sign
Q: Cre du Shaw refers to...
Answer High-pitched cry that is hard to soothe
Q: Percussion of the skull near the junction of the frontal, temporal, and parietal bones will
produce a cracked-pot sound, indicating sutures are separated Answer Macewen's sign
Q: Name 3 S/S of hydrocephalus in children (early to late childhood)
Answer
- Papilledema
- Changes in vision
- New urinary incontinence
Q: CSF fluid is displaced into the subarachnoid space to lumbar cistern + brain mass is
displaced Answer Compensation (early stage of increased intracranial pressure)
Q: Name 3 later S/S of increased intracranial pressure (ICP)
- Answer Papilledema
- Cheyne-stokes respirations
- Flexion or extension posturing
Q: Abnormal breathing pattern w/ periods of apnea
Answer Cheyne-stokes respirations
Q: Measures best eye opening, motor & verbal response to test neurological status/function
Answer Glascow coma scale
Q: In pediatrics, the higher the Glascow coma scale score is...
Answer The more "intact" the motor responses are
Q: Infection of the dura mater, arachnoid mater, and/or pia mater of the meninges
Answer Meningitis Infection of the meninges covering the brain Answer Encephalitis Infection of the meninges covering the spinal cord Answer Myelitis Name 2 ways meningitis can be acquired INDIRECTLY Answer
- Respiratory infection
- Gram-negative organisms Meningitis causes the formation of an ___________________ of _______________ & fibrin ____________ and _______________ Answer Exudation layer; purulent exudate; deposits; adhesions
What are 3 diagnostic signs that indicate the meningitis infection is viral?
- Negative gram stain
- Clear CSF
- Slightly elevated WBCs Is caused by Neisseria meningitidis, begins with a mild to severe meningococcal septicemia (sepsis) Meningococcal meningitis Name 1 S/S of meningococcal meningitis Petechial or purpuric skin rash A nurse is caring for a child who has been diagnosed with meningococcal meningitis, what are 3 actions the nurse should take?
- Closely monitor I&Os + specific gravity
- Elevate the head of the bed and make sure the child's head is midline What are 2 precautions a child with meningococcal meningitis should be placed on? Droplet & seizure precautions Children who have meningococcal meningitis are at a high risk for what? Aspiration What kind of movements may be involved in generalized seizures? (2)
- Tonic (rigid) movements
- Clonic (jerking) movements Involves a sudden loss of muscle tone and loss of consciousness Atonic seizures ("drop attacks") Involves sudden brief jerks of muscle groups w/ possible loss of consciousness Myoclonic seizures Name 2 kinds of medications that can be given to help manage seizures
- Sodium channel blockers
- Calcium channel inhibitors Vagal nerve is stimulated by an implanted device in the left chest wall to initiate seizure activity in the brain, while the seizure is happening, a magnet is held over the stimulator to lessen the seizure or abort it all together Vagal nerve stimulator What kind of motor state may an individual who just experienced a generalized or febrile seizure be in? Paresis or postictal paralysis Complex deformity of the ankle and foot Clubfoot
Disease involving aseptic necrosis of the femoral head causing the thighbone (femur) and pelvis to meet in a ball-and-socket joint due to temporarily interrupted blood supply to the femoral head of the hip joint; bone begins to die Legg-Calve-Perthes disease Name 3 S/S of Legg-Calve-Perthes disease
- Pain/stiffness in the hip and/or groin
- Limited ROM of the hip joint
- Limping Separation of the proximal femoral epiphysis in posterior and inferior directions, resulting in expanded sections within the hip(s) SCFE What is a big risk factor for SCFE? Obesity Name 1 S/S of SCFE Outward turning of the leg For scoliosis to be diagnosed... The spinal curvature must be a certain degree
Name 1 S/S of scoliosis Sides of back appear different in height when bending forward A nurse is caring for a child who is post-operative from a posterior spinal fusion b/c of having scoliosis, what are 2 nursing interventions?
- Do "log rolls" when moving the patient
- Assess bowel motility A fracture to the epiphyseal growth plate will result in what 2 things?
- Bone not growing
- Bone deformity Immobility may cause... Possible psychosis What are the 6 P's?
- Pain
- Pallor
- Pulselessness
- Paresthesia
- Paralysis
- Pressure Name 2 early behavioral signs of cognitive impairment
Complex neurodevelopmental disorders with spectrum behaviors affecting an individual's ability to communicate and interact with others in a social setting Autism (spectrum disorder) Name 2 early signs of autism in babies/toddlers
- Inappropriate playing with toys
- Oversensitive or under sensitive to touch Name 2 possible educational interventions for a child who may have autism (spectrum disorder)
- Applied behavioral analysis
- Speech therapy Risperidone and Aripiprazole are medications to help manage _____________ and can help reduce some ____________________ Autism (spectrum disorder); behavior symptoms in autism The most common chromosomal abnormality of a generalized syndrome & most common cause of intellectual disability Down syndrome/Trisomy 21 Name 5 S/S of Down syndrome/Trisomy 21
- Conductive hearing loss
- Strabismus
- Myopia
- Frequent conjunctivitis
- Weak respiratory musculature A nurse is caring for a child who has autism spectrum disorder, what 2 things should the nurse monitor/educate to the family to monitor? Why? Monitor weight & nutrition d/t them being higher in weight and shorter in stature Nonprogressive impairment of motor function, especially that of muscle control, coordination, and posture; is distinguished by mobility, can cause abnormal perception and sensation such as visual, hearing, and speech impairments, cognitive disabilities, and 80% develop seizures Cerebral palsy If cerebral palsy is suspected, when is the careful assessment done? What may indicate CP? In early infancy; no development within the first 2yrs may indicate CP Name 3 motor signs of cerebral palsy
- Persistent primitive reflexes
- Poor head control after 3 months
- Hypotonia (floppy tone) Excessive irritability, no smiling by 3 months, and persistent tongue thrusting are all what kind of signs of what? Behavioral signs of cerebral palsy Name 1 possible medication that may be given to help manage cerebral palsy
- Edema (indicates CHF) Diagnostic and interventional procedure that can determine oxygen saturation, cardiac output, pressures in chambers and great vessels, and structural defects Cardiac catheterization What are 3 nursing considerations/interventions in post-cardiac catheterization?
- Place child on bedrest for 6hrs (keep affected leg straight)
- Do not raise the head of the bed
- Allow child to only participate in quiet play for 24hrs Heart failure may result in ___________ on the _________ in babies Sweating; scalp Name 3 general clinical manifestations of heart failure
- Cardiomegaly
- Clubbing of fingers
- Polycythemia Heart defect that involves a hole in the septum between the right and left ventricle that results in increased pulmonary blood flow Ventricular septal defect (VSD) Heart defect that has a loud, harsh murmur auscultated at the left sternal border
VSD
Ventricular septal defect (VSD) medical management Complete repair with "drawstring" patch Heart defect that involves a hole in the septum between the right and left atria that results in increased pulmonary blood flow; mixes blood and involves less blood shunts than VSD Atrial septal defect (ASD) Heart defect that has a loud, harsh murmur with a fixed split-second heart sound ASD Atrial septal defect (ASD) medical management (2)
- Closure with cardiac catheterization
- Surgical patch closure Heart defect that occurs when the fetal artery that connects the aorta to the pulmonary artery fails to close after birth Patent ductus arteriosus (PDA) Name 2 key S/S of PDA
- Machine-like murmur
- Bounding pulses
