NURS 407 FINAL EXAM QUESTIONS AND CORRECT
ANSWERS
How do you know when a child has a fracture? - answers - pain
Loss of function
Spasms
Why do kids have spasms when they get fractures? - answers - muscle fibers tear and
cause spasm --> more pain
We must align them and pull apart to avoid spams with traction
Nursing care post fracture includes? - answers - rice
Analgesics
Abcs
Neurovascular assessment
5 p's of neurovascular assessment - answers - pain
Pulse
Pallor
Paresthesia
Paralysis
Why are neuromuscular assessments so important for children with
fractures/casts/traction? - answers - to make sure blood flow goes to the extremity so
that they don't lose function of their extremity
What diagnostic procedures would you use to confirm a fracture? - answers - x-rays
How would you prepare the child for xray? - answers - immobilize the extremity
Prep the parent about procedure
How do we assess for pain in a child with a fracture? - answers - depending on age,
cognitive / developmental level
Rflacc --> 0-3 y/o or cannot self report (non-verbal)
Faces --> 4-8 y/o
Numeric --> >8 y/o
Why do we keep the child warm post fracture? - answers - to maintain perfusion to
extremities / we want vasodilation so that more blood reaches the extremity - if they are
cold the vasculature will vasoconstrictor
, Why do we maintain proper alignment for a child post fracture? - answers - until we can
get them to surgery → we use traction bc we want to lengthen muscle fibers to prevent
muscle spasm and to align the bones
Where do we promote rom for children with fractures? - answers - promote rom in the
unaffected extremities so we can prevent complications of immobility to keep them
moving
What are extra nursing considerations we want to make sure to do for children with
fractures? - answers - fluids
Keep them busy (diversional activities)
Change positions frequently to maintain perfusion
Plaster of paris vs synthetic fiberglass casts? - answers - plaster of paris: heavy, not
water resistant, 10-72 hours to dry
Synthetic fiberglass: light, water resistant, dry 5-32 minutes
What are the two main priorities of a child in a cast? - answers - neurovascular checks
Control pain
Tell me about 1st, 2nd and 3rd degree burns - answers - 1st = superficial --> pain only
2nd = partial thickness lost --> pain, scarring and possible grafting needed
3rd = full thickness lost - no pain (only around the edges), definite skin grafting
What will the labs do when you have a major burn and what happens to fluids? -
answers - k ^
Na (down)
H&h ^ (falsely)
Protein (down)
Fluid leaks out of the capillaries and protein follows (hypoalbunemia)
How will the pt look after a major burn? - answers - edematous (very swollen)
What fluids will a pt with major burns receive in the first 24 hours and then after? What
will you assess after - answers - first 24 hours - isotonic fluids (ns or lr)
After - colloid fluids (albumin)
Assess uop - under 30 kg (1ml/kg/hr), over 30 kg - minimum 30 ml/hr)
What would you expect a patients gi system to be after a major burn? Tx? - answers -
hypoactive, possible illeus, constipation
ANSWERS
How do you know when a child has a fracture? - answers - pain
Loss of function
Spasms
Why do kids have spasms when they get fractures? - answers - muscle fibers tear and
cause spasm --> more pain
We must align them and pull apart to avoid spams with traction
Nursing care post fracture includes? - answers - rice
Analgesics
Abcs
Neurovascular assessment
5 p's of neurovascular assessment - answers - pain
Pulse
Pallor
Paresthesia
Paralysis
Why are neuromuscular assessments so important for children with
fractures/casts/traction? - answers - to make sure blood flow goes to the extremity so
that they don't lose function of their extremity
What diagnostic procedures would you use to confirm a fracture? - answers - x-rays
How would you prepare the child for xray? - answers - immobilize the extremity
Prep the parent about procedure
How do we assess for pain in a child with a fracture? - answers - depending on age,
cognitive / developmental level
Rflacc --> 0-3 y/o or cannot self report (non-verbal)
Faces --> 4-8 y/o
Numeric --> >8 y/o
Why do we keep the child warm post fracture? - answers - to maintain perfusion to
extremities / we want vasodilation so that more blood reaches the extremity - if they are
cold the vasculature will vasoconstrictor
, Why do we maintain proper alignment for a child post fracture? - answers - until we can
get them to surgery → we use traction bc we want to lengthen muscle fibers to prevent
muscle spasm and to align the bones
Where do we promote rom for children with fractures? - answers - promote rom in the
unaffected extremities so we can prevent complications of immobility to keep them
moving
What are extra nursing considerations we want to make sure to do for children with
fractures? - answers - fluids
Keep them busy (diversional activities)
Change positions frequently to maintain perfusion
Plaster of paris vs synthetic fiberglass casts? - answers - plaster of paris: heavy, not
water resistant, 10-72 hours to dry
Synthetic fiberglass: light, water resistant, dry 5-32 minutes
What are the two main priorities of a child in a cast? - answers - neurovascular checks
Control pain
Tell me about 1st, 2nd and 3rd degree burns - answers - 1st = superficial --> pain only
2nd = partial thickness lost --> pain, scarring and possible grafting needed
3rd = full thickness lost - no pain (only around the edges), definite skin grafting
What will the labs do when you have a major burn and what happens to fluids? -
answers - k ^
Na (down)
H&h ^ (falsely)
Protein (down)
Fluid leaks out of the capillaries and protein follows (hypoalbunemia)
How will the pt look after a major burn? - answers - edematous (very swollen)
What fluids will a pt with major burns receive in the first 24 hours and then after? What
will you assess after - answers - first 24 hours - isotonic fluids (ns or lr)
After - colloid fluids (albumin)
Assess uop - under 30 kg (1ml/kg/hr), over 30 kg - minimum 30 ml/hr)
What would you expect a patients gi system to be after a major burn? Tx? - answers -
hypoactive, possible illeus, constipation
