NURS 452 Exam 1 Questions And Accurate Answers
A+ Graded
Talipes Equinovarus
most common clubfoot
may be unilateral or bilateral
Examination and X-Ray
How is Clubfoot diagnosed?
Clubfoot treatment
begins in the first week of life, serial casting for 8-12 weeks (may include Dennis-Browne
bar) followed by corrective shoes
if no improvement by 3 months, surgery is scheduled between 6-12 months (pinning and
post op casting and bracing)
DO NOT REPOSITION BAR
(may cut off ends of shoes for foot growth)
What will the nurse have to instruct the parents regarding the Dennis-Browne bar?
intact skin
cast care
clubfoot nursing care
Necrotizing Enterocolitis (NEC)
Acute inflammatory disease of the bowel. Possible cause vascular compromise of the
bowel in preterm and high-risk infants
,Death of mucosal cells from injury.
Loss of protective, lubricating mucous
Mucosa impermeable to endotoxins and bacteria
Gas from bacteria causes penumatosis
NEC clinical manifestations
abdominal distention
melena
gastric residuals
lethargy
bilious emesis
signs occur between 4-10 days after feed initiation
X-ray shows sausage shaped intestine
bubbly or "soapsuds" that are interstitial pneumatosis
labs show anemia, leukopenia, electrolyte imbalances, positive blood cultures
bilious emesis
NEVER okay (NEC)
forceful expulsion of stomach contents along with bile, resulting in vomit that appears
green or bright yellow in color
management of NEC
prevention!
breastmilk feeds when possible
trophic feeds-slow progression
probiotics with feeds
,infection prevention
serial abdominal x-rays to see treatment response
pre/post op care if necessary
w/ perforation has a mortality of 20-40%
NGT for decompression
hold all feeds, bowel rest
IV antibiotics
What to do if NEC is suspected?
meningitis
inflammation of the meninges
most commonly develops as a result of infection somewhere else in body
(nasopharyngeal)
bacterial greatly reduced due to Hib (pneumoccal vaccine)
clinical presentation of meningitis in infants-2 years
fever, decreased PO< emesis, marked irritability, restlessness, bulging/tense fontanelle,
neuro cry
clinical presentation of meningitis in age 3 to adolescents
abrupt onset, fever, chills, headache, seizure, emesis, altered mental status
Nuchal Rigidity
sing of meningitis
stiff neck
, positive Brudzinski's sign
sing of meningitis
when child is lying flat and head is lifted the legs bend
positive Kernig's sign
sing of meningitis
inability to extend the knee when it is raised
other meningitis exam findings
photophobia and agitation progressing to coma
meningococcemia
meningitis accompanied by petechiae is indicative of this and is an emergency!
purpura
collection of petechiae
gold standard of meningitis
lumbar puncture which reveals increased WBC and protein, decreased glucose
increased WBC
increased protein
decreased glucose
What would you see in a lumbar puncture of a child that is diagnosed with meningitis?
nursing care of child with meningitis
A+ Graded
Talipes Equinovarus
most common clubfoot
may be unilateral or bilateral
Examination and X-Ray
How is Clubfoot diagnosed?
Clubfoot treatment
begins in the first week of life, serial casting for 8-12 weeks (may include Dennis-Browne
bar) followed by corrective shoes
if no improvement by 3 months, surgery is scheduled between 6-12 months (pinning and
post op casting and bracing)
DO NOT REPOSITION BAR
(may cut off ends of shoes for foot growth)
What will the nurse have to instruct the parents regarding the Dennis-Browne bar?
intact skin
cast care
clubfoot nursing care
Necrotizing Enterocolitis (NEC)
Acute inflammatory disease of the bowel. Possible cause vascular compromise of the
bowel in preterm and high-risk infants
,Death of mucosal cells from injury.
Loss of protective, lubricating mucous
Mucosa impermeable to endotoxins and bacteria
Gas from bacteria causes penumatosis
NEC clinical manifestations
abdominal distention
melena
gastric residuals
lethargy
bilious emesis
signs occur between 4-10 days after feed initiation
X-ray shows sausage shaped intestine
bubbly or "soapsuds" that are interstitial pneumatosis
labs show anemia, leukopenia, electrolyte imbalances, positive blood cultures
bilious emesis
NEVER okay (NEC)
forceful expulsion of stomach contents along with bile, resulting in vomit that appears
green or bright yellow in color
management of NEC
prevention!
breastmilk feeds when possible
trophic feeds-slow progression
probiotics with feeds
,infection prevention
serial abdominal x-rays to see treatment response
pre/post op care if necessary
w/ perforation has a mortality of 20-40%
NGT for decompression
hold all feeds, bowel rest
IV antibiotics
What to do if NEC is suspected?
meningitis
inflammation of the meninges
most commonly develops as a result of infection somewhere else in body
(nasopharyngeal)
bacterial greatly reduced due to Hib (pneumoccal vaccine)
clinical presentation of meningitis in infants-2 years
fever, decreased PO< emesis, marked irritability, restlessness, bulging/tense fontanelle,
neuro cry
clinical presentation of meningitis in age 3 to adolescents
abrupt onset, fever, chills, headache, seizure, emesis, altered mental status
Nuchal Rigidity
sing of meningitis
stiff neck
, positive Brudzinski's sign
sing of meningitis
when child is lying flat and head is lifted the legs bend
positive Kernig's sign
sing of meningitis
inability to extend the knee when it is raised
other meningitis exam findings
photophobia and agitation progressing to coma
meningococcemia
meningitis accompanied by petechiae is indicative of this and is an emergency!
purpura
collection of petechiae
gold standard of meningitis
lumbar puncture which reveals increased WBC and protein, decreased glucose
increased WBC
increased protein
decreased glucose
What would you see in a lumbar puncture of a child that is diagnosed with meningitis?
nursing care of child with meningitis
