VN 34 Test 12 genito/muscular

Question 1

1. What is secondary Amenorrhea/nursing actions, causes (pg.847 & ch.39 pp slide 15):

Answer 1

 Missing 3 or more periods after menstrual flow has begun
 Causes: Tumors, genetics, physical or emotional stress
 Nursing action: complete physical examination, including gynecologic screening is necessary to help determine the cause

Question 2

1.WHat is dysmenorrhea/nursing actions (ch.39 pp slide 15):

Answer 2

 pain associated w/menstruation
 cramping abdominal pain
 leg pain & backache
 Nursing action: Ibuprofen (blocks prostaglandins)

Question 3

2. Nephrotic syndrome manifestations (ch.39 pp slide 9)

Answer 3

 Edema both general & periorbital, edema of the scrotum on the male is a characteristic

 Goals for child w/nephrotic: relieving edema, improving nutritional status, maintaining skin integrity, conserving energy & preventing infection

 Respiratory problems
 Anorexia, irritability & loss of appetite develop (leads to malnourishment)

Question 4

2. Nephrotic syndrome nursing actions/client education(Ch.39 pp slide 9)

Answer 4

 Monitor I & O’s
 Measure abdominal girth & weights daily
 No or low salt diet
 Small snacks, appealing meals
 High protein

Question 5

3. Glomerulonephritis causes, manifestations, complications/priority (Ch.39 pp slide 6)

Answer 5

 Causes: Group A strep (ear, throat)

Manifestations:
 Appear 1-3 wks after the onset of a Strep infection
 Hematuria (smoky or bloody)
 Periorbital edema may accompany or precede hematuria
 headache

Complications/Priority:
 HTN (priority)

Question 6

3. Glomerulonephritis nursing management(ch.39 pp slide 7):

Answer 6

 Manage edema (daily weights, accurate I&O’s, daily abdominal girth)
 Monitor VS & Implement seizure precautions in elevated BP
 Nutrition (low sodium, low to moderate protein
 Bed rest not necessary, but most children will normally restrict activity due to malaise
 Susceptibility to infections (no play dates)

Question 7

4. Nephroblastoma nursing action (Ch.39 pp slide 12)

Answer 7

 Abdominal palpation should be avoided (cells may break loose & spread tumor)
 Asses for HTN & hematuria

Question 8

5. Cryptorchidism treatment (Ch.39 pp slide 14)

Answer 8

 If testes have not descended by age 1
 Hormonal treatment w/HCG
 Orchiopexy (surgical correction)

Question 9

6. PMS manifestations &client education (ch.39 pp slide 15)

Answer 9

Manifestations:
 Edema (resulting in weight gain)
 Headache
 Increased anxiety & mild depression

Client Education:
 Increase fluids, decrease alcohol/caffeine, moderate exercise, sleep & relaxation

Question 10

7. Uti manifestations (ch.39 pp slide 3):

Answer 10

 N/V & anorexia
 Chills & fever
 Nocturia, urinary frequency, urgency
 Suprapubic or lower back pain, dysuria (burning on urination)
 Hematuria
 Abnormal dipstick

Question 11

7. Uti Interventions/client education (ch.39 pp slide 4):

Answer 11

 Finish all meds
 Administer antipyretics
 Increase fluids
 Change diapers frequently
 Good handwashing

Question 12

8. Acute kidney injury causes (Ch.39 Pp slide 8)

Answer 12

 Contrast
 Poisoning
 Obstruction
 Nephrotoxicity
 Dehydration

Question 13

9. Enuresis client education (Ch.39 pp slide 11)

Answer 13

 Limit fluids after dinner
 Provide positive reinforcements
 Use the waking schedule treatment

Question 14

10. Cast applications client education/complications

Answer 14

Client Education(ch.40 pp slide 8):
 Elevate first 24-48hrs
 Ice first 24hrs
 Monitor for infection (warm spots)
 Routine skin care
 Report severe pain
 Instruct no placement of foreign objects (may use cool setting of hair dryer for itching)

Complication (pg.854):
 Compartment Syndrome: a serious neurovascular concern that occurs when increasing pressure within the muscle compartment causes decreased circulation.

Question 15

10. cast applications manifestations of complications (pg.855):

Answer 15

 Pain
 Cool, discolored (bluish), pale, red or irritated skin
 Numbness or tingling or swelling
 Inability to wiggle fingers or toes
 Foul smell from under cast
 Increased temperature

Question 16

11. Duchenne muscular dystrophy (DMD) complications and client education (ch.40 pp slide 10)

Answer 16

 Gentle exercise daily
 Good diet to avoid obesity
 Monitor cardiac & respiratory status as disease progresses
 Heart muscle eventually is affected
 Weakness of leg, arm & shoulder muscles progresses gradually w/the child usually becoming wheelchair bound
 Respiratory function is affected late in the stage & common cause of death

Question 17

12. Ewing sarcoma manifestations/causes/treatment (ch.40 pp slide 13)

Answer 17

 Cause: Malignant tumor in the bone marrow of the long bones
 Sometimes pain after non-related injury brings attention to tumor, but pain might come & go
 Tumor can be removed w/out amputation

Question 18

13. Refresh kindergarten vaccines

Answer 18

Age 4-6
V- varicella
D- Dtap
I-inactivated polio
M-MMR

Question 19

14. Osteosarcoma causes, manifestations, treatment (ch.40 pp slide 12)

Answer 19

Causes:
 Malignant tumor in the long bones/past exposures of radiation

Manifestations:
 Sometimes pain after non-related injury

Treatment:
To remove the bone or the limb where the tumor is found
Prosthetic care

Question 20

15. Assessment of Fractures (ch.40 pp slide 6)

Answer 20

 Early manifestation: unrelenting pain unrelieved by analgesics

Late Manifestation: (5 p’s of assessment)
 Pain & point of tenderness
 Pulse- distal to the fx site
 Pallor
 Paresthesia- sensation distal to the fx site
 Paralysis- movement distal to the fx site

Question 21

16. Various types of fractures manifestations (ch.40 pp slide 4)

Answer 21

Complete: fragments separated
Incomplete: fragments partially joined
Compound or open: fractured bone protrudes through skin
Complicated: bone fragments have damaged other organs or tissues
Comminuted: small fragments of bone are broken from the fractured shaft & lie in surrounding tissue
Greenstick: compressed side of bone bends, but tension side of bone breaks, causing incomplete fracture

Question 22

17. Osteomyelitis manifestations and diagnostic values (ch.40 pp slide 9)

Answer 22

(An infection of the bone usually caused by staphylococcus aureus)

 Pain
 Warmth & redness at the site
 Increased WBC & ESR

Question 23

18. JIA Manifestations (Ch.40 slide 15):

Answer 23

(Most common in the wrist, knees, ankles & polyarticular involving 5 to more joints)

 Loss of mobility in affected joints
 Growth retardation
 Stiffness
 Warm to touch (usually w/out erythema)
 Anorexia & weight loss
 Rash
 Fever
 Swelling

Question 24

18. JIA treatment(Ch.40 slide 14):

Answer 24

 NSAIDS: Naproxen & Ibuprofen (1st choice)
 Methotrexate (beware of immunosuppression)

Question 25

19. Scoliosis client education/Treatment (ch.40 pp slide 16)

Answer 25

 Mild scoliosis: electrical stimulations (TENS)
 Prominent scoliosis: braces worn 23-24hrs/day (worn over t-shirt to avoid irritation, hygiene/shower)

 Surgical Tx: use of rods, screws, hooks & spinal fusion (greater than 45% only)
 Goals include minimizing the disruption of activities, preventing injury & maintaining skin integrity & self-image

Question 26

20. Legg-Calve Perthes manifestations (ch.40 pp slide 11)

Answer 26

 Limp (sometimes painless)
 Stiffness
 Limited ROM