exam 3 Peds study guide.docx - NURS 474 Spring 2018 Exam 3 Blueprint Topics Exam Items Alteration in Mobility\/Neuromuscular or Musculoskeletal Disorder

exam 3 Peds study guide.docx - NURS 474 Spring 2018 Exam 3...

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NURS 474 Spring 2018 Exam 3 Blueprint Topics # Exam Items Alteration in Mobility/Neuromuscular or Musculoskeletal Disorder Posterior fontanel closes at 2-3 months; anterior fontanel by 18 months. At birth, the brain is 12% of body weight versus 2% in the adult. Brain and spinal cord development begins earliest and continues through age 12 years. Brain ossification is complete by age 12. Brain and Spinal Cord Development In gestation, 3-4 weeks the neural tube of the embryo begins to differentiate into the brain and spinal cord premature infant has less mature central nervous system higher risk of cervical spine injury children’s spine is very mobile Myelination not complete at birth, complete by age 2 proceeds in a cephalocaudal and proximodorsal fashion gaining head and neck control first Muscular Development newborn is capable of spontaneous movement but lacks purposeful control hypertonia and hypotonia are abnormal findings Duchenne Muscular Dystrophy Management of & Sign & Symptoms X-linked inherited Primarily seen in males; females are carriers Child progresses normally; muscle weakness appears between 3 to 6 years Ambulation not possible by age 12 Complications: “…contractures, scoliosis, disuse atrophy, infections, obesity, respiratory and cardiopulmonary problems.” S/S - Muscle weakness, hypertrophied calves, positive Gower’s maneuver (walking hands up the legs to achieve standing posture), frequent falls. All voluntary muscles are affected initially as well as cardiac and respiratory muscles. Waddling gait, balance is disturbed, Treatment o Promoting mobility- weight bearing activity, supportive equipment, use of a wheel chair become full time around the age of 12. o Maintaining cardiopulmonary function – deep breathing, coughing, assess o Maximizing quality of life – do not place limits on the child, modify as needed for the child o Supportive care o Collaborative 2-3 Cerebral Palsy Management of Pathologic drooling is a problem for many children with cerebral palsy. It can lead to dehydration, dental enamel erosion, and maceration of the skin, and an odor can result, along with social stigmatization. Recent research has shown that intra-glandular injection of botulinum toxin 1-2 This is the Blueprint for Exam 3. This Blueprint is meant to be used as a general guide. There may be times when a question must be removed and replaced last minute changing the number of exam items.
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NURS 474 Spring 2018 Exam 3 Blueprint type A can improve drooling with few side effects in children with neurologic disorders. Management – o Medical Management: Baclofen Pump see Drug Guide Guidelines 22.1 p.807 o Collaborative Care Goal : Early recognition and interventions to maximize the child’s abilities. Includes many health care providers, such as, PT, OT, Hearing and Speech, Orthopedics, Medicine, Nursing, Education System, Technology Support Services o Nursing Care : Devoted to supportive care; community advocacy with parents to preserve child function and maximize normal daily activities o Promote mobility o
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