What is characteristic of fractures in children?
a) Children at greatest risk for fractures are 2 yrs and under
b) Rapidity of healing is inversely related to the child’s age.
c) Bone healing in children is slower due to the weaker surface
membranes of the bones and less blood supply
d) surface of child’s bone is thinner, weaker, and has less osteogenic
potential compared with that of the adult. – ANSWER- b) Rapidity of
healing is inversely related to the child’s age.
*Fractures heal in less time in children than in adults. As the child
ages, the healing time increases.
*fractures are least likely to occur in children under 2 yrs bc of
physiology; if occur its a red flag for abuse
*Bone healing in children is rapid due to the thickened membrane
and generous blood supply.
A nurse is caring for an infant with developmental dysplasia of the hip
(DDH). Based on the nurse’s knowledge of DDH, which clinical
manifestation should the nurse expect to observe? (select all apply)
a) scoliosis
b) Negative Babinski sign
c) Asymmetric thigh and gluteal folds
d) Positive Ortolani
e) Shortening of limb on affected side – ANSWER- c) Asymmetric thigh
and gluteal folds
d) Positive Ortolani and Barlow tests
e) Shortening of limb on affected side
*Asymmetric thigh and gluteal folds seen from birth to 2 mos
*Ortolani test is the abducting of the thighs to test for hip
dislocation; will feel click or flunk on ABDuction; screen until 1 yrs
old, but most reliable in first 2 mos age
*In a walking child: limping, waddling, lumbar lordosis, toe
walking, and/or leg length discrepancy
Which measure is important in managing hypercalcemia in a child who
is immobilized after surgery for DDH w closed reduction w hip spica
cast?
a) Promote adequate hydration
b) Change position frequently
c) Encourage a diet high in calcium
d) Provide a diet high in protein and calories – ANSWER- a) Promote
adequate hydration
*Hydration is extremely important to help remove the excess
calcium from the body. This can help prevent hypercalcemia.
*Changing the child’s position frequently will help with managing
skin integrity but will not affect calcium levels.
*risk is hypercalcemia, but child’s metabolism is slower bc of the
immobilization so a diet w sufficient calories and nutrients for
healing is important.
An 8 yr old has been diagnosed with Duchenne Muscular Dystrophy.
The child recently began participation in a regular classroom for part of
the day. The child’s mother asks the school nurse about joining the afterschool Scout troop. The nurse’s response should be based on knowledge
that
a) most activities such as Scouts cannot be adapted for children with
MD.
b) after-school activities usually result in extreme fatigue for children
with MD.
c) trying to participate in activities such as Scouts l – ANSWER- d)
after-school activities often provide children with MD with opportunities
for socialization and recreation.
*Recreational outlets and after-school activities should be
considered to promote socialization opportunities. *child, family,
and activity director should assess the degree of activity to ensure it
matches the child’s capabilities.
*A supportive environment associated with after-school activities
will add to the child’s self-esteem.
Which statement best describes Duchenne muscular dystrophy (DMD)?
a) inherited as an autosomal dominant disorder.
b) characterized by weakness of the proximal muscles of both the pelvic
and shoulder girdles.
c) characterized by muscle weakness, usually beginning at about age 3
years.d)onset occurs in later childhood and adolescence. – ANSWER- c)
characterized by muscle weakness, usually beginning at about age 3
years.
*Usually, children reach the early developmental milestones, but the
muscular weakness is usually observed early in childhood or late in
life.
*is inherited as an X-linked recessive disorder. *Weakness is usually
first noted in walking, then progressive muscle weakness in other
muscle groups follows.
Which statement is true regarding the genetic transmission of Duchenne
muscular dystrophy (DMD)?
a) Multiple gene expression
b) X-linked recessive
c) Autosomal dominant
d) No carrier states exist – ANSWER- b) X-linked recessive
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