The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately?

A. Duchenne muscular dystrophy is a progressive neuromuscular disorder characterized by skeletal muscle weakness that eventually affects respiratory muscles. Monitoring pulmonary function (e.g., forced vital capacity) and oxygen saturation is essential to detect declining lung function early and guide interventions such as respiratory therapy, assisted coughing, or ventilatory support. This statement reflects an accurate understanding of the progressive complications of DMD.

B. While some children with DMD may have mild cognitive delays or learning difficulties, progressive cognitive decline is not a primary complication of the disease. The main progressive complications involve the musculoskeletal, respiratory, and cardiac systems, so this statement does not best reflect the expected disease progression.

C. In DMD, serum creatine kinase (CK) levels are initially markedly elevated due to muscle breakdown. CK may decline later as muscle mass is lost, but this is not the hallmark monitoring point for progressive complications. Relying on CK alone does not guide management of pulmonary or cardiac complications.

D. DMD does affect the heart, causing cardiomyopathy and arrhythmias as the disease progresses. Cardiac monitoring is essential to manage complications and prevent morbidity and mortality. This statement reflects a dangerous misconception.

A. Eye opening is a core component of the Glasgow Coma Scale (GCS) and is assessed to determine the level of consciousness. Scores range from 1 (no eye opening) to 4 (spontaneous eye opening).

B. Sensory response is not directly assessed in the Glasgow Coma Scale. While neurological exams may include sensory testing (e.g., pain, touch, temperature), the GCS specifically evaluates eye opening, verbal response, and motor response.

C. Verbal response is a main component of the GCS, assessing the patient’s ability to speak coherently and appropriately. Scores range from 1 (no verbal response) to 5 (oriented conversation).

D. Motor response is a key part of the GCS, evaluating purposeful or reflexive movements. Scores range from 1 (no motor response) to 6 (obeys commands).