When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

Skeletal traction.

Physical therapy.

Orthotics.

Occupational therapy.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Skeletal traction involves inserting a pin directly into the bone to apply a continuous pulling force, typically used for complex fractures or severe orthopedic deformities. This is generally not a primary or common treatment for cerebral palsy, where management focuses on function, muscle tone, movement, and joint stability using non-invasive or less invasive techniques.

Choice B rationale

Physical therapy is a fundamental and expected treatment for cerebral palsy (CP). It focuses on improving muscle strength, mobility, balance, gait, and coordination. Specific exercises and techniques are employed to maximize functional independence and minimize the progression of secondary musculoskeletal complications.

Choice C rationale

Orthotics, such as ankle-foot orthoses (AFOs) or braces, are commonly prescribed treatments in the plan of care for children with CP. They provide support, maintain proper body alignment, prevent or correct deformities, and enhance walking ability by assisting with muscle control and joint stability during movement.

Choice D rationale

Occupational therapy is an essential component of the CP treatment plan. It addresses fine motor skills, activities of daily living (ADLs) like dressing and feeding, and visual-motor integration. The goal is to maximize the child's independence in self-care, school, and play activities tailored to their specific deficits.

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Correct Answer is C

Explanation

Choice A rationale

Feeding problems are a common, non-specific finding in early childhood and can be related to many different issues, such as poor latch, reflux, or developmental delays, and are not exclusively indicative of a genetic disorder like Down syndrome. Therefore, this observation is not specific enough to confirm a genetic etiology.

Choice B rationale

Nasal congestion and excess mucus are very common signs of upper respiratory infections or allergic rhinitis in young children. These findings reflect an inflammatory or infectious process in the nasal passages and are not recognized as a primary or specific physical characteristic of a genetic disorder.

Choice C rationale

Low-set ears are a recognized dysmorphic feature or minor congenital anomaly that is often associated with various syndromes, particularly those involving chromosomal abnormalities like Down syndrome, as they reflect atypical fetal development of the first and second branchial arches. Lobe creases, while a potential finding, are less specific than low-set placement.

Choice D rationale

Wheezing suggests obstruction or narrowing in the lower airways, typically associated with conditions like asthma, bronchiolitis, or foreign body aspiration. This is a respiratory symptom related to inflammation and bronchospasm and is not a typical, pathognomonic physical finding of a common genetic disorder.

A. A newborn who is 24 hours post-delivery and has not voided. B. A newborn who is 18 hours post-delivery and has acrocyanosis. C. A newborn who is 24 hours post-delivery and has not passed meconium. D. A newborn who is 12 hours post-delivery and has a temperature of 100.5 degrees

Correct Answer is D

Explanation

Choice A rationale

While voiding is expected, the normal range for the first void is typically within the first 24 to 48 hours of life. A newborn not voiding at exactly 24 hours warrants continued monitoring, but it is not an immediate emergency unless there are other signs of distress or an obvious obstruction.

Choice B rationale

Acrocyanosis is a normal, transient condition in the newborn characterized by a bluish discoloration of the hands and feet due to sluggish peripheral circulation. It is common for up to 24 hours after birth and does not require immediate intervention, only ongoing assessment to ensure central color is pink.

Choice C rationale

Most healthy newborns pass meconium, the first stool, within the first 24 hours of life, with almost all passing it by 48 hours. A lack of meconium passage at 24 hours requires investigation for potential intestinal issues, such as Hirschsprung's disease or meconium plug, but an elevated temperature signals more acute distress.

Choice D rationale

A temperature of 100.5 degrees F (38.1 degrees C) in a newborn, which is above the normal range (typically 97.7 to 99.5 degrees F or 36.5 to 37.5 degrees C), is a serious finding. Newborns are susceptible to rapid temperature changes, and hyperthermia can indicate sepsis, dehydration, or environmental issues requiring immediate assessment and intervention.

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When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

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When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?