Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply)
Waddling gait
Kyphosis
Lordosis
Scoliosis
Gower sign
Correct Answer : A,B,C,D,E
The correct answer is
A. Waddling gait
B. Kyphosis
C. Lordosis
D. Scoliosis
E. Gower sign
Choice A reason
Waddling gait: Children with Duchenne muscular dystrophy (DMD) often exhibit a waddling gait due to progressive muscle weakness, particularly in the pelvic girdle muscles. This gait pattern is a compensatory mechanism to maintain balance and mobility despite weakened muscles. The waddling gait is one of the early signs of DMD and typically becomes noticeable between the ages of 2 and 6 years.
Choice B Reason
Kyphosis: Kyphosis, an excessive outward curvature of the spine, can develop in children with DMD as the disease progresses. Muscle weakness and imbalance, particularly in the back muscles, contribute to this spinal deformity. Kyphosis can lead to discomfort, respiratory issues, and further mobility challenges, necessitating close monitoring and intervention.
Choice C Reason
Lordosis: Lordosis, an exaggerated inward curvature of the lower spine, is another common finding in children with DMD. This condition often develops as a compensatory mechanism to maintain an upright posture despite weakened hip and thigh muscles. Lordosis can cause lower back pain and impact overall posture and gait.
Choice D Reason
Scoliosis: Scoliosis, a lateral curvature of the spine, frequently occurs in children with DMD due to progressive muscle weakness and imbalance. As the disease advances, scoliosis can become more pronounced, leading to discomfort, respiratory complications, and further functional limitations. Early detection and management are crucial to mitigate these effects.
Choice E Reason
Gower sign: The Gower sign is a classic clinical indicator of DMD. It refers to the maneuver children with DMD use to rise from the floor, involving the use of their hands to “walk” up their legs due to proximal muscle weakness. This sign is typically observed in early childhood and is a key diagnostic feature of DMD1.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A"]
Explanation
Choice A reason:
A specific gravity of 1.010 indicates that the child’s urine is adequately diluted, suggesting proper hydration. Normal urine specific gravity ranges from 1.005 to 1.030. A value of 1.010 falls within this range and indicates that the kidneys are functioning well and the child is not dehydrated.
Choice B reason:
Moist mucous membranes are a sign of adequate hydration. When a child is well-hydrated, the mucous membranes in the mouth and other areas remain moist. This is a positive indicator that oral rehydration therapy has been effective in restoring the child’s fluid balance.
Choice C reason:
Capillary refill time of less than 3 seconds is another indicator of proper hydration and good peripheral perfusion. This means that the blood is circulating well throughout the body, and the tissues are receiving adequate oxygen and nutrients. A capillary refill time of less than 3 seconds is considered normal and suggests effective rehydration.
Choice D reason:
A sunken anterior fontanelle is a sign of dehydration in infants. When the fontanelle is sunken, it indicates that the child has lost a significant amount of fluid. Therefore, this finding does not indicate that oral rehydration therapy has been effective. Instead, it suggests that the child may still be dehydrated.
Choice E reason:
A heart rate of 146/min is elevated for an 8-month-old child1. Normal heart rates for infants range from 80 to 160 beats per minute. While this heart rate is within the upper limit of normal, it can also be a sign of dehydration or other stressors. Therefore, it is not a definitive indicator of effective rehydration therapy.
Correct Answer is ["A","B","C"]
Explanation
The correct answers are a) Use a straw to administer the medication, b) Give the medication with vitamin C, and c) It is best to give the medication with food.
Choice A reason:
Using a straw to administer ferrous sulfate is recommended to prevent staining of the teeth. Ferrous sulfate, especially in liquid form, can cause discoloration of the teeth if it comes into direct contact with them. By using a straw, the medication bypasses the teeth, reducing the risk of staining.
Choice B reason:
Giving ferrous sulfate with vitamin C is beneficial because vitamin C enhances the absorption of iron. Vitamin C (ascorbic acid) helps convert iron into a form that is more easily absorbed by the body. Therefore, administering ferrous sulfate with a source of vitamin C, such as orange juice, can improve its effectiveness.
Choice C reason:
It is best to give ferrous sulfate with food to reduce gastrointestinal side effects. While iron is best absorbed on an empty stomach, it can cause stomach upset, nausea, and constipation. Taking the medication with food can help mitigate these side effects, making it more tolerable for the child.
Choice D reason:
Giving ferrous sulfate with milk is not recommended. Dairy products, including milk, can interfere with the absorption of iron. Calcium in milk binds with iron, reducing its bioavailability and effectiveness. Therefore, it is best to avoid giving ferrous sulfate with milk or other dairy products.
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