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Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply)

A.

Waddling gait

B.

Kyphosis

C.

Lordosis

D.

Scoliosis

E.

Gower sign

Answer and Explanation

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.


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Related Questions

Correct Answer is C

Explanation

Choice A reason:

I will have my child rest: Resting is an important part of managing a bleeding episode in children with hemophilia. It helps to minimize movement and reduce the risk of further injury or bleeding.

Choice B Reason:

I will compress the site: Applying pressure to the bleeding site is a standard first aid measure for controlling bleeding. Compression helps to slow down or stop the bleeding by promoting clot formation.

Choice C Reason:

I will apply heat: Applying heat is not recommended for managing bleeding in hemophilia. Heat can increase blood flow to the area, potentially worsening the bleeding. Instead, cold compresses or ice packs should be used to constrict blood vessels and reduce bleeding.

Choice D Reason:

I will elevate the affected part: Elevating the affected limb can help reduce blood flow to the area and minimize bleeding. This is a common and effective first aid measure for managing bleeding episodes.

Correct Answer is ["B","C","D"]

Explanation

Choice A: Increase Sodium Intake

Increasing sodium intake is generally not recommended for patients with renal disorders. High sodium intake can lead to fluid retention, hypertension, and worsening of kidney function. Patients with renal disorders are often advised to follow a low-sodium diet to manage these risks.

Choice B: Monitor Intake/Output

Monitoring intake and output (I/O) is crucial for patients with renal disorders. It helps in assessing kidney function and fluid balance. Accurate measurement of fluid intake and urine output can provide valuable information about the patient’s hydration status and kidney function. This intervention is essential for preventing fluid overload and dehydration.

Choice C: Daily Weights

Daily weights are an important intervention for patients with renal disorders. Monitoring weight daily helps in detecting fluid retention early. Sudden weight gain can indicate fluid overload, which is a common issue in patients with kidney problems. By tracking daily weights, healthcare providers can make timely adjustments to the patient’s treatment plan.

Choice D: Monitor Blood Pressure

Monitoring blood pressure is a key intervention for patients with renal disorders. Hypertension is both a cause and a consequence of kidney disease. Regular monitoring of blood pressure helps in managing hypertension and preventing further damage to the kidneys. It also aids in assessing the effectiveness of antihypertensive medications.

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