Which of the following are important to assess when a child has a cast? (Select all that apply)

The correct answer is c. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Choice A reason:

Aspirin was once commonly used to treat juvenile idiopathic arthritis (JIA), but it is no longer the first-line treatment due to its potential side effects, such as gastrointestinal issues and Reye’s syndrome in children. While it can still be used in some cases, it is not the preferred initial treatment.

Choice B Reason:

Corticosteroids are effective in reducing inflammation and controlling symptoms of JIA, but they are not typically used as the first-line treatment due to their potential side effects, including weight gain, growth suppression, and increased risk of infections. They are usually reserved for more severe cases or when other treatments have failed.

Choice C Reason:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for juvenile idiopathic arthritis. They help reduce inflammation, relieve pain, and improve joint function. NSAIDs are generally well-tolerated and have a long track record of safety and effectiveness in managing JIA.

Choice D Reason:

Disease Modifying Anti-Rheumatoid Drugs (DMARDs), such as methotrexate, are used in the treatment of JIA, but they are not typically the first-line treatment. DMARDs are often prescribed when NSAIDs are not sufficient to control the symptoms or when the disease is more severe. They help slow the progression of the disease and prevent joint damage.

The correct answer is

A. Unable to roll over back to front

B. Head lag

C. Feeding difficulties

D. Floppy posture

E. Arms are stiff

F. Does not smile

G. Unable to sit without support

H. Irritable and cries often

I. Unable to pass an object between hands

Choice A reason

Unable to roll over back to front: At 3 months, infants typically start to develop the ability to roll over from their stomach to their back. Rolling over from back to front usually occurs later, around 4 to 6 months. However, the inability to roll over at all by 3 months could indicate developmental delays or muscle weakness, which requires follow-up.

Choice B Reason

Head lag: By 3 months, infants should have enough neck muscle strength to hold their head up when pulled to a sitting position. Persistent head lag at this age can be a sign of developmental delay or neuromuscular disorders, necessitating further evaluation.

Choice C Reason

Feeding difficulties: Infants should be able to suck and swallow effectively by 3 months. Feeding difficulties can lead to inadequate nutrition and growth, and may indicate underlying issues such as gastrointestinal problems or neurological disorders. This requires prompt attention and intervention.

Choice D Reason

Floppy posture: A 3-month-old should start to show more control over their body movements and have a more stable posture. Floppy posture, also known as hypotonia, can be a sign of various conditions, including genetic disorders, muscle diseases, or central nervous system issues. It is important to investigate the cause of hypotonia.

Choice E Reason

Arms are stiff: Stiffness in the arms, or hypertonia, can indicate neurological problems such as cerebral palsy or other motor disorders. It is crucial to assess the underlying cause of increased muscle tone and provide appropriate interventions.

Choice F Reason

Does not smile: Social smiling typically begins around 6 to 8 weeks of age. If a 3-month-old does not smile, it could be a sign of developmental delay, visual impairment, or other social and emotional issues. This warrants further assessment to determine the cause.

Choice G Reason

Unable to sit without support: While sitting without support is not expected until around 6 months, the inability to show any signs of trying to sit or maintain a sitting position with support at 3 months could indicate developmental delays. This should be monitored and addressed if necessary.

Choice H Reason

Irritable and cries often: Excessive irritability and frequent crying can be signs of discomfort, pain, or underlying medical conditions such as infections, gastrointestinal issues, or neurological problems. It is important to identify and address the cause of the infant’s distress.

Choice I Reason

Unable to pass an object between hands: By 3 months, infants should start to develop hand-eye coordination and the ability to grasp objects. The inability to pass an object between hands may indicate developmental delays or motor skill issues, which require further evaluation.