NUR 336 Exam 5 Questions With Complete Solutions
How do insulin pumps work? Correct Answers Same insulin
(short-acting) is used for all basal and bolus doses; Setting
flexibility allows for exercise, types of meals, sick days; Alarms
can be set as reminders to check blood sugar; Many different
types of pumps on the market; each has unique features,
supplies, all $$$; Most pump sites need changed q 3 days; Need
back up plan (needles, syringes, long and short acting insulin) if
pump were to break; made of metal so needs to be removed for
MRI
How do kids get clavicle fractures? when is it found?
assessment? Correct Answers - causes: birth injury, FOOSH,
fall on shoulder, direct trauma
- found: with obvious deformity in older kids, not seen in infants
until callous makes bump
- assessment: assess for signs of abuse in infants and young
children
How do pediatric bone injuries tend to occur? Correct Answers
- bones bend rather than break
- compressive force results in torus/buckle fractures
- ligaments and tendons are stronger than bones
- the periosteum stabilizes and promotes healing of fractures in
children
What are neural tube defects? Largest risk factor? Correct
Answers - Definition: Congenital abnormalities of the nervous
system
,- Risk: Believed to be related to folic acid deficiency in pregnant
women especially before the 28th day after fertilization; women
of childbearing age should take 400 mcg of folic acid daily
What are septic arthritis and osteomyelitis? pathogen? s/s? Tx?
Correct Answers - definition: orthopedic emergency where
inflammation or infection gets into the joint or bone
- pathogen: often caused by staph aureus
- s/s:
infants= irritable, anorexia, abduction and externally rotated hip,
painful ROM, erythema, edema, low fever, normal CBC
children: limp, wont bear weight, trauma injury Hx, surgery Hx,
infection Hx, hip abnormality (flexed, abducted, externally
rotated, painful ROM), fever, positive leukocytosis
- Tx: emergency incision and drainage repeated every 1-3 days,
systemic IV antibiotics for 3-12 weeks
What are spiral fractures? nursing considerations? Correct
Answers - definition: long bone fracture that goes up the bone
in a spiral around it often from twisting injury
- nursing consideration: assess for abuse because in large bones
such as femur, this can indicate physical abuse
What are the consequences of sleep disorders? types? Correct
Answers - Consequences: social/developmental difficulties,
daytime sleepiness, irritability, poor academic performance
- Types: cant fall asleep (insomnia), waking up at night,
inappropriate sleep timing (hypersomnia, narcolepsy),
Obstructive sleep disorders (obstructive sleep apnea), limb
movements in sleep (periodic limb movement disorder, restless
, leg syndrome), parasomnia (night terrors, sleepwalking, REM
sleep behavior disorders, nightmares)
What are the most common causes of femur fracture? Tx?
meds? healing time? Correct Answers - cause: usually trauma
so abuse should be ruled out in infants and toddlers with femur
fractures
- Tx: traction (weights need to be hanging freely!!!) then ORIF
or external fixation
- meds: lorazepam for muscle spasms
- healing time: cast for 8-12 weeks followed by crutches for 3-4
weeks
What are the three main types of elbow fractures? cause?
Correct Answers - supracondylar: most common, affecting
weakest part of the elbow joint; often from FOOSH
- lateral condylar: most common physeal (growth plate) elbow
injury; often from FOOSH
- medial condyle: overuse/baseball pitcher; may damage ulnar
nerve
What are tics? what is Tourette syndrome? what causes
increased symptoms? Correct Answers - Tics: sudden,
repetitive, and involuntary movements
- Tourette: both motor and verbal tics present for more than 1
year
- Worsens symptoms: sleep depreivation, stress, increased
emotions