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Exam 1: Cerebral Palsy Questions And Answers + Rationale With Complete Solutions
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Exam 1: Cerebral Palsy Questions And Answers + RationaleWith Complete Solutions
A 7-year-old child with cerebral palsy who wears leg braces has
a slight sensory loss in the lower extremities. What is the most
essential information for the nurse to teach the child and
parents?
1. Examine the skin for evidence of pressure points.
2. Keep the braces in good repair and pad them well.
3. Select shoes that have heels that are wide and low.
4. Check that the brace joints are aligned with body joints.
Correct Answers 1
rationale:
When sensory perception is impaired, with resultant lack of
effective specific motor responses, the child will be more
vulnerable to skin irritation and trauma. Although it is important
for the braces to be usable and well padded, the skin must be
assessed daily when there is a sensory loss. Pressure may still
occur even if the braces are well padded. Although this type of
shoe will facilitate balance, assessing the skin for breakdown is
the priority. Although alignment of brace joints to body joints is
important in facilitating joint mobility, assessment for skin
breakdown takes priority.
A 9-year-old child who has cerebral palsy and scoliosis also is
mentally challenged and blind. The child is incontinent, has
contractures of the elbows and wrists, and sits in a customized
wheelchair most of the day. One goal of nursing care is for the
child's skin integrity to remain intact. Which nursing action will
best achieve this goal?
1. padding the child's lower extremities
, 2. repositioning the child every 4 hours
3. replacing the bed linens with sterile linens
4. changing disposable diapers every 2-3 hours Correct
Answers 4
rationale:
The buttocks are at greatest risk for excoriation because the
child sits in a wheelchair most of the day. For skin integrity to
be maintained, the diaper area must be kept dry; disposable
diapers keep moisture away from the skin. Because the child is
in a wheelchair, there is no pressure on the child's legs. The
child should be repositioned every 1 to 2 hours. Replacing the
bed linens is unnecessary; freshly laundered linens will not
prevent the development of a pressure ulcer.
A 9-year-old child with cerebral palsy is to be taught the four-
point alternate crutch gait. The parents ask why this gait was
chosen. How should the nurse respond?
1. "Your child has more power in the arms than in the legs."
2. "Your child doesn't have power or step ability in the legs."
3. "It provides two points of support on the floor between steps."
4. "It provides for equal but partial weight-bearing on each
limb." Correct Answers 4
rationale:
The four-point alternate crutch gait is a simple and slow but
stable gait because there are always three points of support on
the floor, with equal but partial weight-bearing on each limb.
Telling the parent that their child has more power in the arms
than in the legs may or may not be true; the data are insufficient
to justify this conclusion. Some power and step ability is
required to use the four-point alternate crutch gait. The child has
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