When evaluating a child who complains of headaches, which description would lead nurse to suspect migraine headaches?
- Headache associated with stress only
- Associated with frequent use of acetaminophen
- Associated with sinus pressure and upper respiratory symptoms
- Associated with an aura prior to onset
- Associated with aura prior
Rationale - stress =tension. Using med more than 3xwk can trigger headache, sinus ones don’t have an aura. Migraine headaches often have an aura
A nurse is caring for a 15 y/o male who is recovering from a grade 3 concussion. Which educational statement would be important for the nurse to present go this family?
- The pt can experience personality changes within next 6 months
- Concussions usually are associated with skull fractures
- If the patient has another concussion in the future, recovery time should remain same
- The pt should not play sports for one hr after the concussion
- The pt can experience personality changes within next 6 months
Rationale- young athletes should avoid sports for 7days-rest of season to avoid a second one. Symptoms can occur as post concussion syndrome for up to 6 months Inc. Headache, personality changes, poor memory and vertigo. Multiple confusion = longer recovery and can have no evidence of skull fracture
Parents bring a 3 y/o to ED stating she had her first seizure. It lasts less than 5mins and involved jerking movements over entire body. Prior to seizure she had been sick and ran a fever. Based on description the nurse suspects what type of seizure?
- Partial
- Status epileptics
- Febrile
- Generized
- Febrile
Rationale - they are usually associated with fevers. While general and partial are not associated with fever. Status epileptics last more than 30mins
A nurse is educating a family about the type of fracture their 8 y/o has experienced. What description would be an accurate way to explain a closed fracture of the radius to the family?
- One of the bones in the arm broke completely and penetrated the skin
- One of the bones in the arm broke completely, but didn’t penetrate the skin
- One of the bones in the arm is broken incompletely, like a green twig
- One of the bones in the Rm is crushed and broken incompletely
- A closed fracture will break completely but not penetrate skin
A school nurse is evaluating a child whose leg was hurt in gym class . The nurse feels it is a muscle strain, but is still going to refer child to the primary care provider (pcp). Which instruction should the child follow until seen by pcp
- Increase motion to the extremity
- Try to walk on it even if there is pain
- Go back to gym class and participate
- Apply ice for 20min at a time
- Apply ice at 20 min at a time.
Should rest and apply ice 4x daily and gradually increase motion to extremity and should not participate In Sport for 2-3 wks after a strain
A nurse is caring for a child who just received a cast. Which of the following considerations would b important in providing care for child?
- Assess castes extremity every 15-30 min for first 2hrs applied
- When handling cast use fingertips only for first 24hr
- Give the child a blunt object to help with itching under the cast
- Apply powder to inside of cast edges to help decrease moisture
- Assess cast extremity 15-30min for first 2hrs of application
This is important to assess intact circulation, sensation and movement for signs of compartment syndrome
