Question

cerebral palsy. Pamela su/ers from general spasticity, mental impairment, impaired vision and hearing, and hydrocephalus. She has been admitted to the pediatric unit for evaluation of intrathecal spasticity control. (Learning Objectives 2,3, 4, and 6) a. Identify medications that might be used to help control Pamela’s spasticity. b. What information would the nurse include in the health history?c. What nursing interventions would be important in Pamela’s care? d. What information would be important to include in a teaching plan for Pamela and her family? 2. Kyle Stephens, 15 years old, is brought to the emergency department by ambulance after a diving accident at a local lake. (Learning Objectives 1, 2, 3, 4, and7) a. What nursing assessments would be important for Kyle? b. What diagnostic tests would the nurse expect to be ordered for Kyle? Kyle is found to have crushed vertebrae at the S4-5 levelwith a partially severed spinal cord. c. What would be important teaching points for Kyle and his family? (3) Case Studies Chapter 49: Nursing Care of the Child with an Endocrine Disorder 1A. Jalissa Twyman, 8 years old, was admitted to the pediatric intensive care unit with a closed head trauma after being involved in a bicycle/motor vehicle accident. Jalissa is unconscious. The nurses caring for Jalissa document a weight loss of 1.82 kg over a 24-hour period, decreased skin turgor, and dry mucous membranes. Urine output for the same 24-hour period is 3.5 L/m2. (Learning Objectives 1, 2, 3, 4, 5, and 7)

Answer 1

1)

a)Medications used for spasticity are:

* Skeletal muscle relaxants:

Baclofen - gablofen, lioresal

Dantrolene sodium: dantrium, revonta, ryanodex

*Alpha 2 adrenergic agonists:

Tizanicline - zanaflex

Clonidine - catapres, kapvay

*Benzodiazepines:

Diazepam - Valium, diastat

*Botulinum toxins:

Rimabotulinum toxin B: myobloc

Incobotulinum toxin A: xeomin

Abobotulinum toxin A: dysport

Onabotulinum to in A: botox

b) The patient is having problems in muscle tone, movement, balance, coordination and speaking. Even she may be having weight loss.

c) Facilitate activities : should advise them to undergo physiotherapy

Should provide ROM exercise

Educate the patient and family

Speeching and hearing therapy

Advise them to have Nutritional diet

d) Should teach the family regarding the medication and ROM exercise and all. They should be aware to do those exercise themselves. Educate them regarding all the aspects of the disease.

2)

a) Assess O2 saturation and breathing pattern

Assess for any presence of nitrogen nercosis

Assess for O2 toxicity

Asses the temperature there may be hypothemia

Asses sinus and ear for any problems

Assess for decompression sickness

b) X - Ray

CT

MRI

ABG analysis

c) Educate the patient and family regarding the disease condition. Tell them how to prevent diving accident and about further first aids.