Pediatric & Maternal Nursing – Review Lecture

A comprehensive set of question-and-answer flashcards covering cerebral palsy, genetic and congenital disorders, sensory impairment, muscular dystrophy, neural tube defects, leukemia, cystic fibrosis, diabetes, maternal-fetal complications, postpartum care, mental health, and holistic nursing concepts.

What is the basic definition of Cerebral Palsy (CP)?

A group of motor disorders caused by a lesion in various motor centers of the developing fetal brain.

List two prenatal or perinatal risk factors associated with CP.

Prenatal brain abnormalities, maternal chorioamnionitis exposure, prematurity, hypoxic brain injury, or severe neonatal hypoglycemia.

Why do manifestations of CP vary widely among children?

Because the location and extent of brain damage differ from child to child, leading to a spectrum from mild to severe impairment.

Which type of CP is characterized by spasms that occur with movement and is related to cerebral asphyxia?

Spastic Cerebral Palsy.

Which CP type involves continuous involuntary writhing movements and is often linked to hyperbilirubinemia?

Athetoid (dyskinetic) Cerebral Palsy.

Damage to what part of the brain leads to Ataxic CP?

A lesion in the cerebellum.

What two medications are commonly used to manage CP spasticity and athetoid movements?

Botulinum toxin for spasticity and levodopa for athetoid movements.

Why is good skin care essential in children with CP?

Because immobility and spasticity increase the risk of pressure injuries and skin breakdown.

What is the most common chromosomal abnormality that causes Down syndrome?

Trisomy 21 – the presence of three chromosome 21s.

How does Mosaic Down syndrome differ from Trisomy 21?

In Mosaicism, both normal and abnormal cells are present, often resulting in milder physical and intellectual effects.

What prenatal tests screen for Down syndrome between 11–14 weeks’ gestation?

Ultrasound assessment and maternal blood work; amniocentesis confirms the diagnosis.

Name two major impacts of hearing impairment on a child’s development.

It can affect speech/language acquisition and social-emotional development, behavior, and academic achievement.

Differentiate sensorineural and conductive hearing loss.

Sensorineural involves damage to cochlear hair cells or acoustic nerve; conductive prevents sound transmission to the middle ear (e.g., due to cerumen or otitis media).

What are two first signs of possible hearing impairment in an infant?

No startle reflex to sound under 4 months or lack of response to music/voices.

Give two communication strategies nurses should use with hearing-impaired children.

Maintain eye level and face-to-face contact, use short sentences, lip reading, sign language, writing, and visual aids.

What is Duchenne Muscular Dystrophy (DMD)?

A progressive X-linked disorder characterized by muscle degeneration, with onset typically between 2–6 years.

Describe Gower’s sign in DMD.

A maneuver where the child uses hands to push off the floor and walk up their thighs to stand due to proximal muscle weakness.

Which laboratory value is markedly elevated in DMD and serves as an early diagnostic clue?

Blood creatine phosphokinase (CPK).

What is the usual cause of death in DMD?

Cardiac failure or respiratory infection as the disease progresses.

Define Spina Bifida.

A neural tube defect involving malformation of the spinal cord due to imperfect closure of the vertebrae.

How do Spina Bifida Occulta and Cystica differ?

Occulta has a hidden vertebral defect without protrusion; Cystica presents with a cystic sac (meningocele or meningomyelocele).

What visible skin sign may suggest Spina Bifida Occulta?

A tuft of hair, dimple, lipoma, or skin discoloration over the lumbosacral area.

Why is hydrocephalus a common complication of meningomyelocele?

The protrusion disrupts normal cerebrospinal fluid flow, leading to accumulation in the ventricles.

What daily supplement is recommended to prevent neural tube defects such as Spina Bifida?

0.4 mg of folic acid for all women of child-bearing age.

What is the cornerstone of treatment for Spina Bifida Cystica soon after birth?

Surgical closure of the defect to protect neural tissue and prevent infection.

Define Leukemia in children.

A malignant disease of blood-forming organs characterized by uncontrolled proliferation of immature white blood cells.

Which type of childhood leukemia is most common?

Acute Lymphoid (Lymphoblastic) Leukemia – ALL.

Explain how leukemia leads to anemia and thrombocytopenia.

Immature WBCs crowd bone marrow, suppressing production of red blood cells and platelets.

Give two key family-teaching points during chemotherapy for leukemia.

Infection-prevention measures due to bone-marrow suppression and maintaining adequate hydration to protect kidneys.

List the phases of chemotherapy for leukemia management.

Induction, CNS prophylaxis, Maintenance, Re-induction (for relapse), and Extramedullary disease therapy.

Name three common side effects of chemotherapy that nurses must monitor.

Nausea/vomiting, bone marrow depression (anemia, infections), and alopecia.

What genetic pattern causes Cystic Fibrosis (CF)?

An autosomal recessive trait; both parents carry the defective gene.

State two primary pathophysiologic features of CF.

Increased viscosity of exocrine gland secretions and abnormal chloride movement causing electrolyte loss in sweat.

Why do children with CF often have bulky, foul-smelling stools?

Pancreatic enzymes cannot reach the intestine, leading to malabsorption of fats.

List three key nursing interventions for respiratory management in CF.

Postural drainage, aerosol/antimicrobial therapy, breathing exercises, and infection prevention.

What dietary advice is given to children with CF?

High-protein, high-calorie diet with oral pancreatic enzyme supplements and free access to salt.

Differentiate Type 1 and Type 2 Diabetes Mellitus.

Type 1 is destruction of pancreatic beta cells causing absolute insulin deficiency; Type 2 involves insulin resistance or decreased insulin production, often related to obesity.

Give three essential components of patient education for diabetes management.

Blood-glucose self-monitoring, diet therapy (glycemic index), and insulin or medication management (plus exercise, skin and foot care).

List four danger signs in pregnancy that warrant immediate medical evaluation.

Sudden gush of fluid before 37 weeks, vaginal bleeding, severe abdominal pain, or decreased/absent fetal movements (others include severe headache, blurred vision, etc.).

Define anemia in pregnancy and state one supplement used for treatment.

Low hemoglobin reducing oxygen-carrying capacity; treated with iron and folic acid supplements.

What is an ectopic pregnancy, and why is it non-viable?

Implantation of a fertilized egg outside the uterus, usually in a fallopian tube; the location cannot support fetal development.

Name two hallmark symptoms of hyperemesis gravidarum.

Persistent nausea and vomiting leading to weight loss and dehydration.

What distinguishes eclampsia from preeclampsia?

Eclampsia includes the onset of tonic-clonic seizures in a woman with pregnancy-induced hypertension.

Give three classic signs of hypovolemic shock.

Rapid weak pulse, falling blood pressure, and cold clammy skin (others: low urine output, air hunger).

Define uterine involution.

The process by which the uterus returns to its pre-pregnancy size and condition after birth.

List the three stages of lochia in the postpartum period.

Lochia rubra, lochia serosa, and lochia alba.

What postpartum complication is categorized as early or late and is a major risk for hypovolemic shock?

Postpartum hemorrhage (early: within 24 h; late: 24 h–12 weeks).

State two nursing actions to prevent thromboembolism in postpartum women.

Encourage early ambulation/ROM exercises and teach not to cross legs; use anti-embolism stockings correctly.

Identify three common symptoms of perinatal depression.

Lack of enjoyment in life, intense feelings of inadequacy, disturbed sleep or appetite (others: constant fatigue, crying, difficulty with ADLs).

How can nurses support women with perinatal depression?

Provide sympathetic listening, help identify support systems, assess sleep/nutrition, and refer to multidisciplinary teams or support groups.

Define psychosocial rehabilitation in mental health nursing.

A social model of treatment that helps individuals with mental illness adjust and adapt to community life, emphasizing self-help.

Differentiate planned and unplanned change in health-care settings.

Planned change is intentional and ideally faces minimal resistance; unplanned change occurs unexpectedly and is common in daily care.

What does holistic health emphasize?

The integration of psychological, physical, spiritual, and social aspects to view the person as a whole.

Which medication is given during postpartum hemorrhage to stimulate uterine contractions?

Oxytocin.

Explain why steroids used in chemotherapy can mask infection.

They suppress inflammatory responses, hiding usual signs such as fever and redness.

What auditory device may be surgically implanted for severe sensorineural hearing loss?

Cochlear implant.

Describe the purpose of CNS prophylaxis in leukemia therapy.

To prevent leukemic cell infiltration into the central nervous system.

Why are routine immunizations delayed during chemotherapy?

Immunosuppressive drugs reduce the body's ability to mount an effective immune response.

What is the recommended nursing position when addressing a hearing-impaired child?

Be at the child’s eye level, face-to-face, and establish eye contact.

Which spinal defect has normal meninges and spinal cord but a cyst containing CSF protrudes?

Meningocele (Spina Bifida Cystica).

Name two musculoskeletal complications in DMD besides muscle weakness.

Calf muscle pseudohypertrophy and contractures of ankles and hips.

Why are pancreatic enzymes given orally in CF?

To aid digestion and absorption of nutrients due to pancreatic insufficiency.

State two early childhood red flags for DMD besides motor delay.

Frequent falling and clumsiness when walking or climbing stairs.

What is the primary nursing goal for a child with CP regarding mobility?

Prevent contractures and maximize functional motor abilities using braces, therapy, or surgery.

How does persistent vomiting in pregnancy threaten maternal-fetal health?

It leads to dehydration, electrolyte imbalance, and weight loss, compromising nutrient delivery to the fetus.

Which lab test definitively identifies the DMD gene mutation?

Serum polymerase chain reaction (PCR) for dystrophin gene mutation.

State one key reason early ambulation is important postpartum.

It promotes venous return, reducing the risk of thromboembolism.

What is the average inheritance risk that two CF carriers will have an affected child?

25 % with each pregnancy.

Why should high-volume earbud use be limited in teens?

To prevent sensorineural hearing loss from noise exposure.

Which form of CP commonly shows persistence of primitive reflexes and developmental delays?

Spastic quadriplegia form.

What symptom might signal peripheral neuropathy in chemotherapy patients?

Severe constipation due to decreased bowel nerve sensation.

Identify one sign of bone involvement in childhood leukemia.

Bone pain or pathological fractures due to marrow invasion.

Explain the term ‘after pains’ in postpartum recovery.

Intermittent uterine contractions experienced as the uterus involutes.

What is the first nursing step when signs of hypovolemic shock appear postpartum?

Massage the uterus to control bleeding while initiating emergency measures.

Which reproductive complication can arise from CF in males?

Decreased sperm motility due to thick reproductive secretions.

Give one practical travel tip for patients with diabetes.

Carry snacks and insulin supplies, adjust dosing across time zones, and keep medications in hand luggage.

What nursing instruction helps maintain communication clarity with hearing-impaired adults?

Avoid exaggerated lip movements and speak in short, clear sentences.