The mother of a 6-year-old Hispanic girl comes into the clinic ...

[faduma]

The mother of a 6-year-old Hispanic girl comes into the clinic stating that her daughter is developing breasts, pubic hair, and has acne on her forehead.
 
  On assessment, you notice that she has Tanner Stage 2 breast and pubic hair, oily skin, and some blemishes on her forehead. You suspect, based on this assessment, that the child could be having precocious puberty. What laboratory result would you expect to see in a child with precocious puberty? 1. High LH
   2. Low LH
   3. High TSH
   4. Low FSH

Question 2

The nurse is attempting to obtain a physical assessment of a 15-month-old child. The nurse knows that the most appropriate approach to performing the physical assessment includes all of the following except:
 
  1. Demonstrating the use of the blood pressure cuff on a teddy bear.
   2. Performing the most invasive assessments first.
   3. Letting the child exam the nurse first.
   4. Taking the blood pressure first, which will allow the child to ease into the full exam.

[sultansheikh]

Answer to Question 1

1
Feedback
1. Children with precocious puberty have elevated hormone levels, including LH, FSH and Estradiol in females. Males will have an increase in testosterone levels. The treatment goal is to utilize GnRH Analogs to suppress hormone levels until it is a more appropriate time for the child to experience puberty.
2. LH is usually elevated.
3. TSH is not assessed.
4. FSH is usually elevated.

Answer to Question 2

4
Feedback
1. Demonstrating on an object lets the child see what will occur.
2. The invasive procedure will not alarm the child, so the vital signs will not rise quickly.
3. Letting the child examine the nurse allows the child to see what will occur.
4. Taking the blood pressure should not occur until after the heart rate and respiratory rate have normalized.